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Finding Solutions to the Growing Caregiver Crisis

The #60caregiverissues campaign shares research and insights


Part of the Transforming Life as We Age Special Report

We are facing an extraordinary demographic shift that will create new challenges for our society and demand new policy solutions. Each day, 10,000 boomers turn 65 and over the next 30 years, the population of older adults will nearly double — growing from 48 million to 88 million, with the largest percentage increase among those 85 and older. This shift will profoundly impact families all across America.

How will we manage the care and support of our parents, grandparents, aunts and uncles? How will we manage the care of our friends and neighbors who perhaps don’t have children, or at least not in close proximity?

Family Caregivers Facing Financial and Health Issues

About 36 million Americans provide care and support for an aging relative today. Over three quarters of these caregivers work outside the home, while also caring for their loved one. Many have full-time jobs along with children at home. These family caregivers often experience financial stress and health-related problems of their own.

As more Americans face these challenges, we need to create a social infrastructure that will help families manage their caregiving responsibilities. In addition to adopting family-friendly workplace policies — for example, guaranteed paid family leave — we need to ensure that growing numbers of family caregivers can supplement the care they provide with the services of professional home care aides who are compassionate, skilled and reliable.

Low pay, limited training and few advancement opportunities make home care an unattractive career for all but the most dedicated caregivers.

But finding these workers is becoming increasingly difficult.

The Challenge Facing Home-Care Agencies

Home-care agencies report that recruitment of staff is their number one challenge. Home-care aides earn, on average, $10 per hour. But, as one colleague who runs a home-care agency in Philadelphia reports, the local WaWa supermarket pays a starting wage of $16 per hour. It’s not that she doesn’t want to pay her caregivers more; rather, public reimbursements that pay for the services her agency provides haven’t increased in three years.

But it isn’t only agencies that provide publicly-funded services that are having difficulty recruiting and keeping home-care aides.

At a metropolitan Boston private-pay agency, wages start at $14 per hour. But there are no benefits and the work is irregular. An aide’s client might recover from a short-term injury or become too frail to stay at home, but if the agency can’t find a new case that fits the aide’s schedule right away, she is likely to move on to another employer. That means the home-care agency can’t maintain adequate numbers of well-trained, experienced and reliable aides.

These two examples suggest that there are no easy answers to building a stable and skilled home-care workforce that can meet the growing needs of our families and communities. The crisis we expected is upon us: Home care is producing more jobs than any other occupation, but low pay, limited training and few advancement opportunities make this an unattractive career for all but the most dedicated caregivers.

The Coming Caregiver Shortage

By our estimate at PHI (the nation’s leading authority on the direct-care workforce), we will need to fill more than 630,000 home-care jobs over the next decade, but the traditional pool of workers — women between age 25 and 64 — is expected to grow by only 1.9 million. You can bet that a quarter of these new workers are not going to choose physically and emotionally challenging jobs that will leave their families living in poverty.

We need a new employment model for paid caregivers: one that acknowledges their vital role in maintaining the health and well-being of millions of Americans and values them accordingly.

Time for Bold Thinking

PHI has long advocated a “quality care through quality jobs” model, arguing that investing in a stable, robust and well-trained workforce will pay off in lower turnover and more consistent, higher-quality care that our families can rely on. But finding a path to high-quality jobs in an era when governments and families are tightening their belts requires bold thinking to answer a host of complex questions. What is a quality job in the new “gig” (think Uber) economy? How do we make care affordable and assure workers’ incomes are sufficient to support a family? What training do workers need to care for the complex physical, emotional and spiritual needs of older adults who want to age in place? How can home-care workers be better integrated into care teams?

The #60caregiver Issues Campaign

To answer these questions, PHI is launching a campaign called #60caregiverissues, in which we explore the caregiving challenges facing our nation from 60 angles. Over two years, we will be sharing new research, insights and solutions that we hope will help the Trump administration, state policymakers, community leaders, home-care providers and families come together to solve the caregiving challenge.

We hope you will join us for the journey by visiting our website at 60caregiverissues.org and joining the conversation through our social media channels. We can only solve this problem together.

By Jodi M. Sturgeon
Jodi M. Sturgeon is president of PHI, a nonprofit committed to improving quality care for older adults and people with disabilities by creating quality jobs for direct care workers. Sturgeon previously held vice president and chief operating and financial officer roles at PHI and is currently the board treasurer of Cooperative Home Care Associates in the Bronx. She serves on the Board of Directors for Independence Care System in New York and Home Care Associates of Philadelphia.

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