A combination of factors is significantly impacting the care America's growing elder population receives . Crucial shortages are looming everywhere. There are shortages of younger workers to support older persons and, according to the Association of American Medical Colleges, by 2025 the United States may face a shortage of 60,000 to almost 100,000 doctors.
At the same time, there is a growing shortage of senior caregivers to provide their vital services to the senior population. The shortage is likely to worsen unless prompt measures are taken.
In Iowa and Arkansas, for example, there are reports that caregiver shortages have caused some nursing homes to stop taking new admissions. Call buttons from patients in some hospitals are going unanswered for prolonged periods. Everyone is affected as family members move into the breach. What is more, the problem is nationwide, not just in some states.
All occupations in health care are projected to grow exponentially in the coming years. People in direct care positions such as home health aides, home care aides, certified nursing assistants, and others are almost guaranteed employment. The question is why people are not flocking to these occupations.
John Hale, who has studied these issues, wrote in the Des Moines Register that the reasons lie in the lack of respect for these occupations and that the treatment afforded to persons in these occupations does not reflect their status as important stakeholders on the care team. Their contributions are devalued, ignored or often not sought out and their compensation does not match the difficult and demanding job they hold. They have few benefits but their jobs involve heavy workloads and some physical and emotional risks. Their hours can be prolonged and sometimes stretch into evenings, overnight and during holidays. Nor is there a clear-cut career path for advancement in the field.
John Hale, who has studied these issues, write in the Des Moines Register that the reasons are simple. These occupations are not respected. These people are not treated as important stakeholders on the care team. Their input is devalued, ignored, or not sought out in the first place. Nor are they compensated fairly for a difficult and demanding job. They have few benefits, yet their jobs involve heavy workloads and some physical and emotional risks. The hours can be prolonged and may stretch into evenings, overnight, and over holidays. There is no clear-cut career path for advancement in the field either.
This is why, Hale says, there is not only a shortage of workers entering the field, but many of those in the field are leaving it. Nearly half of all direct care workers abandon the field each year. Elderly persons, who benefit from having familiar caregivers attend them, sometimes experience dozens of caregiver changes during one year.
What happens when paid caregivers are unavailable? Families usually move to fill the void, assuming the extra burden as they cannot and will not leave their elderly loved ones to fend for themselves.
Yet studies show that most family caregivers also have to work. A MetLife study showed that 73% of family caregivers have outside jobs. Some are still raising their own families. They tend to become exhausted, have stress-related problems and experience bouts of depression. They tend to miss work, are tardy and often have to shorten their work hours. They suffer physically from stress- and lifestyle-related diseases, such as high blood pressure, diabetes, high cholesterol ratios, and pulmonary disease. They often neglect their own health and the means they use to fend off stress, such as smoking, drinking, and overeating, worsen their health. Because their schedules are so full, they have little time for exercise, fresh air or self-care.
John Hale takes aim at some solutions by suggesting that providing direct care workers more respect, a voice in care plans, a living wage, and an upward and clear career ladder would encourage people to enter and stay in the field.
Family caregivers could also use more workplace support. The MetLife study showed that employers do not lose by increasing benefits and programs for caregivers. In fact, the study also found that expenses are more than offset by increases in employee productivity and less work time lost. Stressed and over-stretched caregiving employees cause employer healthcare costs to rise, sometimes significantly.
The shortage of caregivers is real but not insoluble. Society would probably be well served by directing more attention, care, and pay to senior caregivers.
Association of American Medical Colleges. GME Funding: How to Fix the Doctor Shortage. (September 27, 2016). Available online at https://www.aamc.org/advocacy/campaigns_and_coalitions/fixdocshortage/. Last visited January 17, 2017).
Gardenhire, Katlyn. (January 12, 2017). Caregiver Shortage in Arkansas, Due to Underfunding, Applicants. Available online at http://www.thv11.com/news/local/caregiver-shortage-in-ark-due-to-underfunding-applicants/385696457. Last visited January 17, 2017.
Hale, John. (January 12, 2017). Caregiver Shortage Demands Focus on Solutions, not Status Quo. The Des Moines Register. Available online at http://www.desmoinesregister.com/story/opinion/abetteriowa/2017/01/12/caregiver-shortage-demands-focus-solutions-not-status-quo/96495782/. Last visited January 17, 2017.
Hale, John. (December 8, 2016). Paid Caregiver Shortages Will Affect Everyone. The Des Moines Register. Available online at: http://www.desmoinesregister.com/story/opinion/abetteriowa/2016/12/08/paid-caregiver-shortages-impact-everyone/94764864/. Last visited January 17, 2017.
MetLife Mature Market Institute, National Alliance for Caregiving, and University of Pittsburgh Institute on Aging. (February 2010). The MetLife Study of Working Caregivers and Employer Health Care Costs. Available at https://www.metlife.com/assets/cao/mmi/publications/studies/2010/mmi-working-caregivers-employers-health-care-costs.pdf. Last visited January 17, 2017