The long-predicted shortage of personal care aides is here. And it is creating enormous challenges for frail older adults and people with disabilities living at home as well as for operators and residents of nursing homes and assisted living facilities.

This shortage inevitably will drive up costs for services that already are unaffordable for many consumers. They will increase financial pressures on Medicare and Medicaid and force older adults and others with disabilities to rethink how they receive care. At the same time, labor shortages will drive innovation and new technologies that could remake supports and services.

The US has known this was coming for years. As the aging population grew, the number of personal care aides to provide care at home or in nursing or assisted living facilities was not keeping up. But now the shortage is here.