The in-home care industry has been anticipated to be the largest job creator between 2012 and 2022, with an estimated 1 million new caregivers required during that time. Now some are questioning whether there will be enough people willing to fill those positions and that need.
Elizabeth drives 100 miles a day, to several different locations all over town. She cares for Mary, Donny, and Steve, and then typically has a meeting at her workplace. She doesn’t get a gas allowance or mileage, or benefits (she works hourly). She loves her clients, but is so tired when she gets home that she cannot spend enough time with her boyfriend, or do the things she loves, such as reading and cooking nice dinners. She is 29 years old and she is drained. She is a home health aide, and she is beginning to think she should quit.
Mark, on the other hand, is also stressed. He doesn’t travel quite as much as Elizabeth, because his company doesn’t give him enough hours. He gets no health insurance, and can hardly afford to support his family. His back hurts from lifting patients. He is considering leaving the profession altogether and going back to school.
Elizabeth and Mark are not alone. Based on a national survey of home health and hospice aides published in March 2016 by the Journal of the Gerentological Society of America, having too few work hours or injuries, low pay and lack of benefits, and experiencing burnout, were all associated with a desire to leave the profession.
To assess the current situation regarding home health care workers, surveyors used data from the National Home and Hospice Care Survey in 2007, a sample of more than 1,000 Medicare and/or Medicaid certified home health and hospice agencies and more than 3,300 aides working for those agencies. In phone surveys, the participants answered questions on job satisfaction, stressors, and demands, intent to leave the job, and compensation, among other factors. These are some of the findings:
- About one quarter of workers said they were very likely to leave their job in the next year or were currently looking for a different job.
- More than 80% said they were assigned to the same patients each week and
- 13% said they had suffered an injury on the job in the past year. Most injuries are back injuries and other strains that come from lifting.
- In-home care providers working for for-profit agencies are twice as likely to leave their job as those working for non-profit organizations.
- Preventing on-the-job injuries and providing enough work to those who want it are good first steps to retain valuable home health care aides.
- Higher job satisfaction and feeling valued by the organization often meant less intent to leave the job, as did employer-provided health insurance, but hourly wages did not correlate with intent to leave.
According to study coauthor, Natasha S. Bryant of the LeadingAge Center for Applied Research in Washington, D.C., “It can be difficult to attract and retain high quality home health aides due to low wages, inadequate training, physical and demanding work, and schedules that are often part time and unpredictable.” She suggested that aides need education and ongoing support as well as advancement opportunities to help them grow professionally and earn better wages. She also recommended that families respect the boundaries and the scope of the aide’s responsibilities and learn how to communicate with workers and to treat them with respect and dignity.
Sandra Butler of the School of Social Work at the University of Maine, agrees with Bryant. She adds, “The work is not suited to everyone, but many who do it really love it, but find the conditions sometimes force them to leave the jobs they love.”
The Desire to Age-in-Place versus the Lack of Assistance
In the coming decades, increasing life expectancy, a declining birth rate, and the aging of the baby boom generation will dramatically increase the number and proportion of the U.S. population over the age of 65. This aging of the population presents a number of challenges and unanswered questions, including where people will live and how they will obtain the support and care they will need as they age, while retaining as much independence as possible.
Most older adults have a strong desire to live in their own homes and communities. In an AARP survey, nearly 90% of people over age 65 indicate they want to stay in their home as long as possible, and four of five in that age bracket believe their current home is where they will always live. Unfortunately, a shortage of home health aides, and other factors such as unaffordable and inaccessible housing, and a lack of access to needed services can thwart this desire.
What Are Some Other Options?
As you can see, as much as most of us would like to age in place, it isn’t always possible, and you should therefore plan for contingencies. Research shows that 70% of the population will need long-term care in the future. With an average cost of a nursing home in Metro DC is $10,000-$14,000 a month—an amount that can be devastating to most families—it is definitely prudent to plan ahead. The Living Trust PlusTM maintains much of the flexibility of a Revocable Living Trust, but protects your assets from the expenses and difficulties of probate PLUS the expenses of long-term care while you’re alive, PLUS lawsuits and a multitude of other financial risks during your lifetime. Read more on our website.
Life Care Planning and Medicaid Asset Protection is the process of protecting your assets from having to be spent down in connection with entry into a nursing home, while also helping ensure that you or your loved one get the best possible care and maintain the highest possible quality of life, whether at home, in an assisted living facility, or in a nursing home. Call one of our offices to make an appointment for an initial consultation:
Fairfax Elder Law: 703-691-1888
Fredericksburg Elder Law: 540-479-1435
Rockville Elder Law: 301- 519-8041
DC Elder Law: 202-587-2797
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About Evan H Farr, CELA, CAP
