A shortage of caregivers for older adults is expected to become more severe as the senior population booms in the next decade.

Dallas County has grown in its population of people age 65 and older in recent years. From 2010-17, the population of seniors increased by 36.1%, according to data from the U.S. Census Bureau.

The growth is not expected to stop any time soon, and neither is the increase in demand for professional caregivers.

“Most of the hands-on care for older adults who have disabilities is not provided by licensed professionals,” said Doni Green, director of aging programs for North Central Texas Council of Governments. “It’s provided by home health aides and medication aides. There’s a critical shortage with those direct care workers.”

Competing demands

Dallas County is home to 283,154 people aged 60 and older, according to population data from the Texas Health and Human Services Commission and the U.S. Census Bureau. That number is projected to swell by 86% by 2040.

For comparison, the overall population of Dallas County is expected to increase by 32% in the same time frame.


“The north Central Texas area has been growing very, very quickly, leading the state and, at times, the nation in terms of percentage growth among all ages,” Green said. “It creates tremendous demand [for caregivers] at all skill levels.”

One of the main reasons for the shortage in licensed caregivers, Green said, is low pay and lack of benefits.

According to the U.S. Bureau of Labor Statistics, home health and personal care aides had an average annual income of $24,060 last year. Their average hourly pay was $11.57, according to the bureau. Statistics show there will be a need for about 1.86 million more professionals in this field in the U.S. by 2028.

Home health and personal care aides help people with disabilities, chronic illnesses or cognitive impairment with their daily living routines, according to the bureau.


“That’s where I see the real crisis coming—when fast food pays better than those direct care professions,” Green said. “It’s just really, really difficult to find qualified people who will stay in the profession for any amount of time.”

The bureau also projects there will be a steep increase in demand for nursing assistants and orderlies, who help provide basic care for patients in hospitals and residents of long-term care facilities, such as nursing homes. By 2028, there is expected to be demand for 1.56 million additional positions in this field.

Green said it is similarly challenging to find enough nursing assistants and orderlies because of low pay.

In 2018, nursing assistants and orderlies had an average annual income of $28,530, according to the bureau.


“There’s definitely some challenges in terms of professional caregivers, but I think it’s important to recognize that most of the care that’s provided to dependent older adults is [provided] by unpaid family members,” Green said. “So they really are the backbone of our long-term services and support system.”

Local resources

Although demand for professional caregivers and resources is on the rise as the senior population continues to expand, a variety of local resources already exists for seniors.

The Dallas Area Agency on Aging administers federal funds to support services for people age 60 years and older as well as to family caregivers. That agency covers the cities of Coppell and Irving.

DAAA Director Doris Soler said her work includes providing various avenues of financial and living assistance for caregivers and older individuals alike.

Soler said she has seen a growing need for caregivers among older individuals who are living on their own for the first time.


“We know that a lot of seniors are living by themselves, or ... a caregiver that was there before is no longer there,” she said. “It could be a couple that ... their husband passed away and then she [has been] living by herself. ... That’s our major ... program that is growing so fast.”

Care for those individuals includes home repair, health maintenance, and medical supply and other basic needs.

Another program provides temporary relief to caregivers.

“The respite services voucher program is to provide that caregiver a break of their caregiving responsibility,” Soler said. “We understand that it’s very stressful to be a caregiver.”


The agency also provides assistance to caregiving grandparents age 55 and older.

“[Caregiving] as a grandparent can be a little burden financially ... because of the expenses for those grandkids,” Soler said.

Those services cover month-to-month financial support services as well as minor home repairs, she said.

The agency’s work is meant to serve as temporary relief for seniors and their caregivers, and individual support normally lasts between three to six months.

For those in need of food assistance, the local nonprofit VNA provides Dallas County’s Meals on Wheels program.

VNA will deliver meals five days a week for seniors with chronic illnesses or who have special dietary needs. Other qualifications for the Dallas County Meals on Wheels program are being homebound, low-income or not having a reliable source of food, according to the nonprofit.

State resources

Seniors in Coppell and Irving can also find support and resources through state programs, said NCTCOG Senior Case Manager Cathy Stump.

Adequate access to transportation is a common hurdle for seniors, but those living in Dallas County may fare better than those living in more rural areas.

“They can get low-cost transportation either funded by the [DAAA] or by individual grants with cities,” Stump said. “If they are on the Star+Plus waiver program, which is a full Medicaid program, they can access the Medicaid transportation.”

The various state-funded programs include in-home assistance with daily living activities as well as in-home medical care.

Stump said educating seniors and their caregivers about those resources can be difficult due to misconceptions about who qualifies for Medicaid assistance. She suggested local seniors reach out to the North Central Texas Aging and Disability Resource Center to determine which resources they qualify for.

“They think that it’s just the really, really low-income individuals with the long-term care program,” Stump said. “The income limit is ... $2,313 a month for an individual. ... When you talk Medicaid, it automatically scares people away because they think they make too much for it. “

Coppell and Irving residents over 65 can also receive financial relief in the form of homestead exemptions. The city of Irving, for example, provides residents age 65 or older a $30,000 homestead exemption on the value of their properties.