Demand for in-home care for elders growing

Lynne Lyne decided to move her 93-year-old mother, Jacque, into her Camas home in 2022 after noticing her mother’s cognitive decline worsening alongside her father’s health. It was a difficult decision and one that quickly proved harder in practice.

At first, Lyne hired a caregiver to help with her mother’s daily tasks and provide companionship. But as her dementia progressed, her mother became paranoid and irrationally suspicious, she said — common symptoms of the disease.

It became clear that the level of support was no longer enough.

“It was just so consuming,” Lyne said. “You feel guilty if you aren’t there, but when you are, you just feel overwhelmed.”

Before Lyne’s mother died in 2025, she was one of thousands of Clark County residents navigating the landscape of long-term care for residents older than 60.

Already, 122,664 Clark County residents — 23 percent of the county’s total population — are older than 60, according to the most recent U.S. Census figures. Meanwhile, Clark County has eight skilled nursing centers with a combined 744 beds, according to the Washington State Department of Social and Health Services.

Lyne’s mother was one of the few who secured a bed. Once she moved into a skilled nursing center, their relationship improved dramatically, and she had a team of doctors and care professionals supporting her.

“I didn’t feel 100 percent comfortable with assisted living, but I also needed a little downtime myself,” Lyne said. “She became so much more content, and it gave my husband and myself our privacy back.”

Ken and Linda Hess — owners of Griswold Home Care, a Vancouver-based in-home care services company — said caregiving burnout is among the top reasons families reach out for additional support.

Struggles with daily tasks such as bathing, dressing, eating or taking medication are often key signs that more help might be necessary.

“Family members are sometimes doing a job that they are not equipped to do with their loved one, which makes it even more stressful,” Linda Hess said. “It’s so important that they get some kind of respite care, at the very least, to be able to keep going and keep their loved one at home, which is everyone’s goal.”

Yet, as demand for in-home care continues to grow, the availability of professional caregivers has struggled to keep pace. In 2024, 38.2 million people provided unpaid elder care, according to the U.S. Bureau of Labor Statistics.

Deportation of immigrants might exacerbate the shortage of direct-care workers who play a pivotal role in providing long-term care services in both home care and institutional care settings, according to KFF, an independent public health nonprofit.

Direct-care workers typically perform demanding, high-stress work for low wages and often no benefits, according to KFF research.

Ken Hess said his in-home care company has been affected by the shortage of professional caregivers and direct-care workers. He interviews three to four people a week and aims to hire one of them.

“We’ve managed to stay on top of it. We haven’t had to turn down any cases from not having caregivers, but at times it gets tight,” Ken Hess said. “It’s an industry that you know it’s going to get worse before it gets better.”

‘It became about safety’

Erica Vandervort of Vancouver assists her mother from Bend, Ore., in caring for her grandmother, Nicki. She said her family didn’t consider in-home care due to its high cost. Instead, they began looking into public resources to help fill in the gaps in care.

While the family struggled to qualify her grandmother for Medicaid, they eventually secured an in-home caregiver to provide support.

However, Vandervort’s mother and uncle remained heavily involved in her grandmother’s care.

Like Lyne, Vandervort’s family ultimately made the decision to transition her grandmother into memory care once the caregiving demands became too burdensome to manage at home.

“You’re grieving a person that’s standing right in front of you, and every day there’s something new that’s missing,” Vandervort said. “The decision to move her into memory care, it became about safety.”

For Lyne, conversations between aging parents and their adult children about end-of-life care can be critical for future decision-making, something she said she wished she had done sooner.

“These are conversations that most people try to avoid because they’re uncomfortable, but they’re so necessary,” Lyne said. “If parents don’t have conversations like this with their children, they will become a burden, because it will all be decided by their kids, hoping they’re doing the right thing.”