Shortage of home-care workers in US, Arizona called a ‘growing crisis’
In
These crucial home-care workers in
The jobs can be difficult as many elderly patients suffer from illnesses or cognitive impairments, and the pay often tends to be around minimum wage, with no employee benefits. Employee turnover is generally high.
Clinco, a registered nurse who founded the home-care agency in 1981 when her mother needed support to remain in her home, said, "Families have not had discussions about what is needed now and in the future for their parents, and where it will be provided as they age." Discussions about costs and what families can afford also must take place, she said.
In many families, adult children usually take care of their aging parents. But there are families who cannot because of their jobs or they live out of state or they need help because of their parents' declining health. Then there are seniors who never had children or married.
That's where the home-care worker comes to fill those needs. Their work is vital to senior citizens who want to remain in their homes as long as possible.
As the home-care industry, communities and government officials grapple with these facts, they also have to face the fact that the turnover rate of employees in the industry is high and must be remedied as Americans live longer and 10,000 baby boomers will be turning 65 each day until 2030.
Among the main reasons home-care workers leave their jobs is low pay, part-time hours, shifting schedules and lack of benefits, industry experts say.
"Born to be a caregiver"
Sabah Bouhamouda, a native of
"I just love my job. It is nice to feel that you are helping others," said Bouhamouda, 46. "I feel like I was born to be a caregiver."
She said she works with three clients ranging in age from their 80s to 100.
"I help them with personal care such as bathing, dressing, preparing their food, laundry and cleaning. I work nights and stay in their homes," she said.
Bouhamouda said it takes a special person to be a caregiver.
"You have to care about people and be very, very patient. It can be difficult when they are sick and don't feel good, or have dementia or Alzheimer's," she said. "You are a stranger in their home and they may be mean to you, but it is the disease. You can't take it personal. You have to make them feel safe and build trust."
She praised Catalina In-Home Services for refresher courses and training every six months to teach workers the latest methods and techniques in helping clients.
Bouhamouda said she earns
"They treat workers with respect, give us support during our work shifts when we need it," she said, explaining that she has access to a nurse if a client becomes sick. "We get briefed about each client before we decide if we want to work with them or not."
Another agency she previously worked for paid her
For
Most of her clients were 65 to nearly 90 years old. Some had strokes and others were doing relatively well. Some remained in their homes while their spouses had to be placed in an assisted living facility.
It was Merino's nature to want to nurture and help people by doing the "little things that we all take for granted," like being able to bathe, groom, cook and clean.
"I enjoyed going into their homes and accomplishing tasks they weren't able to do. I liked spending time with them and getting to know about their lives," she said.
However, Merino found it difficult when her clients died.
"I was attached to them and it was super hard for me to let go," she recalled.
She also agreed with Bouhamouda that pay and benefits have to improve to attract and retain workers.
Merino, 36, now works as a part-time driver delivering food, earning
"I treated my patients like I would treat my mom. It is a lot of work. You are dealing with human beings, not car parts," said Browne.
"Some can be crabby. But they are aching and they can't do for themselves like they used to. They are lonely and their friends have died," she said about her days in the nursing home.
To earn more money, on weekends she traveled to
When she returned to
"I remained in the medical field working with the sick because I saw this as a calling. I wanted to help people. I worked on patients pulling out needles and putting in catheters," Browne said.
"I was slugged by a patient and passed out. I was bitten by a patient and I had to undergo an exam to make sure I did not have HIV. That scared me. I was very lucky.
"I comforted families who were scared. I talked to a woman in the parking lot who was crying in her car. There is an emotional toll."
One day, Browne said she found out a young man working at a
"Although you may love your job very much, workers have to get paid more than the guy at the
Tight labor market
By 2026 in
"These occupations have low barriers to entry and offer wages that are similar to those in home care, so competition for workers will continue to be tight," said Campbell.
Also, there are some exemptions in state law that require businesses to provide workers with paid sick time.
Some agencies provide some level of health care coverage, said Clark, "unfortunately, like all employer-sponsored health care, all have co-pays and deductibles, which can make it hard for employees to make use of it."
He also said businesses only have to provide health benefits for employees who work more than 30 hours a week, and many home-care workers are hired as part-timers.
Getting high school students interested in home-care careers through the Pima JTED Career and
"At the end of the day, it comes down to costs and revenue," said Clark. Agencies are funded by the state and "we turn around and pay the providers," he said, explaining that the council on aging owns PimaCare at Home, the only home-care provider in the county whose workers are represented by a union.
The agency was launched in
As Americans live longer, about 17 percent of adult children care for their parents at some point in their lives, and the likelihood of doing so rises with age, according to a study by research economists
By 2035, for the first time in
Initially, the family caregiver may be able to provide the care for their loved one, but as the person declines in health they will need more assistance, said Clinco. If a person is low-income, they may qualify for the Arizona Long Term Care System under the Arizona Health Care Cost Containtment System for fixed-income seniors and those with disabilities.
If qualified, a family can get care paid for by the state provided a company or a family caregiver is trained by a state-contracted agency. Such caregivers must meet certain standards, including continuing education, submit to a background and fingerprints check, and undergo a state review for compliance.
However, home-care companies are not licensed by
Many families cannot afford to pay an agency for a professional caregiver, said Clinco, explaining that not all seniors have purchased or qualify for a long-term-care policy from a private insurer.
In the
Many families have to turn to neighbors or people they know or are recommended to them to care for their loved ones, Clinco said.
Others take to the internet and look for help through online classified employment ads.
This so-called "gray market" worries Clinco, because a stranger with no training or background checks enters a home to care for a vulnerable person and there is a greater potential for abuse and neglect.
Clinco, an advocate for clients and caregivers, founded a training institute in 2001 for caregivers working in home care, assisted living facilities and nursing homes.
"The client needs skill, compassion and reliability, and caregivers need to be valued, appreciated, receive higher wages and continued training," said Clinco, adding that more than 3,000 certified nursing assistants have gone through the institute.
"In
"The worse thing that can happen to a dog is a bad hair day," Clinco said. "The worse that can happen for an elderly, vulnerable person is death."
"As baby boomers age, they will see the writing on the wall, and their voices can rise to make demands on some federal government subsidy to provide for home-care services," said Clinco.
"We cannot afford to ignore long-term-care issues," said Anna Maria Chávez, the
"The nation is ill-prepared to address the growing crisis and lacks a coordinated, national public-private system for adequately and efficiently delivering high quality long-term supports and services."
The national agency has worked on educating politicians and communities about this issue over the years, said Chavez.
She said the council supports a bipartisan effort to establish a national long-term-care insurance financing system that would be fully paid for and increases affordable options for working Americans.
The insurance would not exclude buyers because of pre-existing health conditions. Among benefits the financing system would create are market opportunities for private insurance and significant savings to the Medicaid system, according to a brief from the council.
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