Denton County has seen significant growth in its population of people age 65 and older in recent years. From 2010 to 2017, the population of seniors increased by 76.35%, 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.”
Denton County’s senior population is expected to increase significantly in coming years, but meeting the need for professional caregivers will be challenging, Green said.
According to a 2019 population estimate and to population projections from the Texas Health and Human Services Commission, Denton County is currently home to 137,211 people aged 60 and older. That number is projected to swell by 38.64% by 2024.
The overall population of Denton County is expected to increase just 13.32% 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 that 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 of Labor Statistics also projects that 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.”
Although demand for professional caregivers and resources is on the rise as the senior population continues to expand, a variety of local resources already exist for seniors.
NCTCOG’s Area Agency on Aging, which was created through the Older Americans Act of 1965, administers federal funds to support services to people age 60 years and above as well as to family caregivers and younger people with disabilities.
Cathy Stump, a senior case manager for NCTCOG who serves Denton County, said a lot of her job is helping seniors identify resources and providing assistance to family caregivers.
That short-term assistance is typically provided for up to 90 days and is cost-free for caregivers and clients, Stump said. Clients for the program are typically found through referrals from hospitals, social workers, family members, caregivers and clients themselves, she said.
“We provide assistance in various ways,” Stump said. “Sometimes, it is assistance with housekeeping or assistance with activities of daily living, like bathing and meal preparation. Or, for caregivers, we can provide respite services, which allows us to help them by providing supervision for a client. We also can provide things like prescription assistance and medication management.”
Filling the need
NCTCOG also contracts locally with Span of Denton County to provide both home-delivered and group meals as well as transportation services to older adults and people with disabilities. These nutrition services are better known as Meals on Wheels.
Michelle McMahon, executive director of Span of Denton County, said Meals on Wheels often helps seniors continue to live in their homes rather than in nursing facilities. It also helps lift a burden for family members of older adults who need assistance, she said.
“Our deliveries are made by volunteers, and 90% of the time, it’s the same volunteers delivering meals to the same seniors, day after day,” McMahon said. “They really build a rapport and get to know each other. And that’s one thing that helps family members, just knowing somebody is checking up on mom and dad every day.”
In order to receive Meals on Wheels home-delivery service, an individual must first fill out an eligibility form. McMahon said this form can be printed from Span’s website and mailed, faxed or emailed in. After that, a caseworker evaluates the application to determine if the applicant is eligible. McMahon said this process usually moves quickly.
To be eligible, an applicant must be 60 years of age or older or be housebound due to physical or emotional health. Eligibility also depends on whether applicants are able to prepare nutritious meals for themselves or if they live with anyone who could help them.
Last year in Lewisville, Span served 10,815 communal meals to 115 seniors and home-delivered 13,437 meals to 115 seniors. In Flower Mound, Span delivered 2,352 meals to the homes of 26 seniors. And in Highland Village, Span served 714 home-delivered meals to five seniors.
“The numbers don’t represent everybody who needs us,” McMahon said. “Across the board, there are people who need our services that don’t know about us—in Lewisville, Flower Mound and Highland Village. We’re trying to reach those people who are out there who need help but don’t know that there are resources out there for them.”
In addition to nutrition services, Span of Denton County also offers transportation services to eligible adults age 60 or older for a $3 fare.
McMahon said Span offers rides to a variety of places, including grocery shopping and clothes shopping. As with Meals on Wheels, those interested in the service can print an application from Span’s website and submit it. Once eligibility is verified, an applicant can call in advance and book a ride.
“We actually talk to family members who stop in here sometimes, and they say, ‘Span is a lifesaver,’” McMahon said. “We have daughters and sons in tears because they’re saying, ‘You know, we didn’t know how we were going to get dad or mom to these needed medical appointments.’”