Bridging the Gap: Addressing Georgia’s Caregiving Shortage

An older woman holds a tablet in front of her face. Behind her, a younger woman reaches out to point out something on the tablet.
Caregivers play an essential part in the lives of many older people and people with disabilities.

Did you know the United States is experiencing a caregiving shortage? Paid caregivers, such as personal care aides, home health aides, and nursing assistants all provide essential services to older people and people with disabilities. This crucial workforce makes it possible for people to maintain a high quality of life. However, there are currently 800,000 older people on waiting lists due to worker shortages, according to data analyzed by The Mesothelioma Center. Out of all 50 states, Georgia currently has the lowest paid caregiver to population ratio, with only 7.1 caregivers per 100,000 residents, says Georgia Public Radio.

This lack of paid caregivers highlights an additional issue: the unpaid caregiving labor of family members. According to AARP, 21.3 percent of Americans are caregivers, having provided care to an adult or child with support needs at some time in the past 12 months. Of these, one in five is providing care services completely unpaid. Up to 61 percent of family caregivers are also working a separate job on top of their caregiving duties. The financial impact of this uncompensated labor adds up quickly. As stated in one ARC brief, Georgia residents provided over 576 million hours of unpaid caregiving to loved ones living with Alzheimer’s in a single calendar year. This unpaid work was valued at roughly $7 billion.

To learn more about the strain that a caregiving shortage can put on a community, and how Empowerline is trying to alleviate the pressure, we reached out to Cara Pellino, Manager of Access to Services at the Atlanta Regional Commission. The following questions and answers have been condensed and edited for clarity purposes.

Lex Echols: In what ways does a caregiver shortage impact the day-to-day lives of older people and people with disabilities?

Cara Pellino: It impacts their quality of life. If there is a caregiver shortage, people who could be receiving in-home services struggle. These are people who may need help with bathing, preparing meals, cleaning their home, or transportation to important appointments.  Without caregivers in the home, people may go without bathing and may stay in their pajamas all day because they need help dressing. They may not be able to do laundry or make their beds. There have been individuals who could not make their beds without help so when they didn’t have that help, they would just sleep on a bare mattress. The paid caregiver support is in place to really help people thrive and maintain as much independence – or maybe I should say interdependence – as possible so they can remain in their homes and communities.

LE: Can you tell me more about the CARES Flex program and what issues it addresses?  

CP: CARES Flex is a consumer-directed program that allows people to become an employer of service, meaning they can hire their own staff. They have a monthly budget that they can use, and they can choose any variety of services and goods. If they want in-home caregivers, they can choose to work with an agency or they can hire their own.

This helped greatly during the worst of the COVID-19 pandemic. Agencies weren’t allowing their staff to go into homes, and many clients didn’t want staff entering their homes anyway because they wanted to stay safe and healthy. This meant that people who previously had services in place were not receiving them. The CARES Flex program allowed them to hire their own caregivers, including family. Family is often likely doing that work anyway.

The lack of paid caregivers in our state really speaks to the number of family members who are providing this level of care and not tapping into paid community services. During the pandemic, many family members were dealing with reduced employment, so CARES Flex was a great solution.

LE: That sounds like a great program; what other services does Empowerline provide to help support caregivers, older adults, and people with disabilities?

CP:  We have an amazing program, the Benjamin Rose Institute’s Care Consultation Program, which is a year-long telephonic caregiver support program. We have two care consultants who work with caregivers, calling them at different intervals to listen to their needs and help connect them to resources and services to help them thrive. It is an evidence-based program, and the studies show that it reduces caregiver burden and lessens the likelihood that the person they’re caring for will be placed in long-term care.

Empowerline also does intake and screening for Georgia’s Elderly and Disabled Medicaid Waiver Program (EDWP) as well as Older Americans Act funded services such as personal care, homemaker, respite, and home-delivered meals. These funded programs as well as private pay options, allow eligible individuals to receive care in their home which often reduces caregiver burden. For instance, an aging caregiver may find it increasingly difficult to physically care for their spouse. Having help with bathing, dressing, and toileting their loved one will reduce their level of caregiver burden. This can be a great option.


For more information about services for older people and people with disabilities in the Metro Atlanta area, check out our Caregiver Policy Brief and Caregiver Resource Page. For information about public policy and direct care workers, check out the State Policy Strategies for Strengthening the Direct Care Workforce document from PHI. 

Visit the Empowerline website to be connected with counseling and resources. 


Lex Echols

Lex Echols is Management Services Specialist for the Aging & Independence Services Department of the Atlanta Regional Commission. Born and raised in Utah, Lex moved to Atlanta to complete a degree in International Relations from Agnes Scott College. In their free time, they enjoy hiking, reading, and volunteering in their community.