Trends in the elder care workforce in Indiana: Evidence for a shift to home-based elder care?

• Author: Zipper, Riley

Introduction

As we soldier on through the COVID-19 pandemic, there are a few economic trends nationally and in Indiana worthy of keeping an eye on. Inflation is likely the most salient one, as rising prices at the grocery store and the gas pump cause stress on Hoosiers' pocketbooks and threaten the tenuous economic recovery. Another trend is so-called labor shortages, as businesses continue to sound alarm bells about the lack of qualified applicants to fill jobs.

The phrase "labor shortage" is somewhat of an over-simplification, as the issues firms face are more multifaceted than simply a shortage of workers. Educational disruptions, child care needs, worker empowerment and remote work are just a few of the factors that contribute to labor force challenges reported by firms. Industries that have been hit particularly hard by labor force challenges include health care, particularly for the elderly (which this article will refer to generally as elder care).

This article analyzes the elder care workforce in Indiana and reveals some important trends about the changing dynamics of the workforce. Employment data on five elder care industries in Indiana--assisted living facilities for the elderly, continuing care retirement facilities, nursing care facilities, home health care services and services for the elderly and persons with disabilities--present evidence suggesting a shift in the workforce from predominantly facility-based care toward home-based and outpatient care.

Elder care workforce analysis

In the wake of the pandemic lockdown of 2020, there is evidence for a restructuring of the elder care workforce in Indiana. The left panel of Figure 1 shows quarterly employment in the five primary elder care industries in Indiana since 2017. The industry with the starkest decrease over this time frame is nursing care facilities (skilled nursing facilities), more commonly known as nursing homes. Though a slow decline began prior to the pandemic, the lockdown (which lasted the entirety of 2020's second quarter) quickened the decline.

Whereas other industries began recovering once the lockdown ended, employment in nursing homes continued to drop through the third quarter of 2021, the latest quarter available. Declines in other facility-based elder care industries, like continuing care retirement facilities and assisted living facilities for the elderly, mirror the decline in nursing homes, though they're lesser in magnitude and their employment...