I feel very fortunate to be living in my home of 31 years with my dogs. I still love working in my yard, setting up a new garden and even doing minor maintenance on outside furniture. My yard is very large so the gardener takes care of the major things but taking care of my plants is a big part of every spring and summer. I do have help with pool and house cleaning but as of now I can handle the rest.
Could my situation change? Could an illness or fall cause me to need care to accomplish my activities of daily living like dressing, eating, transferring and bathing? I belong to Conejo Valley Village (part of the Village to Village Network) and our wonderful volunteers could help me with transportation and minor household maintenance. They cannot however perform any personal services such as bathing and/or dressing. So what options would I have to allow me to remain in my home and maintain the care level I need?
When I grew up, there were always extended family members nearby to help. Few women worked and families were not geographically divided like they are now. Having a family caregiver is not an option that would work for me or for most seniors I know.
Many families want to try to care for a parent or spouse while continuing with their own work and family responsibilities. I can personally attest to the physical and mental stress this brings with it. When caregiver stress becomes too difficult, most families have to seek outside help.
My next option would be to hire a home care worker, which sounds simple enough, but is it? The need for home care workers is anticipated to grow dramatically in the future with 7.8 million job openings in 2026. Government labor projections rank home care as one of the fastest growing occupations.
The following sheds light on the growing need for direct care workers:
- Seventy-five percent of Americans over 65 live with multiple chronic conditions from diabetes to dementia (CNBC April 2019).
- Our already strained health care system aims to keep seniors at home rather than in hospitals, RCFE’s or SNF’s (CNBC April 2019).
- The US spent an estimated $103 billion on home healthcare last year and according to the Centers of Medicare and Medicaid Services that expenditure will reach $173 billion by 2026 (CNBC April 2019).
- Ten thousand baby boomers turn 65 every day (CNBC April 2019)
- Our aging population is expected to double in the next 20 years and grow to 88 million in 2050.
- The number of Americans 85 and older is projected to more than double going from 1.08 percent of the population to 4.5 percent in 2050 (Forbes 2018).
- CDC reports that 5 million (1.6 percent) Americans had Alzheimer’s and related dementias in 2014; it is projected to rise to 13.9 million (3.3 percent) in 2060.
The projected increase in seniors who may need help to stay home makes it is clear why the need for home health care workers will increase dramatically in the next years and decades.
Many experts in the field fear there will not be enough home care workers to fill the positions. This increase is attributed to low wages, inconsistent work schedules, lack of benefits, low prospects of advancement and hard physical aspects of the work which result in on the job injuries. Only one-third of home care workers are full time employees and part time employees very rarely receive benefits.
Forbes Magazine says home care workers are being hired away by big box retailers, fast food restaurants, online retailers and other businesses paying high wages. They report that the median wage for home health workers is $10.60 an hour per the US Board of Labor Statistics. Howard Gleckman of the Urban Institute and an expert in long term care says this is two thirds of the hourly rate of a veterinarian technician. He says we “pay people $5-hour-more to care for our cats than our mothers.”
Forbes also reports that turnover rates at home health care agencies are around 60 percent. Home health care agencies in Massachusetts report hiring 18 people every three months but losing 15.
The impending care giver shortage is recognized as one of our society’s most pressing health care problems. Several states including California are working on programs to improve the prospects in this field. The Public Policy Institute of California reports that California’s over 65 population is expected to almost double by 2040 and that 1 million seniors will require some assistance with self-care by 2030.
California is considering a plan to build up the next generation of long term care providers creating a trained Care Corps to be modeled after AmeriCorp. It would recruit high school and college graduates to spend a year providing non medical care to seniors with cognitive issues. The members would receive a monthly stipend and an education grant and family caregivers would be given some respite.
We cannot individually solve this problem but it is important to be aware of and to keep apprised of developments in the field if you or a loved one may need home care in the future.
Most people working in long term care agree that better compensation, benefits, training and advancement potential will be a start to solving the issue of caregiver shortages. There is also agreement that these very important jobs need to be held in higher esteem than they are now in order to recruit well-qualified, motivated employees.
Note: There are courses now in almost every community through Adult Education to train caregivers. This is one example in the Conejo Valley where they offer 7 week training sessions to become a “certified caregiver.”