Who Will Care for YOU?

As a social worker for a company providing community based home care services, I see firsthand the needs of the elderly who want to remain living as independently as possible in their own homes and apartments. Their needs often include routine weekly housekeeping, meal prep or home delivered meals, assistance with laundry, transportation for errands and shopping, or just plain old companionship because of isolation when they can no longer drive. As they continue to age, many into their 80’s and 90’s and beyond, their needs typically increase to include assistance with bathing, dressing, grooming, medication management, toileting and management of chronic disease processes.
Anytime we can do something to enable a person to remain in their own home, we are rewarded tenfold by their gratefulness. People are happier in their own homes and it is well documented that institutional care is much more costly.
The task of keeping people at home, however, as well as providing care in institutions such as skilled nursing and assisted living facilities, is becoming more and more challenging as the number of those needing assistance explodes (baby boomers aging), and the labor pool shrinks. According to the Department of Labor, economists expect about a million more health care workers such as home health aides (HHA’s), personal care attendants (PCA’s), and certified nursing assistants (CNA’s) will be added up to 2024. These positions are expected to be among the nation’s fastest growing occupations.
The home care industry in the metropolitan area of Minnesota is already feeling the pinch from a shortage of workers. County and insurance case managers are frustrated finding it difficult to well near impossible to find the services their clients need.
While the smaller labor pool and the increasingly higher demand for services are reasons for the shortage of workers, another huge contributing factor is that the reimbursement rate from the government to agencies providing services for low income seniors (many living on social security alone after having worked their entire lives) is so low that many companies cannot afford to pay their workers a decent hourly wage and operate a financially viable business. Most people who own or operate these companies are anything but greedy. Government rates have not kept up with inflation. More and more providers of homecare for seniors are choosing to provide services to private pay clients only because then they can incur a decent profit margin which is simply not possible when providing services to low income seniors who, many times, desperately need the services. And while homecare work is rewarding, it is also a huge responsibility to be involved in the care of a real live human being. Many choose to work at McDonald’s instead with better pay and less responsibility.
Better trained and higher paid workers would not only ensure that more people can get the services they need, but would also improve the management of chronic diseases and the overall health of our elderly therefore allowing them to remain at home longer, out of hospitals and other institutions which are obviously more expensive. Investing in our workforce with better wages, better training and acknowledgment of the importance of this kind of work would seem to me to be beneficial and more cost effective in the long run. Higher reimbursement rates to those providing services to low income seniors is absolutely necessary. Furthermore, if we don’t find a way to value the care of the elderly in our society and show that value with better pay and benefits, we will lose more and more workers to other jobs. I’m not knocking McDonald’s, but surely our elderly are more important than fast food? And surely, as well, people doing this important work should be paid a living wage.
It’s time to have some discussions with your legislators about this important topic. You may well be one of those needing care in the future. Who will care for you?

Julie Ellingson, LSW


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