But finding help proved nearly impossible. The long-term-care insurer would only work with two agencies in the area, and they were swamped with demands. Often my grandmother would call and request help and no one could come. The agencies' staff tended not to live in Amherst, a college town with a population of 35,000, and would have to come from other towns, driving a long way from one client to another.

In western Massachusetts, where unemployment is low and full-time steady work isn't too hard to find, working a few hours a day for different clients for low pay didn’t appeal to many people. My grandmother didn’t need someone to be at the house all day. She mostly needed help getting my grandfather out of bed in the morning—he was a tall man, and was suffering from Parkinson’s disease, which meant his body sometimes wouldn’t obey his mind— into and out of the shower, and out of his wheelchair into bed at night. Though the agency charged $25 an hour, the workers only got about $15, which was, in fact, high for the field. The agency set a minimum visit of two hours, more than my grandparents needed at any one time.

Eventually, my grandmother stopped depending on the agencies, and, through a friend of a friend, found a Ph.D. student from Kenya named John. John was vastly overqualified for the job, but he was looking for a little extra cash, so he came to help my grandfather get out of bed in the morning and back into it at night, all while juggling his studies and his small family, who had moved with him to Amherst. John quickly became adept at the tasks of a home health aide, and he and my grandfather shared a bond, talking about Kenya and public health and academia. John was there when my grandfather suddenly died two years ago. My grandmother gave a donation to his village in his name as thanks for his help. She’s never heard from him again.

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My grandparents lived in Amherst for 50 years. They didn’t want to move as they got older, and they weren’t unusual in this. Nearly 90 percent of seniors want to stay in their own homes as they age, according to AARP. Sometimes, it’s not a choice: Government programs such as Medicaid, in an effort to save money, are shifting spending away from institutional settings toward home and community-based care.

At the same time, the number of seniors is growing. In 2010, one-sixth of the adult U.S. population was older than 65; by 2030, about one-fourth will be.

“What’s coming down the pipeline—it’s a demographic tsunami,” Lawrence Force, director of the Center on Aging and Policy at Mount Saint Mary College, told me.

But the resources to help seniors stay at home are shrinking. Many seniors are finding that their boomer children are staying in the workforce longer than they did, and are unable to care for them. Demand for direct-care workers is expected to grow 37 percent between 2012 and 2022. Demand for personal care aides alone—the entry-level workers in the field—will grow 49 percent. There are currently 3.5 million direct-care workers in the country, according to the Bureau of Labor Statistics. Seven years from now, there will be 1.3 million more.