This blog has been sending up an alert about our country’s looming long-term care crisis for the past two years. In our book, The Aging Tidal Wave, we warned that the country’s finances, facilities, and aged care personnel were about to be overwhelmed by the rapidly aging baby boomer generation.

Tsunami

The crisis is no longer looming - but is now active. Every day 10,000 baby boomers turn 65. Between 2015 and 2050 the adult population over the age of 65 will grow from about 48 million to 88 million. Adults over 85, and in need of the most care, will triple in number from just over 6 million to 19 million. How are we responding to this tidal wave as it rolls ashore? Who is going to care for the country’s largest generation as it ages? Are we recruiting, training, and compensating sufficient personnel?

First Responders

The answer is a resounding – NO! The home care workforce is not only largely ignored but tragically neglected. Here are the current facts:

• Immigrants make up nearly 30% of the home care workforce
• 90% are women.
• The majority are women of color.
• The average income of home care workers is $17,000.
• The average income of elder care workers is only $13,000.
• Home care workers are not included in the Fair Labor Standards Act which guarantees minimum wage, overtime, and sick and vacation pay.
• 75% of nursing home and home health care is paid for through Medicaid and Medicare and reimbursement rates have not increased for several years. This eliminates the normal market forces that would allow wages to rise to competitive rates.
• There is no opportunity for advancement in home health care.
• Home health care workers have an on-the-job injury rate three times higher than the average US worker.

These conditions have already led to a serious shortage of home health care workers that very soon will become a full-blown crisis. At the same time, our current political establishment is ignoring this crisis while it pursues a different agenda.

• The latest immigration proposal from the GOP, the Reforming American Immigration for Strong Employment (RAISE)Act, would reduce the flow of legal immigrants by about half. Moreover, it shifts priorities in terms of who will be welcome in the US. According to a recent story in Nonprofit Quarterly, the RAISE Act “gives wealthy, highly educated, English-speaking applicants priority over the humble working class who are simply seeking to reunite with family already here in the U.S. (called chain migration).
• And Medicaid is facing steep cuts, putting increased pressure on states to reduce costs for long-term services.

Too Late

Therefore, rather than addressing the looming long-term care employment crises, we seem to be going in the opposite direction. It appears that the political establishment will not concern itself with this crisis until it becomes front-page news. Then it will be too late.

If you'd like to read other blog articles on this topic - you can find them here.