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After the pandemic many seniors have opted to stay in their homes and remain independent.  The cost of assisted living and nursing home care has become out-of-reach for many.  Families willingly search for alternative living placements only when a physician determines their elders cannot live alone, or a catastrophic health issue occurs.  Families have instead opted for in-home care for aging parents who wish to remain living independently in their own homes. 

A recent NPR article discussed home-based worker issues.  The article offers little hope and raises more concerns for people hoping to remain independent and in their homes. It is a consequence of the fact that in-home care workers are in short supply after the Covid pandemic and seniors could wait months for in-home care. 

People hoping to remain independent sometimes have issues which include having trouble walking or standing for longer periods of time making it difficult to clean the house or cook a meal. When seniors stop driving, they become dependent upon family or neighbors to help buy groceries or go to a doctor’s visit.  Some home-based senior programs offer an in-home personal aide to assist with household chores or errands several hours a week.  Program help, however, is often unavailable or inconsistent due to high turnover and fewer people willing to be in-home workers.  Some state programs have months long waitlists.  The risks for seniors to fall or not get medical care increases exponentially in this environment.

Katie Smith Sloan, CEO of Leading Age, which represents nonprofit aging services providers, says the workforce shortage is a nationwide dilemma. “Millions of older adults are unable to access the affordable care and services that they so desperately need.” She went on to say, “It is no secret that state and federal reimbursement rates to elder care agencies are inadequate to cover the cost of quality care and services, or to pay a living wage to caregivers.”

As baby boomers hit their senior years the need for people trained in senior care has become dire.  Low wages and benefits, heavy workloads, and difficult working conditions make recruiting and retaining in-home care workers, nurse assistants and front-line workers a major problem.   Home health agencies are competing with jobs that don’t require a background check, special training or driving to people’s homes in bad weather.  The root of the problem with home-based worker issues is these jobs are more challenging and less appealing to job seekers.  

One of the major issues for home-based care issues is setting wages.  Most of these home care jobs pay between $13 and $15 an hour, which is comparable to McDonald’s.   Many home-based agencies struggle to recruit and retain staff.  Agencies allow help to set their own schedules, offer paid training and vacation pay.  The main concern is that many elderly people are not getting the care they need.  People want to remain at home.

In addition to adequate wages, home-based care issues include finding qualified people to care for people with physical disabilities, dementia, and depression.  It is difficult work.  The industry leaders complain that these programs will work if money is targeted to training, recruiting, and retaining workers as well as providing benefits and opportunities for career growth.   Looking at this problem from a different perspective, if you put $32 million into a hospital, you get a boiler room upgrade.  But if you put $32 million into home-based care for the elderly you will get 70,000 visits a year.

Additionally, there is movement toward providing hospital-level care in-home such as IV infusions to limit the duration of hospital stays. The issues of adequate wages, training and people willing to do the work must be addressed before developing an advanced service continuum.  The industry mindset needs to focus on what is necessary for seniors to remain at home and helping families make the best choices before the situation becomes catastrophic.

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