Last Updated on April 4, 2024 by BVN
Breanna Reeves
In six years, 10.8 million Californians will be over the age of 60 — accounting for 25% of the state’s population. California has one of the fastest growing populations, with a projected 30% increase by the year 2060.
The population aged 60 years and over is expected to grow more than three times as fast as the total population. In Riverside County, 20% of the population was over the age of 60 in 2020. By 2060, the aging population is projected to become 32.5% of the county’s population. Adults 60 and older in San Bernardino County made up 18% of the county’s population in 2020 and is expected to increase to 29% by 2060.
With older Californians aging and their numbers rapidly growing in size, state officials are grappling with who will care for these older adults who need access to different care services.
“As California undergoes a significant demographic shift with the over-60 population growing rapidly and becoming more diverse, we anticipate both opportunities and challenges,” California Department of Aging (CDA) Director Susan DeMarois said in an email.
“One of the challenges is the looming shortage of paid caregivers as well as available family members, especially as our older population increases.”
As the need for home- and community-based services grows, the demand for California caregivers is at an all time high. According to AARP, the nation’s largest nonprofit that provides resources to adults over 50, roughly 53 million adults in the U.S. are caregivers.
Direct care workers and family caregivers
The term caregiver is often mistakenly only defined as someone who is a healthcare professional and is paid to care for someone, and while that is true, a caregiver is also anyone who is providing support to someone else — a friend, a spouse or a relative — in their daily lives.
Carmen Estrada, executive director of the Inland Caregiver Resource Center, explained that another misconception about caregiving is that it requires 24-hour care. That’s not always the case. Caregiving can be a granddaughter picking up prescriptions for a grandparent or grocery shopping for a parent.
“We’ve seen a lot — since the pandemic — of intergenerational families providing care for one another,” Estrada said. “Sometimes people don’t see themselves as caregivers, and that happens a lot with our minorities, with our Latino families, with our African American families.”
Culturally, communities of color are often raised with an understanding of taking care of their own family members, but shouldering the burden of caregiving can be hard. With these cultural norms of caring for family members and keeping the need for care within the family, many communities of color don’t access support services.
The Inland Caregiver Resource Center was established in 1985 to provide support for caregivers who are specifically caring for individuals who sustained a traumatic brain injury, experienced a stroke, received an Alzheimer’s diagnosis or other cognitive diagnoses after the age of 18.
The Center provides support that focuses on older adults and family caregivers or “informal caregivers,” as Estrada puts it.
“A lot of times services focus on the person needing the care and not the person taking care of them. We’re different from other organizations in that our clients are the caregivers,” Estrada explained. “They’re the ones that are providing the care. Our services are tailored to help them through their caregiving journey.”
There are several types of caregiving options across the state, as well as support services for older adults who need personal care, custodial care or skilled care.
For aging adults who need care, there are several types of care and support options available that range from Community-Based Adult Services (CBAS), adult day programs and Multipurpose Senior Services Program (MSSP), among other services like food home delivery, CalFresh and Medicare counseling.
For caregivers, there are several programs administered by local nonprofit organizations and the CDA, including caregiver resources centers like the Inland Caregiver Resource Center that offers support groups, counseling, training and respite care. The CDA also offers training for caregivers across the state, both for formal and informal caregivers, through CalGROWS, a program that not only provides free training courses, but also incentive payments to caregivers who work in home and community settings.
“Meeting the needs of our aging population demands a robust and skilled caregiver workforce, and that starts with valuing direct care workers and family caregivers,” DeMarois said. “With workforce shortages, California is committed to investing in wages, training, and career ladders.”
Doing God’s work
According to Dr. Renita Polk, assistant director at the Office of Direct Care Workforce at CDA, California faces a projected labor shortage of 3.2 million paid direct care workers. During an Ethnic Media Services briefing, Dr. Polk emphasized the pivotal role of caregivers and home health care workers to the state’s healthcare system.
While CalGROWS offers a variety of training courses, both online and in person, ranging from end-of-life care or grief, managing stress to Alzheimer’s disease, the deadline to use the funding for the program is set to expire. CalGROWS will expire by September 30, 2024.
“We do recognize that this is an ongoing need. And with California’s population getting older, there will be a continued need to train caregivers,” Dr. Polk said during the briefing on March 7.
Among the growing need for caregivers, there are concerns regarding expanding the workforce of caregivers, which is majority women. According to the Commonwealth Fund, in 2020, of the 53 million Americans who acted as caregivers to an adult or child with disabilities, more than 60% were women.
The United Domestic Workers of America (UDW) is working to address the strain put on caregivers who are historically underserved as a workforce and have spent decades fighting for labor and protection rights. UDW comprises more than 171,000 home care and family child care providers across California.
One of the key challenges to expanding the homecare provider workforce is a fair wage. UDW Regional Director Yvette Elam, who works with homecare providers who are union members, explained that one of the union’s biggest fights is demanding better wages and attracting people to do this type of work.
“This work is God’s work that [caregivers] do,” Elam said. Caregivers forget to care for themselves as they deliver care to others, Elam explained. “This work is hard work. It’s laboring. It’s a lot, but it’s very fulfilling, too, because you’re able to give this person a better life.”
California’s increasing older adult population and growing population of adults, youth and children with disabilities will continue to put a strain on the caregiver workforce. According to the California Aging and Disability Alliance (CADA), a network of 20 organizations, in 2019, California had nearly eight million people who were either older adults or persons with mobility, sensory, intellectual/developmental, and/or mental health disabilities. CADA predicts this population will continue to grow.
Among the options for care for this growing population are long term services and supports (LTSS), rehabilitation centers, in-home supportive services, among others, but these forms of care have limitations. Those in need of care often face restrictions to receiving care due to insurance restrictions, inability to afford adequate care and limited hours allotted for care depending on a diagnosis.
This article is the first in the Black Voice News’ year-long reporting series, Care in the IE – Will You Care for Me?, which explores what it means to receive and give care throughout Southern California. The series will explore a myriad of topics related to caregiving including but not limited to the impact on caregiving resources resulting from California’s aging population, family caregiving, how to navigate the system for support, the costs of care, options for in-home care support versus placement in a care facility, types of care facilities, resources available to support in home care and how access them, as well as the quest for labor protections and fair wages for those working in the industry.
This series also aims to highlight how caregiving is about more than the numbers or the processes related to care, whether it is caring for a senior, a person with disabilities, or someone with a terminal illness. It is about individuals. It is about the mutual bonds forged between caregivers and those receiving care as well as the challenges each faces as part of this human experience.