How the Global Population Collapse in Developed Economies Is Wreaking Havoc on Aged Care
How the Global Population Collapse in Developed Economies Is Wreaking Havoc on Aged Care
With falling birth rates & aging societies, population collapse triggers a silent aged care crisis. International talent is eyed as a key solution for sustainable elderly care worldwide.
In the corridors of hospitals and the quiet rooms of aged care homes, a silent crisis is unfolding—one that is not caused by war or economic recession, but by a profound demographic collapse. Aged Care leaders around the world are grappling to find realistic solutions that create a sustainable future for the healthcare sector.
An overwhelming majority of the healthcare industry’s top executives are forecasting a sustainable solution by hiring international talent, as it promises a permanent solution while augmenting employment gaps with part-time local talent. This paper explores how this is unfolding around the world.
Developed economies are ageing rapidly while simultaneously witnessing a dramatic fall in birth rates. This leads to a shrinking pool of working-age people and an explosion in the demand for elderly care. This worrying phenomenon—known as population collapse—is redefining the global economy, reshaping migration patterns, and placing existential pressure on aged care systems around the world.
The world is growing older — and not evenly. Across the wealthiest economies, a demographic cliff is eroding the foundations of aged care, a sector already under immense pressure worldwide.
While medical breakthroughs have extended life expectancy, falling birth rates and stagnating working-age populations have left a shrinking pool of care workers to tend to rapidly aging populations. This slow-moving demographic earthquake triggers tremors throughout aged care systems, with consequences reverberating across policy, labor markets, and the global migration map.
A Demographic Time Bomb
According to the OECD's Pensions at a Glance 2017 report, dependency ratios in most developed countries are approaching critical levels. The dependency ratio—which compares the number of dependents (children and the elderly) to the working-age population—has shifted dramatically. Where once societies contended mainly with a high number of dependent children, today, it is the elderly who outnumber the young.
A high dependency ratio signals greater strain on economies: fewer care workers are supporting more retirees, while national budgets strain to sustain pensions, healthcare, and aged care services worldwide.
Countries like Japan, Italy, Germany, and South Korea—each with a median age over 44—have entered a phase of population contraction. South Korea’s fertility rate fell to 0.78 in 2022—the lowest in the world. Japan has hovered near 1.3 for decades. Australia, once considered a youthful nation, now reports a fertility rate of only 1.58—well below the replacement level of 2.1.
In Australia alone, the number of people aged 65 and over is expected to increase by 20% by 2031. A recent report by the National Skills Commission predicts that the aged care sector will require an additional 199,000 workers by 2026 to keep pace with demand. Meanwhile, the Australian Institute of Health and Welfare underscores that 1 in 5 Australians will be over the age of 65 by 2057.
Japan is currently short 180,000 aged care workers, needing to add 30,000 more each year to meet growing demand. The United Kingdom faces a deficit of 110,000 caregivers, and Canada’s population over 65 is projected to double to 11.6 million by 2040. The United States anticipates a sectoral growth of 34% by 2029, requiring over 150,000 new workers even as tens of thousands exit the field annually due to burnout and low wages.
“This is not just a workforce issue — it's a national emergency,” said Professor John Piggott, Director of the ARC Centre of Excellence in Population Ageing Research.
“The aged care system is facing a structural failure unless we take decisive, global action,” Piggott emphasised.
Human Cost of Workforce Collapse
The 2021 Royal Commission into Aged Care Quality and Safety in Australia revealed widespread systemic neglect, describing aged care as a "shocking tale of neglect" — much of it attributed to staff shortages and underqualified personnel.
As aged care becomes more specialized due to increasing rates of dementia and mobility impairment, the stress on already stretched workforces becomes unbearable. In Australia alone, 65,000 workers leave the aged care sector annually, and 38% are projected to exit by 2025.
The World Health Organization estimates that by 2050, the number of people over 80 will triple to 426 million globally. These individuals will need not just homes, but professional, compassionate care. And yet, many nations are struggling to recruit, train, and retain care workers and nurses. Workers often cite inadequate staffing, lack of respect, and mental health challenges as reasons for leaving the already ailing sector.
