·Pulse issue · June 30, 2026

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.

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.

5 briefs · 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?

Briefs in this issue

Analysis

More 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

Analysis

Massachusetts 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

Brief

Dementia'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

Brief

Twelve 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

Brief

The 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

Reference paths

01GiveCare WikiEvergreen caregiver guides, source notes, and research synthesis.02GiveCare BenefitsSource-backed benefit records and program search.03GiveCare ScoreCaregiver load assessment and scoring context.04InvisibleBenchCare AI benchmark method and findings.05GiveCareProduct home and official GiveCare positioning.

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