If we plan to evolve our care models to focus on embracing those we serve remaining in their environments of their choice, care givers will need to contain different skill sets than those that provide hospital-based care. Knowing this, with the current landscape, our ability as providers and health systems is unfortunately, more complacent than we should be in understanding our home care and assisted living communities.
Currently, home health and personal care aides comprise one of the largest, most rapidly growing groups of health care workers in the United States. And the patients supported by this group require higher-level services within their home that often demands uninterrupted care. Unfortunately, low wages and high turnover continues to plague the depth and breadth of this industry. According to a recent report by the American Society of Aging, “while the homecare and personal assistance industry is adding jobs faster than any other U.S. industry, the problematic quality of homecare jobs—poor wages, inadequate training and lack of supervisory support—undermines our efforts to recruit and retain workers.” Furthermore, the training of health care providers is inconsistent, without regulations, and care worker’s overall satisfaction with their training and role is paltry.
These challenges make it necessary for us to enhance the services we provide as we create not only redesigned services for the home but also the workforce required to carry-out these changes. Recruitment into these fields is problematic, stemming from the lack of societal value as well as the stigma associated with the personal care aide industry. Concurrently, this stigma has meant lower wages and less emphasis on training and education.
An additional barrier of the recruitment process is the public spotlight on our current immigration policy. Immigrants fill a disproportionate share of lower paid health care and direct care worker positions. Not only are a multitude of those that provide these services unsure of their future, but there is also a reduction in the numbers entering the field.
Moreover, there are no federal regulations regarding training for personal care aides. In fact, currently ten states have no requirements at all for these care givers. Additionally, if one finds those willing to work, retention is a serious problem. Studies indicate that the median turnover rate in one year is 67 percent. There are innumerable factors, including subpar supervision, arduous assignments with an ever-increasing acuity, occupational safety, lack of career growth, and, undoubtedly, compensation causing this situation. The current low unemployment rate creates a double whammy, fewer people available, and increased turnover since there is competition for workers.
The key to solving these dilemmas is to understand the value of participants in this field provide. We are entrusting our loved ones in their hands when we can’t be there. Accordingly, we expect them to deliver exceptional care in a setting that is foreign to them. Notwithstanding, elevating our perception is the first step. Then it is essential to commence attacking each item one by one. Payment models for caretakers supporting the aging population (increasing by 30% in the next 20 years) need to improve substantially. Studies support our aging population is happier and healthier if they can remain in the environment of their choice, so let us shift our focus to delivering care outside the four walls of a building and instead train our workers to meet the needs of their patients where they choose. Let us pay them what they deserve and find ways to combat the stigma that surrounds this field, thus allowing us to support the workforce of tomorrow.