Meanwhile, families of aged care residents are feeling the pinch. As more of their loved ones fall into the care gap, many are forced to reduce work hours or quit jobs to take on caregiving responsibilities, further constraining the labor market. Care work is increasingly becoming an unpaid second shift for millions across the developed world.
In some countries, this has become a gendered crisis. Women, who make up the majority of unpaid caregivers, are disproportionately affected. The International Monetary Fund has reported that caregiving responsibilities reduce women's participation in the labor force, undermining gender equality and economic productivity. Addressing aged care isn’t only about supporting the elderly—it’s about enabling full societal participation.
It’s Not Just a Western Problem
China’s 2023 population decline marked the beginning of a historic shift in the aged care crisis. The country now confronts the prospect of becoming old before becoming rich.
As Professor Wang Feng of Fudan University notes, “China faces a demographic tsunami.” The World Bank estimates that by 2050, 39% of China’s population will be over 60.
This aging shift is spreading across emerging economies, including Thailand and parts of Eastern Europe. These nations face a double challenge: an aging population and the lack of fiscal resources to meet growing social care demands.
Researchers warn that the effects of population collapse are nonlinear. Small imbalances in age structure can compound into major disruptions in the economies of most developed nations. Pension funds become unsustainable, productivity stalls, housing markets stagnate, and intergenerational inequality deepens in society.
Economic Boom, Labor Bust
Australia’s record-low unemployment rate of 4.5% as of early 2022 and 4 % in 2025, means workers have abundant job choices. In such an environment, aged care—a demanding field that pays less than retail—struggles to attract talent.
“This isn’t just a labor shortage,” says Dr. Joseph Ibrahim at Monash University. “It’s a market signal. The sector isn’t competitive.”
Other sectors are poaching potential care workers with better pay, flexible hours, and career progression. The care sector, meanwhile, is seen as a dead-end for many Australian workers. Without government intervention to subsidize wages, provide training, and elevate the profession, aged care will continue to bleed talent.
In this regard, policymakers must consider aged care in the same breath as energy, infrastructure, or defense. A collapse in care services worldwide leads to cascading effects—hospital bed shortages, emergency room overcrowding, and mental health crises. The ripple effects touch every aspect of public health and economic well-being.
Rethinking Solutions: Pay, Policy, and People
Improving wages is necessary, but structural reforms are critical for a sustainable aged care industry. Governments must be ready to treat aged care as essential infrastructure by providing career pipelines, incentives, and public subsidies for sector workers.
“Care work is a public good,” says Dr. Catherine Needham, Professor of Public Policy and Public Management at the University of Birmingham.. “We need intentional policymaking that values caregivers,” she said in a recent publication.
Public campaigns that destigmatize and promote the care profession as noble, skilled, and stable are also equally important, especially for Australians who don’t see carework as a lifetime career.
Countries like Germany and the Netherlands, as an example, have launched national awareness initiatives to rebuild the image of caregiving as honorable work.
Education systems should also embed care training early—not just for future professionals but as part of civic education. A developed society that understands and respects care from a young age is better prepared to sustainably support its elderly population.
Global Migration as a Solution
In the U.S., nearly 30% of care workers are immigrants. In the UK, it’s 17%. In Australia and Canada, Filipino workers are starting to dominate healthcare facilities. With a median age of 24.5 and high English proficiency, the Philippines is exporting care talent globally, albeit at a rapid rate during the COVID era.
Groworx data shows that Filipinos already make up nearly 20% of Australia’s aged care workforce, and this number continues to grow every year. For the past two years, over 500 Filipino nurses and careworkers have been deployed in Australia by Groworx for its Filipino International Labour Opportunity program. Requests for more aged workers have also been increasing month after month from residential and home care managers, especially in regional and rural areas where closures of aged care facilities have become imminent.
To address the global need for migrant workers from the almost unlimited talent pool from developing countries like the Philippines, governments have initiated and formalized the Philippines government-to-government partnerships with countries like Japan, Israel, Germany, the UK, Australia, and other developed countries, ensuring ethical migration practices. Such programs help fill labor shortages while empowering workers with training, legal protections, and economic opportunity.
