Came upon this excellent review article on the problems we are facing with caregivers. It offered a good description of the current market for caregiving, plus its historical roots of the problems. I was naive to think that recruiting caregivers is not much different from recruiting anyone else in any industry or business. There is a bigger crisis of finding caregivers these days, not something that individual entity can solve by outsmart the competitors.
First of all, the article was right that seniors face cliffs of deteriorated health when they age. “As someone ages, their health appears to gradually deteriorate in a way that doesn’t seem alarming. Most of the time, though, they’re inching toward a cliff — and when they fall off, they find themselves on another health cliff, and another, and another. With each cliff, it gets more difficult for a family member to catch them.”
Secondly, in home care is still the cheapest option. As “the median yearly cost of in-home care with a home health aide in 2020 was $54,912, and the median cost for a private room in a nursing home was $105,850.”
Thirdly, I learned that the problem with Medicaid — the only governmental program offering long term care — is not just losing grace or dignity by not being allowed to have more than $2,000 in asset in order to qualify, but currently you have to wait for years. “Even if you qualify, the waiting list for home care assistance for those with Medicaid tops 800,000 people and has an average wait time of more than three years.“
At the end of day, in home care is “almost always what the care recipient wants, especially if it means the ability to stay in their own home.” It is called “aging in place.”
Fourthly, taking care of humans is never easy, especially with seniors: “The feeling was not dissimilar from caring for a baby, only babies get older and their care gets easier. The opposite is true for elder care.”
Fifthly, the personal story that the report covered about an adult child named Laura had to see her parents died four months apart, and “Laura found herself with a decimated retirement account, no other savings, and no income.” Apparently, her case was a bad one without final expense covered.
Sixthly, Laura was not alone. “According to the most recent data from the AARP, an estimated 41.8 million people, or 16.8 percent of the population, currently provides care for an adult over 50. That’s up from 34.2 million (14.3 percent) in 2015.” What’s the financial situation of these family caregivers? Not good. “Of those caregivers, 28 percent have stopped saving, 23 percent have taken on more debt, 22 percent have used up their personal short-term savings, and 11 percent reported being unable to cover basic needs, including food.”
A quick demographic picture: “The average age of someone providing care for an adult is 49, but 23 percent are millennials and 6 percent are Gen Z. Sixty-one percent are women, and 40 percent provide that care within their own homes, up from 34 percent in 2015.”
The dark picture does not stop there. Among the family caregivers, “only three in 10 have additional paid help, and 27 percent struggle to hire affordable care in their area. One in four caregivers find it difficult to take care of their own health, and the same percentage report that their health has deteriorated because of caregiving.”
On top of these, the society has an appreciation problem. “So much of the labor — and struggle — associated with caregiving goes unnoticed, unappreciated, and underdiscussed.” Demography has something to do with the low appreciation, because “family caregiving is largely performed by women in the home and thus discounted as labor; when it is paid, it’s almost entirely performed by women of color, particularly immigrant women, and socially devalued.”
Now look at the waged caregivers, and the situation is not much better. “In most states, they have close to no labor protections for incredibly physically taxing work. Most barely earn enough to provide for their own families, let alone save for retirement.”
The smartest words from the article are those highlighted here: “If you haven’t faced figuring out care for yourself or a loved one, you might think this isn’t your problem. It likely will be at some point, but even if it isn’t, it still matters. When one pillar of society is broken, the rest of the pillars are asked to bear even more weight.” How true it is.
What are the ways out? The article lists three: Federal investments, universal and mandatory LTC insurance and a face lifting of the caregivers’ job.
“The most straightforward fix, according to Caroline Pearson, the elder care expert from NORC, is to invest federal dollars in creating an actually useful program for those navigating elder care.”
“Much harder — but more important, and what we should start advocating for — is a comprehensive program for long-term care, which starts with making long-term care insurance universal, mandatory, and at least partially funded through a payroll tax.”
“At the same time, we need to make home health care a “good American job,” with the corresponding ability to unionize and bargain for worker’s comp, health benefits, and higher pay — which will then attract more workers, reduce turnover, and reduce subsequent stress on family caregivers.”
My overall thinking after reading the article is that we need urgent acts to change the status quo. I also feel my home care organization can make a difference by hiring young, smart, energetic, caring and dedicated caregivers to change the landscape of LTC for the upper middle class families in the East Bay!