U.S. Caregiving Crisis – Wellness Shepherd

When it comes to navigating the older adult care crisis in the U.S., there is no single solution. Every family and elder I speak with faces a unique, incredibly complex set of circumstances. When they cannot find viable solutions at home, they are increasingly searching for affordable care elsewhere—mainly long-term care in Mexico due to its proximity and climate, or in nations where they qualify for a second heritage passport.

In recent magazine and podcast interviews, we dive into this international perspective—unpacking real-world pros and cons of domestic care and the honest truths of crossing borders for help.

In 2024, I wrote an extensive piece about eldercare beyond U.S. borders and why families are running out of options at home: Finding Eldercare/Senior Care Abroad.

That post brought insightful journalists to my door.

The first was Hikari Mae Hida, an international journalist and translator who deeply understands caregiving through her own global reporting and family experiences. Her well-crafted story for Deseret Magazine, (apologies as Deseret requires registry to read) “The Great Global Caregiving Crisis,” masterfully outlines the high-stakes families face. The article opens with my serious question:

“What if we live a long life and are abandoned or without funds despite our best efforts?” For Wendy Jane Carrel, a senior care specialist with over two decades of experience who operates the consulting service Wellness Shepherd, this question is a looming reality.

I am grateful to Hikari for quoting me throughout and bringing vital mainstream attention to this systemic issue. You can explore more of her work at Hikari Mae Hida’s Official Site.

International social impact consultant Anna de la Cruz published a powerful, deeply personal account of the care economy for Slate. Her article, “Exporting Our Elders,” (sorry, no complimentary read from Slate),highlights my mission at Wellness Shepherd to help families discover compatible, affordable long-term care workarounds abroad. Thank you, Anna, for sharing your heart-wrenching story as a sandwich-generation caregiver balancing young children while managing complex, high-stakes medical logistics for your disabled brother and your parents. Learn more about Anna’s consulting work at Anna De La Cruz | Social Impact Consulting.

Following that piece, Anna Sale—the creator and host of Slate’s Death, Sex, and Money podcast—invited Anna de la Cruz to share her story on air. The episode also featured Laura Silverstein, a Seattle-based Aging Life consultant who helped design the care plan for Anna’s mother, and me.

My reflection “humane eldercare has often become a luxury item” ended up as the header for the episode. A quick disclaimer if you listen to the podcast: you may wonder if I was recovering from watching a weepie movie! Between my “stealth-whisper” and sounding unrecognizable – I usually deliver actionable advice and solid support nuggets – I have determined host Anna Sale’s famously hypnotic, soothing voice must have lulled me into a trance.

While it’s safe to say I won’t be winning any broadcasting awards for performance, the brilliance and clarity Anna de la Cruz and Laura Silverstein bring to the conversation make it a truly necessary listen for anyone facing care choices.

You can hear the full episode on Slate: Humane Eldercare Has Often Become a Luxury Item

Ultimately, my hope is that these stories continue to spark an urgent conversation: the critical need for a more affordable, dignified, and humane care infrastructure throughout the nation.

Wendy Jane Carrel, MA, is a trusted Older Adult Advocate and Cross-Border Consultant who has hands-on experience with healthcare systems, Aging in Place, international retirement transitions, long-term care, palliative care, and end-of-life care in Mexico, Ecuador, other nations, and the USA. She provides informed, thoughtful guidance and curated, compatible care options for reitrees, solo agers, families, and their loved ones. She is a speaker and published author on subjects related to senior well-being and a trauma-informed end-of-life doula. Wendy’s web site is http://www.WellnessShepherd.com.

Resources:

https://www.businessinsider.com/long-term-care-costs-growing-problem-for-americans-2026-8

https://www.businessinsider.com/eldercare-crisis-long-term-care-costs-families-2026-8

https://www.elderlawanswers.com/long-term-care-costs-are-hollowing-out-generational-wealth-21539

https://www.usatoday.com/story/money/2026/03/12/aarp-us-costs-middle-class-home-care-crisis/89085293007

https://www.youtube.com/shorts/b3Awxd1T780 Anna de la Cruz shares her story on You Tube

Wellness Shepherd Wendy Supports a Healthcare Guest Worker Program to Address the U.S. Nursing (and Nursing Assistant) Shortage

I heartily support the American Health Care Association’s (AHCA) request to include a viable guest worker program in immigration reform. North America faces a critical shortage of geriatricians, nurses and nursing assistants—a deficit that will only worsen as the “Silver Tsunami” of our aging population drives up demand. We do not have enough domestic personnel to meet current or future patient needs.

Caregiving is a universal skill that transcends borders. High-quality care requires an open heart, deep empathy, and an unwavering commitment to care for the elderly, the disabled, and the infirm. Based on my experience in senior living, healthcare professionals from Canada, Colombia, Ecuador, El Salvador, Europe, Mexico, the Middle East, and the Philippines consistently display this profound dedication and connect deeply with their patients.

This proposal does not diminish the incredible work of the United States’ own remarkable nursing corps; rather, it acknowledges they need reinforcement. By implementing a system that vets and qualifies international candidates, a guest worker program would safely infuse our healthcare system with the talent it desperately needs. Attentive, supportive care is a universal language, and it is time our immigration policies reflect that reality.

Article from TheHill.com (health blog section) based on a request from the U.S. nursing home industry to include a “viable” guest worker program in any immigration reform is below.

NURSING HOMES WANT GUEST WORKER PROGRAM IN IMMIGRATION BILL

By Sam Baker – 03/13/13 10:34 AM ET – TheHill.com

The nursing-home industry said Wednesday that Congress should include a “viable” guest worker program in any immigration overhaul, and should also lift caps on employer-sponsored visas for healthcare workers.

The American Health Care Association (AHCA) said immigration reform should recognize the needs of employers — including nursing homes and long-term care providers, who rely heavily on immigrants for positions such as nurses.

“Members of the long term care community employ immigrants and boost the economy. Any visa program must give employers, not the government, the primary say in which workers they need to staff their businesses,” the AHCA said. “In addition, the labor market should also have the primary say in how many workers enter the country annually in a legal program.”

The group is scheduled to testify at a House hearing Thursday on immigration reform.

AHCA said the supply of skilled nurses in the U.S. will fall more than 30 percent short by 2020 if Congress does not act. The nursing-home group said immigration reform should allow employers to access “previously unused” temporary visas for healthcare workers.

Category: U.S. Caregiving Crisis

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Dedicated, Loving, Well-Trained Nurses of Any Nationality Should Be Able to Work in the US