The success of the Filipino care worker model lies not just in workforce supply, but in cultural affinity. Care is deeply ingrained in Filipino values. The majority of Filipino families continue to provide care for their elderly family members.
For many Overseas Filipino Workers arriving in countries like Australia to provide care in primary and residential aged care facilities give them a sense of mission and compassion that cannot be trained overnight.
“Care work is not just an optional job for many Filipinos,” says Dan Sandiford, Co-founder and CEO of Groworx Global, an international workforce and talent solutions company providing the best healthcare professionals in developed countries like Australia.
“It’s a career, a dream. They’re driven by purpose which is culturally ingrained from an early age. This is one of the key reasons why these international cohorts have the lowest attrition rate of any single ethnic group.” Sandiford emphasized.
Remittances from Overseas Filipino Workers reached nearly US$40 billion in 2023, with $12 billion coming from healthcare, according to the latest Philippine government report.
Migration, when managed ethically, supports both sending and receiving nations. In our experience at Groworx, providing training, individual support certification, and long-term support helps care workers succeed abroad.
The key to this success is by creating reciprocal models: workers thrive, families are supported, and elderly residents receive dignified care. This ethical approach counters narratives of labor exploitation and fosters cross-border solidarity among nations.
Based on the experience of Groworx as a migration workforce solutions provider, governments must avoid the pitfalls of extractive migration—poaching talent without investing in the origin countries’ capacity. True global care partnerships require shared responsibility, transparency, and investment in upskilling local populations. Groworx, for example, currently spends millions of dollars annually to recruit, train, deploy, and support careworkers before sending them to Australian aged care facilities.
Technology Is Not a Replacement
Let’s all admit that Automation and AI can be a game-changer in supporting the aged care industry. However, these emerging technologies can never replace human empathy.
“At Groworx, we believe that hybrid models and human-assisted technology combined with an intelligent staffing mix of local and international are critical to creating a sustainable aged care into the future.—blending compassionate care with technological assistance,” adds Sandiford.
As a company, Groworx believes that AI-driven scheduling, telehealth platforms, and robotics for physical support are reshaping aged care logistics. But no robot can offer the warmth of a reassuring hand or the comfort of shared laughter brought about by foreign workers like Filipino care workers and nurses.
Dan Sandiford, Co-founder and CEO of Groworx Global, an international talent solutions company reshaping the future of healthcare through workforce innovation
“We always believe that technology must augment, not replace, the human touch, especially in industries like aged care,” the Groworx CEO stressed.
Technology also raises questions of accessibility. Older adults must be included in the digital transformation. This means training programs for seniors, user-friendly interfaces, and culturally sensitive design will hasten and enhance the adoption of technology and equity in the aged care sector.
Family Care and Community Support
Another significant aspect that needs much thought and implementation for the aged care industry is for governments to empower families to care for their loved ones at home through tax breaks, education, and support networks.
However, this also assumes families have time, training, and stability to be effective in providing elderly care. Many dual-income households in growing metropolises worldwide simply can’t manage the added burden of taking care of their ageing family members.
Community care models—like time banking and neighborhood care co-ops—offer localized solutions for the aged care sector. These models distribute care responsibilities across volunteers and part-time carers, easing pressure on families and institutions.
Faith-based institutions, non-profits, and grassroots networks also play a role in addressing the aged care crisis. In many cultures, religious and community leaders are trusted facilitators of care. Empowering these groups with funding and frameworks can expand the care ecosystem in every country.
A Global Reckoning
The global population collapse is not just a statistic—it’s a reckoning. Aged care systems must evolve through coordinated international action. Migration offers hope, but not escape. Technology offers support, but not compassion. The path forward must be intentional, ethical, and human.
Countries must collaborate on workforce mobility, invest in training infrastructures, and create care ecosystems that value both caregiver and recipient.
This is the civil rights issue of our aging century: Will we allow our elders to be neglected in the twilight of their lives, or will we stand up and reimagine care as the moral infrastructure of modern society?
