The heart & soul of long-term care are the people who provide care. Without caregivers, the organizations and institutions we consider essential to the social and medical safety net, as well as comfort in old age, vulnerability and dependency would simply not exist. And loneliness in advanced age is as deadly as any other chronic condition.

Several recent stories in the news highlight the Achilles’ heel in the US, UK and most aging societies. This is the availability of enough willing people to provide care. And while technology will help, we are years away from relying on remote monitoring, telemedicine and robots. Technological efficiency won’t get us out of this mess anytime soon.

We must have people. And these people must be willing to provide care at the available hourly compensation.

Numbers

Demographics is destiny, and ours is not good for the purpose of providing a workforce adequate in raw numbers to care for the elderly. We baby boomers are a large cohort (60+ million) and while we haven’t been as fertile as our parents, we have cranked out 70+ million millennials, more than enough to serve us soup in our dotage. But are they willing? The answer is – flatly – no. They’re not inclined to the personal care work in the adequate numbers which are needed. And my hope is that we don’t waste a lot of time and energy bemoaning this as their character defect. Let’s all remember that we create them, and so we’ll have to live (however uncomforatably) with our creation.

Motivation

There are not, nor will there be enough millennials to care for us boomers, and even those who are motivated are being put through the wringer. A a recent story in the New York Times highlighted the difficulties facing those who would work for minimum wage to provide home care for the elderly. Who are they? Many are immigrants.

Immigration to the UKAnother story brought the point home even more sharply. A group of volunteers stepped up to do jobs that, historically, immigrants provide. And while this example focused on farm work – harvesting crops – it is equally true that immigrants provide most of caring services in care homes and domiciliary care in the UK.

The Solution

Where will we find the human resources we need? Immigration. Especially in the heartland, which millennials are fleeing, we need a national program of incentives to attract immigrants who are willing to come to America and work for the wages that are available.

immigration to the USImmigrants are, and will continue to be motivated because they see peace, and an opportunity for a better, safer life for their children.

We once called this the American dream.