Next 50 Initiative logo

NextFifty Initiative is a Colorado-based private foundation dedicated to funding mission-driven initiatives that improve the lives of the older adult population and their caregivers. NextFifty seeks to fund game-changing efforts to improve and sustain quality of life for people in their second 50 years. NextFifty Initiative educates about proven initiatives and advocates for transformational change.


Closing the Care Gap

Opportunities for Employers to Support and Grow Colorado’s Direct Care Workforce
May 9, 2023

Key Takeaways

  • Colorado’s older adult population is growing faster than the workforce many older adults rely on for direct care services.
  • A wide range of issues presents challenges to retaining and recruiting direct care workers, from low wages to the unique social and emotional demands of care work.
  • Colorado’s employers are using a variety of strategies to promote retention and recruitment at their organizations and can learn from one another’s examples.

As Colorado’s older adult population grows, so too does the need for caregivers. By 2030, Colorado will be home to 1.2 million people over age 65, many of whom will require assistance with activities such as preparing meals, dressing, bathing, and taking medication. The question is: Who will care for them?

About 59,000 direct care workers provide needed long-term care and support services to thousands of older adults in Colorado. By providing a range of medical and non-medical services to the state’s aging population, this workforce ensures Colorado’s older adults are safe, healthy, and well cared for. And the demand for their services is growing quickly.

An estimated 1.2 million Coloradans will be over the age of 65 in 2030, roughly a 50% increase from 2018. A majority (about 70%) will likely need some level of support from family members, friends, and/or direct care workers at some point in their lives.

The growth of this population is putting pressure on an already short-staffed direct care industry to keep up with rising demand. Care facilities report chronically low staffing ratios, and home care agencies report turning down work because they are short staffed. At the heart of the workforce challenges in Colorado are high employee turnover rates and difficulty recruiting new staff.

A wide range of challenges presents problems for recruitment and retention. Despite the difficulty of their work and the value of the services they provide, direct care workers receive low wages and few benefits. Many workers struggle with finding housing, child care services, and transportation that are affordable and meet their needs. Inadequate training makes it more difficult for workers to do their jobs, and limited career ladders make it less desirable to stay. And the challenges of relatively isolated work and end-of-life care contribute to employee burnout.

These challenges signal a need for creative, multi-pronged approaches to recruitment and retention of the direct care workforce. While policy and regulatory interventions hold promise, employers and other community leaders also have the power to better support and attract the direct care staff with whom they work.

To reflect consumer demand, this report focuses much of its discussion on home care services. Three in four older adults prefer to spend their retirement and later years of life in their homes, referred to as “aging in place.”

However, direct care work is complex and fluid. Many workers have multiple jobs across multiple settings or transition between home care and facility-based care over the course of their careers. Similarly, some organizations provide services across a range of settings. Additionally, many data sources do not distinguish between care settings but instead describe the direct care workforce as a whole. This report therefore touches on the experiences of employers and direct care workers providing services across a diversity of settings, even as it remains attentive to the particulars of home care.