As we confront this demographic winter, we must remember: aging is a universal destiny. The systems we build today will be the ones we inherit tomorrow.
Discover how Groworx solves your workforce staffing gaps through International Talent Solutions
Australia’s aged care sector faces a growing workforce crisis, but international recruitment offers a scalable, sustainable solution for providers of all sizes.
Leading aged care provider IRT implements innovative workforce strategy with Groworx International Recruitment Program by hiring Filipino care workers and nurses to overcome critical staffing shortages.
In the corridors of hospitals and the quiet rooms of aged care homes, a silent crisis is unfolding—one that is not caused by war or economic recession, but by a profound demographic collapse. Aged Care leaders around the world are grappling to find realistic solutions that create a sustainable future for the healthcare sector.
An overwhelming majority of the healthcare industry’s top executives are forecasting a sustainable solution by hiring international talent, as it promises a permanent solution while augmenting employment gaps with part-time local talent. This paper explores how this is unfolding around the world.
Developed economies are ageing rapidly while simultaneously witnessing a dramatic fall in birth rates. This leads to a shrinking pool of working-age people and an explosion in the demand for elderly care. This worrying phenomenon—known as population collapse—is redefining the global economy, reshaping migration patterns, and placing existential pressure on aged care systems around the world.
The world is growing older — and not evenly. Across the wealthiest economies, a demographic cliff is eroding the foundations of aged care, a sector already under immense pressure worldwide.
While medical breakthroughs have extended life expectancy, falling birth rates and stagnating working-age populations have left a shrinking pool of care workers to tend to rapidly aging populations. This slow-moving demographic earthquake triggers tremors throughout aged care systems, with consequences reverberating across policy, labor markets, and the global migration map.
A Demographic Time Bomb
According to the OECD's Pensions at a Glance 2017 report, dependency ratios in most developed countries are approaching critical levels. The dependency ratio—which compares the number of dependents (children and the elderly) to the working-age population—has shifted dramatically. Where once societies contended mainly with a high number of dependent children, today, it is the elderly who outnumber the young.
A high dependency ratio signals greater strain on economies: fewer care workers are supporting more retirees, while national budgets strain to sustain pensions, healthcare, and aged care services worldwide.
Countries like Japan, Italy, Germany, and South Korea—each with a median age over 44—have entered a phase of population contraction. South Korea’s fertility rate fell to 0.78 in 2022—the lowest in the world. Japan has hovered near 1.3 for decades. Australia, once considered a youthful nation, now reports a fertility rate of only 1.58—well below the replacement level of 2.1.
In Australia alone, the number of people aged 65 and over is expected to increase by 20% by 2031. A recent report by the National Skills Commission predicts that the aged care sector will require an additional 199,000 workers by 2026 to keep pace with demand. Meanwhile, the Australian Institute of Health and Welfare underscores that 1 in 5 Australians will be over the age of 65 by 2057.
Japan is currently short 180,000 aged care workers, needing to add 30,000 more each year to meet growing demand. The United Kingdom faces a deficit of 110,000 caregivers, and Canada’s population over 65 is projected to double to 11.6 million by 2040. The United States anticipates a sectoral growth of 34% by 2029, requiring over 150,000 new workers even as tens of thousands exit the field annually due to burnout and low wages.
“This is not just a workforce issue — it's a national emergency,” said Professor John Piggott, Director of the ARC Centre of Excellence in Population Ageing Research.
“The aged care system is facing a structural failure unless we take decisive, global action,” Piggott emphasised.
Human Cost of Workforce Collapse
The 2021 Royal Commission into Aged Care Quality and Safety in Australia revealed widespread systemic neglect, describing aged care as a "shocking tale of neglect" — much of it attributed to staff shortages and underqualified personnel.
As aged care becomes more specialized due to increasing rates of dementia and mobility impairment, the stress on already stretched workforces becomes unbearable. In Australia alone, 65,000 workers leave the aged care sector annually, and 38% are projected to exit by 2025.
