When Edward Jones, an immigrant with no family in the U.S., began receiving assistance from Autrice Wildman, a case manager at Encore Community Services, in June 2022, his situation was dire. Experiencing advanced macular degeneration, Mr. Jones struggled with depression and even thoughts of suicide as his eyesight faded. He was also grappling with unresolved medical bill disputes, a missing pension, and denial of Home Health Assistance due to his immigration status.
Ms. Wildman was quick to step in, coordinating a comprehensive plan that included mental health support and specialized services for the visually impaired. Today, Mr. Jones has stabilized and continues to receive care while pursuing permanent residency status.
At older adult centers across the city, frontline workers are seeing an increase in demand for vital services. Day-to-day, case managers, like Ms. Wildman, assist clients with a range of needs, including those living with profound mental illness and older New Yorkers experiencing normal aging without the support of family or professional help. Increasingly, staff and volunteers act as ad-hoc caregivers, translators, appointment makers, and therapists.
There is empirical data that demonstrates what service providers witness first-hand daily. According to a report by the Center for an Urban Future, the share of older adults in New York City requiring care is soaring, and an ad-hoc system is simply not enough. To build a New York that supports healthy and dignified aging, we’ll need to build a sustainable, expert workforce. This will take public investment, philanthropic support, and long-term collaboration from nonprofit organizations and local and state governments.
Since 2000, the population of older New Yorkers has ballooned by 38 percent. And, among these older New Yorkers, poverty is far more common than in their peer groups across the country. They are also far more diverse: 59 percent of New Yorkers age 65 and older identify themselves as other than white. The trend is even more pronounced upstate: Saratoga County’s older adult population experienced a staggering 55 percent increase in a ten-year period.
Simply put, we’re not ready to meet the needs associated with this ongoing and future demographic shift. For example, a survey found that 42 percent of nursing assistants leave a job within a year—and the turnover is 56 percent outside the five boroughs and Long Island. The social and fiscal costs of that churn impact all of us.
The direct care workforce, essential to supporting older adults, will face even more significant challenges in the coming decade. Projections show a rapid increase in demand, with an anticipated addition of 1.3 million new jobs from 2019 to 2029. Long-term care employers are expected to generate 7.4 million job openings in direct care over the same period, highlighting the need to improve the quality of these jobs.
We are observing this phenomenon from multiple perspectives: as a member of the New York City Council and Chair of the council’s Committee on Aging; as an Executive Director of one of New York City’s largest aging nonprofit service providers, Encore Community Services; and as two people who have experience coordinating care for a loved one.
What lessons have we learned about this vital community? First, in recent decades, we’ve seen what not to do. We should not thoughtlessly warehouse older New Yorkers in nursing homes. We should not silo them away. Instead, aging adults should remain in their homes–in the communities they’ve nurtured–whenever possible, supporting their health and independence with first-rate caregiving, medical care, and connections to the community.
New York must invest in a robust aging services workforce to accomplish this. We need to train and hire more case workers, occupational therapists, mental health experts, geriatric medical professionals, and home caregiving workers. We must ensure they are ready to meet the nuanced needs of an aging population, and we must guarantee this workforce dignified labor, including fair pay. Supporting family caregivers with financial assistance and resources is also critical.
This change requires action from all of us: lawmakers who provide public support for older adults to remain healthy and independent for as long as possible; healthcare experts who guide healthy aging; colleges that develop courses to train an expert workforce; and nonprofits that support professional and kin caregivers.
We believe that New York is up to the challenge. Together, we can set a national standard for healthy and dignified aging and create a dynamic workforce in the process.
Crystal Hudson is chair of the New York City Council Committee on Aging and represents District 35 in Central Brooklyn. Jeremy Kaplan is executive director of Encore Community Services, an aging services provider in Manhattan.
