Overcoming Caregiver Shortages as a Barrier To Growth in 2026
Despite how long the caregiver shortage has plagued the home care industry, many organizations are still grappling to overcome it. They continue to find themselves up against a structural workforce crisis, greatly impacting their ability to grow and thrive.
According to an industry report commissioned by AxisCare, staffing shortages are keeping home care leaders up at night more than any other challenge. Fifty-four percent of respondents stated this was the leading pain point for growth, underscoring caregivers’ roles as a strategic asset for an organization’s overall wellness.
This piece will cover everything you need to know about overcoming caregiver shortages in 2026, with an emphasis on how cracking this code is the key to home care agency growth.
The State of the Caregiver Shortage in 2026
Caregiver retention and recruitment issues are complex and multifaceted. It all begins with a workforce that’s stretched tighter than a drum: qualified caregivers are in short supply, and when agencies finally find someone they’d like to hire, the retention marathon begins.
Caregiver turnover rates routinely hit 70-80% within the first 100 days, leaving agencies scrambling to keep talent on board and expending countless resources on the hire-train-rehire cycle. In an effort to retain new hires, agencies must offer competitive salaries, benefits, and perks while maintaining healthy, balanced cash flows. At the same time, competition in the industry has never been higher, and caregivers frequently move agencies – or leave the field entirely – in search of greener pastures, amplifying the need for even better benefits and salaries.
On the client side, demand for caregivers is growing at warp speed. From 2024 to 2034, the American home care workforce is projected to have over 6.1 million total job openings, ranking second among all occupations. This accounts for more than 681,000 new jobs created by growing demand, due in large part to the aging population across the United States. Another 2.3 million openings trace back to workers switching occupations, and another 3.2 million openings due to workers leaving the labor force.
How Caregiver Shortages Constrain Organizational Growth
The caregiver shortage’s impact has extended far beyond a staffing issue to become a critical bottleneck for business operations. For many agencies, it’s a primary reason behind stalled growth and financial instability.
Without enough staff to meet client demand, agencies find themselves pressed up against a revenue ceiling. Even with clients lining up for home care services, agencies routinely need to turn them away, closing the door on a recurring revenue opportunity. Instead, they must allocate resources to their current roster and conduct triage to prioritize the most in-need cases.
When agencies rely on a skeleton crew of caregivers, managers and schedulers also suffer. Much of their time is spent firefighting, reallocating missed visits and call-outs instead of pouring their energy into strategic development. With employees’ attention spread so thin, understaffing is also closely linked to higher rates of errors and omissions. There is often no time left to double-check small details on forms and shift assignments, leading to consequences ranging from mis-entered information to rejected Medicaid bills.
Finally, agencies must bear the cost of replacing caregivers who have turned over. Recruiting, onboarding, and training are resource-intensive processes; organizations have no choice but to continue spinning their wheels on these processes, even if the majority of their new hires will be gone within three months.
Root Causes Behind the Caregiver Shortage
In the caregiving world, there is a chasm between effort and reward. In-home aides have the potential to transform lives, but their salaries leave much to be desired. According to PHI’s Direct Care Workers Key Facts report for 2025, 59% of home care workers receive some form of public assistance, 15% live in a household below the federal poverty level, and 41% live in low-income households. Ironically, many of them also find themselves without healthcare coverage: 48% rely on Medicaid, and 11% have no coverage at all.
As the American population ages, many older workers will be exiting the caregiver talent pool themselves, drumming up a massive wave of retirements at the exact moment demand is peaking. That is, if they don’t exit the field before they retire, as caregivers are highly susceptible to burnout for a number of reasons.
Demand for hospital beds is spiking right alongside demand for home care services, leading hospitals to discharge patients faster and earlier on in their recovery. The burden is then placed on caregivers to manage complex medical tasks, often without clinical supervision. Unlike hospital staff, caregivers work in private residences where they may face unsanitary conditions, physical strain from helping clients with their mobility, and a high emotional toll due to the sensitive nature of their work.