The World Health Organization estimates that by 2050, the number of people over 80 will triple to 426 million globally. These individuals will need not just homes, but professional, compassionate care. And yet, many nations are struggling to recruit, train, and retain care workers and nurses. Workers often cite inadequate staffing, lack of respect, and mental health challenges as reasons for leaving the already ailing sector.
Meanwhile, families of aged care residents are feeling the pinch. As more of their loved ones fall into the care gap, many are forced to reduce work hours or quit jobs to take on caregiving responsibilities, further constraining the labor market. Care work is increasingly becoming an unpaid second shift for millions across the developed world.
In some countries, this has become a gendered crisis. Women, who make up the majority of unpaid caregivers, are disproportionately affected. The International Monetary Fund has reported that caregiving responsibilities reduce women's participation in the labor force, undermining gender equality and economic productivity. Addressing aged care isn’t only about supporting the elderly—it’s about enabling full societal participation.
It’s Not Just a Western Problem
China’s 2023 population decline marked the beginning of a historic shift in the aged care crisis. The country now confronts the prospect of becoming old before becoming rich.
As Professor Wang Feng of Fudan University notes, “China faces a demographic tsunami.” The World Bank estimates that by 2050, 39% of China’s population will be over 60.
This aging shift is spreading across emerging economies, including Thailand and parts of Eastern Europe. These nations face a double challenge: an aging population and the lack of fiscal resources to meet growing social care demands.
Researchers warn that the effects of population collapse are nonlinear. Small imbalances in age structure can compound into major disruptions in the economies of most developed nations. Pension funds become unsustainable, productivity stalls, housing markets stagnate, and intergenerational inequality deepens in society.
Economic Boom, Labor Bust
Australia’s record-low unemployment rate of 4.5% as of early 2022 and 4 % in 2025, means workers have abundant job choices. In such an environment, aged care—a demanding field that pays less than retail—struggles to attract talent.
“This isn’t just a labor shortage,” says Dr. Joseph Ibrahim at Monash University. “It’s a market signal. The sector isn’t competitive.”
Other sectors are poaching potential care workers with better pay, flexible hours, and career progression. The care sector, meanwhile, is seen as a dead-end for many Australian workers. Without government intervention to subsidize wages, provide training, and elevate the profession, aged care will continue to bleed talent.
In this regard, policymakers must consider aged care in the same breath as energy, infrastructure, or defense. A collapse in care services worldwide leads to cascading effects—hospital bed shortages, emergency room overcrowding, and mental health crises. The ripple effects touch every aspect of public health and economic well-being.
Rethinking Solutions: Pay, Policy, and People
Improving wages is necessary, but structural reforms are critical for a sustainable aged care industry. Governments must be ready to treat aged care as essential infrastructure by providing career pipelines, incentives, and public subsidies for sector workers.
“Care work is a public good,” says Dr. Catherine Needham, Professor of Public Policy and Public Management at the University of Birmingham.. “We need intentional policymaking that values caregivers,” she said in a recent publication.
Public campaigns that destigmatize and promote the care profession as noble, skilled, and stable are also equally important, especially for Australians who don’t see carework as a lifetime career.
Countries like Germany and the Netherlands, as an example, have launched national awareness initiatives to rebuild the image of caregiving as honorable work.
Education systems should also embed care training early—not just for future professionals but as part of civic education. A developed society that understands and respects care from a young age is better prepared to sustainably support its elderly population.
Global Migration as a Solution
In the U.S., nearly 30% of care workers are immigrants. In the UK, it’s 17%. In Australia and Canada, Filipino workers are starting to dominate healthcare facilities. With a median age of 24.5 and high English proficiency, the Philippines is exporting care talent globally, albeit at a rapid rate during the COVID era.
Groworx data shows that Filipinos already make up nearly 20% of Australia’s aged care workforce, and this number continues to grow every year. For the past two years, over 500 Filipino nurses and careworkers have been deployed in Australia by Groworx for its Filipino International Labour Opportunity program. Requests for more aged workers have also been increasing month after month from residential and home care managers, especially in regional and rural areas where closures of aged care facilities have become imminent.
