What does this question even mean? There isn't a 1:1 ratio of nursing aids to nursing home residents.

>But millennials are having even fewer kids.

Thanks to the world the Baby Boomers helped create. Real wages have flatlined, careers being sold as more meaningful than families, and horrible maternity and paternity laws. Meanwhile, the wealth that a responsible couple generates is subsidizing the unemployed person who is on their fourth child. We basically live in a society that has inverted natural selection. That includes flooding the first world with people from the third world and pretending that we're all interchangeable and that the social conflicts created by multiculturalism aren't real.