Frontline workers in long-term care already have it plenty tough. But the worst may be yet to come, if one predicted scenario plays out.

A Brookings Institution report looking at how things will be in 2050 paints a fairly bleak picture for many of those who literally do the heavy lifting.

First, the big picture, as seen by Harry J. Holzer, the paper’s author: Labor supply will be constrained by slower population growth and reduced labor force participation. We will also see a more diverse labor force catalyzed by immigration and fertility trends. (I’ll take “fertility trends” to mean immigrant families will produce more children.)

As for how skilled care facilities and other firms will react to these and other changes, he lays out several likely results:

  • Operators will adopt “alternative staffing arrangements.” That’s a nice way of saying many of today’s employees will likely be tomorrow’s subcontractors.
  • Operators will increasingly outsource their human relations departments. Got a problem? Call the 800 number.
  • Automation, in the form of robots and robotics, will probably reduce the need for hired hands.
  • Perhaps most ominous of all is a prediction that operators will take “low road” employment practices to minimize expenses.

In “Leviathan,” author Thomas Hobbes noted that without proper government, life becomes “nasty, brutish and short.” Is that the sort of existence those at or near the bottom can look forward to? Not sure about the short part, but nasty and brutish would appear to be in play.

As Holzer sees it, non-college workers will clearly fare the worst in this new world order.

But he does offer a few recommendations to make the predicted changes less jarring. For example, he suggests policymakers incentivize firms to train employees, rather than replace them.

He also says it would be a good idea for schools and colleges to teach skills that are flexible and transferable, as the need to adapt will only quicken.

He also predicts that eased immigration rules and retirement policy might help minimize future staffing shortages.

One thing that struck me about the report: It may be a forecast for 2050, but some of its troubling predictions are hardly decades away.

John O’Connor is McKnight’s Editorial Director.