To address the global need for migrant workers from the almost unlimited talent pool from developing countries like the Philippines, governments have initiated and formalized the Philippines government-to-government partnerships with countries like Japan, Israel, Germany, the UK, Australia, and other developed countries, ensuring ethical migration practices. Such programs help fill labor shortages while empowering workers with training, legal protections, and economic opportunity.
The success of the Filipino care worker model lies not just in workforce supply, but in cultural affinity. Care is deeply ingrained in Filipino values. The majority of Filipino families continue to provide care for their elderly family members.
For many Overseas Filipino Workers arriving in countries like Australia to provide care in primary and residential aged care facilities give them a sense of mission and compassion that cannot be trained overnight.
“Care work is not just an optional job for many Filipinos,” says Dan Sandiford, Co-founder and CEO of Groworx Global, an international workforce and talent solutions company providing the best healthcare professionals in developed countries like Australia.
Migration Isn’t Exploitation—When Managed Ethically
Remittances from Overseas Filipino Workers reached nearly US$40 billion in 2023, with $12 billion coming from healthcare, according to the latest Philippine government report.
Migration, when managed ethically, supports both sending and receiving nations. In our experience at Groworx, providing training, individual support certification, and long-term support helps care workers succeed abroad.
The key to this success is by creating reciprocal models: workers thrive, families are supported, and elderly residents receive dignified care. This ethical approach counters narratives of labor exploitation and fosters cross-border solidarity among nations.
Based on the experience of Groworx as a migration workforce solutions provider, governments must avoid the pitfalls of extractive migration—poaching talent without investing in the origin countries’ capacity. True global care partnerships require shared responsibility, transparency, and investment in upskilling local populations. Groworx, for example, currently spends millions of dollars annually to recruit, train, deploy, and support careworkers before sending them to Australian aged care facilities.
Technology Is Not a Replacement
Let’s all admit that Automation and AI can be a game-changer in supporting the aged care industry. However, these emerging technologies can never replace human empathy.
As a company, Groworx believes that AI-driven scheduling, telehealth platforms, and robotics for physical support are reshaping aged care logistics. But no robot can offer the warmth of a reassuring hand or the comfort of shared laughter brought about by foreign workers like Filipino care workers and nurses.
Technology also raises questions of accessibility. Older adults must be included in the digital transformation. This means training programs for seniors, user-friendly interfaces, and culturally sensitive design will hasten and enhance the adoption of technology and equity in the aged care sector.
Family Care and Community Support
Another significant aspect that needs much thought and implementation for the aged care industry is for governments to empower families to care for their loved ones at home through tax breaks, education, and support networks.
However, this also assumes families have time, training, and stability to be effective in providing elderly care. Many dual-income households in growing metropolises worldwide simply can’t manage the added burden of taking care of their ageing family members.
Community care models—like time banking and neighborhood care co-ops—offer localized solutions for the aged care sector. These models distribute care responsibilities across volunteers and part-time carers, easing pressure on families and institutions.
Faith-based institutions, non-profits, and grassroots networks also play a role in addressing the aged care crisis. In many cultures, religious and community leaders are trusted facilitators of care. Empowering these groups with funding and frameworks can expand the care ecosystem in every country.
A Global Reckoning
The global population collapse is not just a statistic—it’s a reckoning. Aged care systems must evolve through coordinated international action. Migration offers hope, but not escape. Technology offers support, but not compassion. The path forward must be intentional, ethical, and human.
Countries must collaborate on workforce mobility, invest in training infrastructures, and create care ecosystems that value both caregiver and recipient.
This is the civil rights issue of our aging century: Will we allow our elders to be neglected in the twilight of their lives, or will we stand up and reimagine care as the moral infrastructure of modern society?
As we confront this demographic winter, we must remember: aging is a universal destiny. The systems we build today will be the ones we inherit tomorrow.
Discover how Groworx solves your workforce staffing gaps through International Talent Solutions
JM Agreda, corporate journalist at Groworx Global, crafts sharp, data-rich stories on healthcare staffing, guiding providers through the challenges of hiring and supporting international talent.
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