·Pulse issue · June 30, 2026
GiveCare Pulse · June 30, 2026
A wage study, a Tennessee enforcement move, a state nursing-home exodus, and an $818 billion dementia estimate show the federal care system withdrawing on both supply and obligation while the cost settles on families.
Background
Home-care wages fell even as states expanded home care, the federal government pressed the immigrant workers who staff it and loosened the duty to fund the care they provide, and the cost moved onto families already carrying an $818 billion dementia bill.
5 developments · 8 cited sources
What to watch next
- Why are home-care wages falling even as states expand the home- and community-based services that employ those workers?
- What happens to the roughly 400 Tennessee children whose families now face a choice between disability services and immigration exposure?
- Can states like Massachusetts meet community-living goals while the federal legal posture says they need not provide that care?
Developments in this issue
AnalysisMore Home Care, Lower Pay, and a Harder Path to Stay
A JAMDA study finds home-care wages fell even as states expanded home care, while Tennessee and a federal fee hike press the immigrant workers who fill those jobs.
WorkforcePolicyElder CareChild CareDisability
AnalysisMassachusetts Moves Disabled Residents Home as Washington Retreats
Massachusetts marked year one of a plan to move 2,400 people out of nursing homes, days after federal actions advocates fear could undercut the legal basis for it.
PolicyElder CareDisabilityChild Care
BriefDementia's 2026 Bill: $818 Billion, Mostly Unpaid
A USC-led study puts dementia's U.S. cost at $818 billion this year, driven largely by the unpaid care families provide and the earnings they lose.
ResearchPolicyElder CareChild CareDisability
BriefTwelve Years, $10,000 a Month, One Daughter's Math
Jessica Guthrie left a VP job to care for her mother with early-onset Alzheimer's; twelve years on, her math is also an employer's retention problem.
CultureResearchElder CareGeneral
BriefThe Fraud Takedown's Real Message: Watch the Fast-Growing Lines
Behind the DOJ's $6.5 billion, 455-defendant headline, Foley & Lardner says the government now treats fast-growing billing categories as data-driven risk.
PolicyWorkforceDisabilityChild CareElder Care