Dementia and Alzheimer’s disease are projected to cost the United States $818 billion in 2026 — and an industry insider posits that the growing economic burden could add pressure to an already strained home health workforce. 

A new study published in “Alzheimer’s & Dementia” estimates that families and individuals shoulder more than 80% of dementia’s societal costs through unpaid caregiving, lost earnings, out-of-pocket expenses and quality-of-life losses. These findings point to mounting challenges for the home health industry, as home health workers increasingly may exit the workforce to care for aging relatives, according to Faris Flournoy III, CEO of Flournoy Health Systems.

“We’re going to see a workforce reduction,” Flournoy told Home Health Care News. “Not only are individuals going to be exiting the healthcare field, but they’re going to be exiting the workforce altogether to become family caregivers.”

Flournoy Health Systems, based in Milledgeville, Georgia, is a home care management company operating in Georgia and Indiana through a portfolio of brands, including Primecare Home Care and Just Care Home Care.

These departures would exacerbate pandemic-era losses in the home health workforce. The home health workforce shrank by more than 3.4% in the pandemic’s first year, and 800,000 more workers could leave by 2027, Home Health Care News previously reported. Flournoy said the home health and hospice industry has already been wrecked by the pandemic, and workers are now often seeking out higher wages elsewhere. 

“Our workforce is vanishing because individuals are flocking to, honestly, higher-paying jobs, because a lot of HCBS services are covered through Medicaid, which is a relatively low reimbursement [creating] low margins to run the business,” he added.

Not only that, but providers will increasingly have to educate family caregivers, who often assume dementia care without formal medical backgrounds, on managing the disease as they work alongside professional staff. Family members are increasingly acting as caregivers, Flournoy said, but often lack the necessary skill set to care for a loved one with these conditions.

As dementia progresses, caregiving demands grow from intermittent assistance to continuous supervision, further straining families and providers.

“Dementia care eventually is going to become round-the-clock care,” Flournoy said. “If we don’t equip our family caregivers or our caregiving team or create a workforce that understands that, eventually [it] is going to tie over to a larger bill that unfortunately we will not be able to pay.”

Families without sufficient home-based care may increasingly rely on emergency services or skilled nursing facilities for their loved one with dementia, increasing healthcare costs. 

“We’re seeing some home and community-based service providers exiting the Medicaid systems and going just private,” Flournoy said.

Medicaid beneficiaries have fewer care options while agencies find it harder to recruit the best nurses and aides, he added. Without addressing the hidden costs of dementia care on both family caregivers and professional staff, Flournoy expects the economic burden to only grow.

“I can see it exceeding a trillion dollars [in cost] over the next decade,” he said.