In the places with high fertility rate, you will almost surely observe joint families. I'm from India where we have such demographic variety that you can see adjacent areas with completely different fertility rates. In one, you will see old-style large houses with courtyards and 15+ people in them living as a joint family. Invariably these people have more kids. But in the next town with more nuclear families and modernish apartments, you will be lucky to see 2 kids per family. [1]
This is what births the secondary economic incentives which are mentioned a lot in popular discourse. For example, if you're already living in a house with 15 people your financial realities will require a similar number of people in the next generation to continue the same lifestyle.
[1] Wealth is not a confounding factor here. The specific two areas I have in mind are both more or less equally wealthy, one has folks running a coconut business primarily and the other is a small town with the usual assortment of office jobs.
So … probably most straightforward solution is to update local zoning laws to encourage a more communal style of living. Not communes but more along the lines of suburbs-as-village.
Having a child has a significant impact on your professional career (women in particular). Even in countries with great parental leave, like Denmark, the absence still reduces the years of experience you would otherwise get. Once they are "ready" for a child, they are in their late 30's and barely have time to birth one or two babies and would probably not have the stamina required to take on more.
The social pressure of raising the perfect kid with multiple activities in their "spare" time is much higher today and require more from the parent.
Ideally, people should get children in their early 20's, when they are physically more fit to handle the pressure. Unfortunately the current education system does not combine well with young parents. The government would need to integrate child care in colleges so that the parents have somewhere to place the children while studying.
Well yeah, because it's difficult, taxing, often traumatic work that pays the same as any other nursing job with a higher QoL and social status. And even then they're pushing out all the actual nursing staff that pays well in favor of MAs/CNAs who get paid like shit.
I personally don’t think wages always correspond to how essential a job is, but for the sake of the argument let’s pretend that wages match the necessity of a job, its difficulty, educational requirements, etc.. In this case, I’d expect that we would see people move to jobs that are more essential than their prior job. I think this is more complex that just “poaching”.
I really don't mean to get into the nitty gritty details - I'm not an economist and I'm not providing solutions, just stating what I see as the problem. I believe that we have enough resources, and there are issues getting those resources to where they need to go.
Example: Assume we do have a shortage of elderly care workers. Why is this the case? Could this be fixed by increasing their wages? Then that implores the question of who is paying for these increased wages, which is the question I'm not answering and I don't know enough to answer.
I just don't really believe that keeping the birth rates high is the answer to this economic problem. It might be a solution, but it's more of a band-aid than truly facing the issue. If you have a inefficient engine you can either figure out how to produce more gasoline (babies), or you can figure out how to produce a more efficient engine.
A truthful ad for working in an old folks home in the US would be, "slightly over median wages, but with inflexible and unreliable schedules, rampant industry wide exploitation of workers and their rights, likely multiple ownership changes of your place of business, caring for potentially deranged and violent individuals, high non-refundable monetary investment up-front, no guarantee of residency availability"