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·Pulse issue · July 23, 2026

GiveCare Pulse · July 23, 2026

In A Place for Mom's survey, sixty-two percent of family caregivers call home care long-term or permanent — while Medicare home health use declines and an operator warns of workforce exits.

Background

Medicare's home health benefit covers intermittent skilled nursing and therapy for homebound beneficiaries and is not a long-term care benefit. Nonmedical home care is paid help that families hire, covering needs such as bathing or mobility. Many home- and community-based services are covered through Medicaid.

The read

Read together — a referral platform's proprietary survey, Commonwealth Fund policy briefs, and one operator's forecast — the sources describe three separate strains on home-based care rather than one shared trend: A Place for Mom's survey finds family caregivers treating nonmedical home care as a long-term commitment, even as they keep logging significant coordination hours and citing cost as the top reason others discontinue it; Commonwealth Fund's briefs document declining use of the distinct Medicare home health benefit, tied to payment incentives, Medicare Advantage practices, and workforce shortages; and Flournoy Health Systems' CEO forecasts that dementia's unpaid-care burden could pull workers out of the paid home health workforce altogether. Each source carries a limit: the survey serves a referral business, and the workforce warning is a forecast, not an observed exit count.

The lead

Sixty-two percent of family caregivers view nonmedical home care as a long-term or permanent solution for helping a loved one age in place, according to A Place for Mom's 2026 Home Care and Family Caregiving report, covered by Home Health Care News. The senior-care referral platform evaluated its own proprietary survey data from 708 family caregivers with experience with nonmedical in-home care, and its general manager of family sales, Martin Hernandez, said families are more likely to increase or alter home care hours than move a loved one into a senior living facility when health needs change — evidence, he said, that families increasingly treat home care as part of a longer-term plan to keep a loved one at home.

Hiring paid help does not end the family's work. After engaging a professional caregiver, family members shift from hands-on tasks to roles as care coordinators — managing appointments, transportation, and emotional support — and still spend around nine to 13 hours a week coordinating care. Still, 85% of long-term users described home care as good or very good value, and 69% of current users said it reduced their daily stress.

The public benefit and paid workforce beneath that commitment are under strain. Paired Commonwealth Fund issue briefs published July 9 find that use of Medicare's home health benefit — skilled nursing and therapy for homebound beneficiaries — has declined in recent years despite an aging population, held back by misaligned payment and quality incentives, Medicare Advantage plan practices, and workforce shortages. Flournoy Health Systems CEO Faris Flournoy III warns that dementia's unpaid-care burden could push home health workers out of paid work to care for their own relatives. With cost already the top reason families discontinue home care, the open-ended commitment they describe rests on household money, hours, and coordination.

3 developments · 5 cited sources

What to watch next

  • Will home-based care services grow and stabilize as A Place for Mom's Martin Hernandez projects, with families extending home care hours rather than moving relatives into senior living as health needs change?
  • Will Medicare policymakers act on the options the Commonwealth Fund's interviewed experts identify — aligning payment with patient needs, improving oversight and transparency, and strengthening workforce capacity — to reverse declining home health use?
  • Will the home health workforce lose the 800,000 more workers Home Health Care News has reported could leave by 2027, as Flournoy Health Systems' CEO predicts family dementia care will pull staff out of paid work?

Developments in this issue

Families treat home care as the permanent plan, A Place for Mom survey finds

In A Place for Mom's survey, sixty-two percent of family caregivers call home care long-term or permanent — while Medicare home health use declines and an operator warns of workforce exits.

BusinessResearchElder Care

Commonwealth Fund: Medicare home health use declines despite aging population

Paired July 9 issue briefs trace declining use to misaligned payment incentives, Medicare Advantage practices, and workforce shortages — and find many beneficiaries don't understand the benefit.

PolicyResearchElder Care

Home care CEO warns dementia's family burden could drain the paid workforce

Dementia and Alzheimer's disease are projected to cost the United States $818 billion in 2026.

WorkforceResearchElder Care

Reference paths