The direct care workforce, a crucial backbone of the health care industry, faces unprecedented challenges when it comes to overall wellbeing, as revealed in the newly released 2024-2025 State of the Direct Care Workforce Report by St. Petersburg, Florida-based MissionCare Collective.
Based on MissionCare Collective’s comprehensive data, the report illuminates important issues related to caregivers’ emotional, physical and financial positions. It goes beyond statistics, providing an analysis of the factors that contribute to the struggles of the workforce, including financial instability, training and development, and poor physical and mental health.
Furthermore, the report offers specific data for each state regarding workforce gaps, wages, and the composition of the workforce, equipping industry leaders with the insights necessary to address these challenges directly.
“One of the most concerning findings in the report is the poor health and wellbeing of direct care workers,” MissionCare Collective CEO Brandi Kurtyka told Home Health Care News. “These caregivers, who dedicate themselves to supporting those in need, struggle financially, mentally and physically. This creates a paradox where we have a workforce tasked with ensuring the wellbeing of others while they face significant personal health challenges.”
A lack of health insurance and reliance on public assistance affects caregivers’ personal and professional wellbeing. According to the report, 15% of caregivers lack health insurance, and 42% come from low-income households.
Additionally, the report emphasizes a widening wage gap, with direct care workers in most states earning $2 to $3 less per hour than workers in industries requiring similar skills.
“While many caregivers are motivated by more than just a paycheck, the widening gap in competitive wages is exacerbating workforce shortages and creating challenges in recruitment and retention across the health care industry,” Kurtyka said.
When caregivers lack access to proper health care, they are at a higher risk of developing chronic health problems, facing delays in treatment and experiencing increased stress, all of which can negatively impact their physical and mental wellbeing. This difficulty can make it challenging for them to fulfill their caregiving responsibilities effectively. Additionally, the financial instability that comes from relying on public assistance adds another layer of stress.
“Worrying about necessities like food or transportation can distract caregivers, no matter how dedicated they are,” Kurtyka said. “A healthier, better-supported workforce is essential for delivering higher-quality and more consistent care.”
The emotional health of direct care workers is a significant concern, with 21% reporting poor mental health, according to the report. Direct care workers are three times more likely to struggle with anxiety and depression, with role misunderstandings and expectations to perform tasks beyond their training adding to their stress. Working in unfamiliar and potentially unsafe environments exposes them to risks such as drug activity, violence and assault. Social isolation, coupled with the high physical and emotional demands of the job, leads to elevated stress levels as well.
How leaders can provide support
Supporting the workforce begins with understanding their needs and going beyond traditional employer approaches. The report indicates that caregivers don’t often feel respected and sometimes feel as though they are seen as housekeepers, which is beyond the scope of their job duties. One survey participant called for a professionalization of the role, which begins with educating the client on what the caregiver is there to do.
“It’s difficult to scale and manage a workforce that is struggling at home, but to build a high-performing team that shows up and is capable of delivering great care, we need to ensure they are supported,” Kurtyka said. “The data in the report needs to be better understood and discussed, and the workforce’s wellbeing needs to be prioritized.”
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