What the Home Caregiver Shortage Means for Seniors and Disabled

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As the population of Americans over the age of 85 grows dramatically, so too has the need for home caregivers. By the year 2026, demand for home caregivers will grow by another million. This is an alarming prediction, because there is already a serious shortage, which is making it very difficult for seniors and people with disabilities to find the assistance they need. Many overall healthy people have resorted to living in nursing homes and other institutions simply so that they can receive basic help with daily tasks. What the Home Caregiver Shortage Means for Seniors and Disabled

Causes of the Home Caregiver Shortage

Although it is a quickly growing profession, there are still not nearly enough people interested in working as caregivers in order to keep up with the demand. Caretaking jobs tend not to pay very well; currently, the average home caregiver is paid only $10.99/hour. This is similar to what employees in retail or food service earn. Additionally, caregivers often have inconsistent schedules, part-time work only, poor benefits, and few opportunities for advancement (1).
Moreover, the job comes with a lot of responsibility, and mistakes can result in serious injury, police investigations, and other issues.
Strict immigration policies may also affect the caregiver shortage, as roughly one quarter of caretakers are immigrants.
With all of these factors combined, it is not exactly shocking that home care agencies experience an annual turnover rate of 60% (1).

Impact of Caregiver Shortage on Individuals and Families

The Columbus Dispatch recently interviewed a woman named Kenna Robinett, who is the guardian for her twin nephews, who are both on the autism spectrum. She was able to find home caregivers for her nephews, but they were far from reliable. The caregivers served her nephews frozen hot pockets (unheated), microwaved bread sticks until they were burnt to a crisp, and stored ice cream in a cabinet drawer. On one occasion, the boys’ school called because one of them had arrived with feces on his hands. Another day, Robinett received a message saying that there would be no one available to care for her nephews as of 3p.m. that same day, because the agency was shutting down.
In addition to causing the inconvenience of rapidly finding a replacement, caregiver turnover can be emotionally traumatic. “This is deeply personal, intimate care,” Patty Lyons told The Columbus Dispatch, discussing her 15-year-old daughter, who has several disabilities and health conditions. “She has a G-tube (which delivers food to the stomach), takes 13 different medications. Essentially, she’s nonverbal. She has to be left alone with a provider while I’m at work.”
Lyons’ daughter, Adriana, previously had a private-duty nurse. Then Medicaid policies changed and she was declared ineligible for nursing services, under the assumption that a less expensive care provider could meet her requirements. However, it took Lyons months to find someone who could appropriately care for Adriana(2).

Caregiver Shortage Causes Unnecessary Institutionalization

Although staying in an assisted living center or nursing home is a viable option for some, seniors increasingly prefer to age at home (3). For those with the financial means, this can work very well; 102 year old Leroy Neuberg told the Radio program Bostonomixthat he credits his longevity to his dedicated and qualified home caregiver (4). However, many seniors who are healthy enough to live at home with some assistance are unable to do so due to the lack of available caregivers. People with disabilities have the same issue –even those who are very young.
25-year-old Korrie Johnson has cerebral palsy and limited mobility, but is overall healthy and mentally fit. Her mother used to help her with daily tasks, but is now unable to do so because she was injured in a serious car crash. Johnson had no other choice but to move into a nursing home in order to receive basic assistance.
“This is no place for someone my age,” she told the Star Tribune. Most of the other residents have dementia and other debilitating conditions.
Johnson is far from the only disabled person living in an institution and wishing to be free. In her home state of Minnesota, approximately 1,500 people under age 65 live in nursing homes. With a bit of help, many of them would likely be able to live at home and lead productive lives.

Solving the Home Caregiver Crisis

Advocates argue that unnecessary institutionalization, such as what Johnson is experiencing, violates civil rights. The Supreme Court “Olmstead” ruling (1999) mandates that states provide their residents with care in the most integrated environment possible.
Even from an economic perspective, home care makes sense. It tends to cost taxpayers less than nursing home care (5).
A critical component of fixing the caregiver shortage is making home caretaking a better profession. Worker cooperatives may help improve conditions for home caregivers, as well as provide training opportunities. Additionally, changes to Medicaid rules could provide caregivers with increased pay and benefits, more stability, and room for advancement (1).
As a society, we must recognize the importance of this profession, and treat home caregivers with the respect they deserve.
Sources

Forbes– The Shortage of Home Care Workers: Worse Than You Think
The Columbus Dispatch– Crisis in care: Lack of quality caregivers, constant turnover tough on disabled, families
The Chicago Tribune– ‘Crisis mode’: As boomers age, a shortage of caregivers
Bostonomix– Demand For Senior Home Care Grows, But Its Pay Remains Low
Star Tribune– Shortage of home health workers forcing young Minnesotans with disabilities into institutions

This guest blog post was contributed by Reiter & Walsh ABC Law Centers.