Aide helping resident

Residential care settings such as assisted living communities will need to fill more than 1.2 million direct care jobs over the next decade, including new jobs and positions that become available as existing workers leave the field or the labor force, according to a report released Tuesday.

The number is small, however, compared with the 4.7 million direct care jobs that will be available in home care from 2018 to 2028, according to “It’s Time to Care,” a report citing data from the U.S. Census Bureau and the Bureau of Labor Statistics and released by national research and consulting organization PHI. But it’s more than the estimated 621,000 direct care positions that nursing homes will need to fill in the same timeframe, PHI said.

“Our primary goal with this campaign is to spark and sustain a year-long conversation across our field — from policymakers to industry leaders to the full array of advocates — about why the direct care workforce matters, the variety of structural barriers facing these workers, and what we must do to transform these jobs and improve care for all of us,” Robert Espinoza, vice president of policy at PHI, said in a statement.

Residential care aides — direct care workers who help residents of assisted living communities, adult family homes and other community-based residential care settings — currently number 720,500, according to the report. The residential care sector will grow 23% by 2028, adding 168,400 new jobs. Most of the positions that will need to filled, however (1,035,500 of 1,203,900), will be due to “separations” — including job openings caused when workers leave the labor force due to retirement, disability or other reasons, or move into other occupations — rather than new jobs.

Hourly wages and annual earnings need to be increased to improve the recruitment and retention of direct care workers, according to the report. Forty-eight percent of residential care aides are considered low-income workers, PHI said. Their median hourly wage in 2018 was $12.07 (up only 2% since 2008), and their median annual earnings in 2017 were $20,200. Thirty-eight percent receive some form of public assistance.

Another way to improve recruitment and retention of residential care aides — who may be called personal care aides, home health aides or nursing assistants, depending on state-level regulations and local hiring practices — would be to build the workforce pipeline by targeting new populations of potential workers and by addressing immigration policies, PHI said. Seventy-nine percent of residential care aides were born in the United States, 12% are naturalized citizens, and 9% are not citizens.

More profile information about residential care aides from the report:


  • Female: 84%
  • Male: 16%

Median age: 36


  • White: 46%
  • Black/African American: 30%
  • Hispanic / Latino: 15%
  • Asian /Pacific Islander: 6%
  • Other: 3%

Education level

  • Less than high school: 9%
  • High school graduate: 36%
  • Some college, no degree: 36%
  • Associate’s degree or higher: 19%

See the report for more information, including details about direct care workers in home care and nursing homes.