Caregiving is also a tough sell for anyone looking for upward mobility. This role is often treated as a job rather than a career, and the path to a higher wage or more responsibility is murky. There are also no nationwide requirements for training, meaning programs and standards vary widely by state (if they exist at all). Agencies usually view caregiver education as an expensive barrier to entry rather than a value-add, leaving staff feeling under-equipped for the complexities of their role.
Strategic Responses To Overcome Caregiver Shortages
By now, organizations have accepted that they can’t hire their way out of this crisis. Structural changes are required to maximize their existing team’s capacity and set the conditions for effective hiring and retention.
Caregiving has none of the trappings of a traditional nine-to-five, and agencies should be using that to their advantage. Moving away from rigid 8-hour blocks toward on-demand, more flexible scheduling allows caregivers to schedule shifts around their own lives, reducing burnout and call-outs.
Changing the narrative around the job-versus-career conversation is also essential. Offering pathways to certification is a great way to hold caregivers’ interest longer-term, such as becoming a Dementia Specialist. Alongside those titles, employees should also get a salary bump to reward their expanded knowledge.
Tailor-made home care platforms amplify teams’ abilities by a huge magnitude, giving them the tools to scale their support and impact. Even simple upgrades like clocking in via a caregiver mobile app or using digital forms to document each visit can drastically reduce administrative burden, freeing up time to focus on clients and reducing the amount of catch-up they need to manage post-shift.
Operational & Scheduling Innovation
When hiring and retention are so fraught, maximizing existing capacity is the name of the game. Operational excellence hinges on eliminating waste, such as non-billable hours and administrative friction that monopolizes caregivers’ time.
AI tools can add massive value here, using complex algorithms to optimize many aspects of an employee’s day. Intelligent routing reduces travel time between appointments, often affording the ability to squeeze in an additional billable visit per day without increasing total shift length. It also reduces the risk of wasting time stuck in traffic as caregivers attempt to drive across town.
Advanced caregiver scheduling software is one of the most impactful resource-saving features AI can offer. Rather than scrambling to fill open shifts, systems can analyze dozens of variables to automatically pair caregivers with client assignments that match their availability and qualifications. If a staff member calls out last-minute, schedulers don’t need to jump on the phone to find someone; their AI-enabled platform can simply scan the roster and offer the shift to someone who is actively looking for hours.
AI also helps agencies weave more balance into their scheduling. While human schedulers might give priority to caregivers they already know and trust – leaving newer or less familiar team members with an insufficient hunger of hours – AI removes all bias from the process. It can also optimize for keeping the same caregivers on the same routes, guaranteeing continuity of care for clients who likely find comfort in seeing a familiar face during visits.
Aligning Caregiver Strategy With Business Growth Goals
The agencies that will thrive in this landscape are the ones that will treat their caregivers like a competitive advantage, rather than numbers on a payroll sheet. Tapping into their talent pool’s specialized skills, for example, can help agencies expand into service areas like post-surgical recovery or chronic disease management.
Strategically focused hiring efforts can also pave the way for agencies to enter new geographic markets. By using data to map out regions of greatest need versus oversaturated markets, agencies can recruit specifically in areas that are aligned, allowing for a profitable entry with a leaner team.
With every automated documentation process and every route optimized with technology, agencies increase their billable-to-non-billable hour ratio. Even a slight reduction of time spent traveling between visits or filling out paperwork translates directly to larger profit margins, giving them more wiggle room to reinvest in their most pressing operational needs.
Overcome Caregiver Shortages & Grow With AxisCare
AxisCare is an all-in-one solution for improving caregiver workflows and operational efficiency. Tools like AI scheduling, custom forms, and our mobile app work together to ease employees’ workloads and reduce strain – a key component of supporting your caregivers and keeping them on for the long haul. Request a free demo with our team to learn more about how we can support your retention efforts and boost your bottom line.
