The ratio of middle-age adults (future caregivers) to adults over 80 (people in need of care) is like the downhill of a roller coaster, plummeting by 4 to 1 by 2030. All the while the number of older adults is climbing, reaching 98 million by 2060. It will be the first time in the US when older adults outnumber those at age 5.

In the gloomy reality that is American’s long-term care system, unpaid family members or friends provide the majority of support and services for older people. Many of these informal caregivers neglect their own health and families, and are at risk for emotional, financial or physical burnout as a result of caring for a loved one.

The National Academy of Sciences has reported that the stress from caregiving effects the immune system for up to 3 years. This adds up to a group so involved in looking out for the health and well-being of others that they increase their own risk of dying. A heartbreaking outcome for both the elder and their families.

The dwindling numbers of adult children makes it clear that family caregivers will be in short supply in the near future. So who will be there to provide care for the older adults who are living longer? One solution is to turn to paid caregivers to deliver care.

Sadly, demand for paid caregivers is also outstripping the supply. Data indicates there are a total of 4.6 million direct care workers. Sounds like a lot until you consider that every company in the nation providing paid assistance to an adult, whether services are from home health aides, nursing assistants, or personal care aids, draws from this same workforce. There simply aren’t enough caregivers to meet the needs of an ever-increasing aging population.

Until the time when the federal government creates legislation to create better salaries, benefits and opportunities for caregivers, older adults will be forced to rely on a patchwork of support from a spouse, daughter, relative, friend, the next door neighbor or the occasional paid caregiver. The future holds no other options.