The Current Challenges for Senior Home Care

Many people would agree with LeadingAge President and CEO Katie Smith Sloan that “Policymakers and government officials have long undervalued and under-invested in older adults for decades”. The COVID-19 pandemic further exposed vulnerabilities for both elders and those who care for them.

Senior Home Care: Family Caregiver Strain

Family members provide the bulk of senior home care and coordination. About 75% of working caregivers rely only on their families and themselves. And, they do so with little support currently. Here are some caregiver stats to consider to set the stage.

  • Although we are living longer, we’re facing more chronic and debilitating age-related illnesses. The huge Baby Boomer generation is in the prime age for caregiving. They’re also on the cusp of needing some senior home care themselves.
  • Hospital stays are shorter and people wish to age at home. This means more senior home care is needed over longer periods of time.
  • About 60% of caregivers were employed in the last year. Additionally, over half of them work full time. Caregivers’ average age is 49, meaning career and savings goals can be seriously impacted.
  • The average caregiver provides more than 24 hours of care a week. And, many provide much more care than that.
  • Around 10% of working caregivers eventually quit their jobs. This results in an average loss of more than $303,880 each in wages, Social Security income, and pension income. Others reduce hours or give up promotions and other opportunities.

Clearly, family caregivers need more support. We’ll share some of the ways Biden’s plan may help them. One important factor will be bolstering senior home care services which can provide respite and other assistance. However, that workforce also faces significant challenges.

Workforce Challenges in Senior Home Care

To keep up with demand for senior home care services, the home care industry will likely need to fill at least 4.2 million more caregiver jobs by 2026. Even now, caregiver jobs are difficult to fill. And, labor force participation among women ages 25 to 64, who currently make up 73 percent of the home care workforce, will increase by only 2 million in the next decade. Thus, while demand increases, the pool of applicants may be smaller.

The industry has been plagued by issues like low pay, lack of benefits, and poor training and support. Without addressing these, the gap between demand and supply will definitely widen.

EasyLiving has spent many years focusing on solutions and building better ways to support our senior home care team members. But, these senior home care issues also require bigger picture changes in policy and the industry.

Biden’s Plan

Senior home care plays a key role in Biden’s plan. We’re not here to promote a political agenda or get into how programs may be funded or managed. There are often downsides to what sound like positive ideas. We simply want to provide information on what is being proposed to address the issues mentioned above. We encourage you to do additional research and follow what happens with implementation.

Obviously, we’re still facing a public health and resulting fiscal crisis. So, any plan will likely start in a crisis-recovery mode. Therefore, Biden has stated he will immediately provide states, tribal, and local governments with the fiscal relief they need to keep workers employed and vital public services running. This includes direct care services.

Senior Home Care and Caregiving Provisions

Biden’s care infrastructure plan, laid out below, is combined with a proposal to provide up to 12 weeks of paid family and medical leave.

The proposal calls for a $775 billion overhaul of the nation’s caregiving infrastructure. Interestingly, the plan addresses caregiving holistically, not separating out eldercare from child care and other needs. Based on what we know about family and paid caregivers, it makes sense to address the support they need. This in turn will bolster the overall system of care.

Here are the specifics Biden has explained thus far. The plan aims to:

  1. Expand access to a broad array of long-term services and supports in local settings, including through closing gaps in Medicaid for home- and community-based services. This includes using $450 billion to boost senior care. Some of those funds will be likely be used to increase Medicaid funding to states to eliminate the 800,000-person waiting list for community-based care.
  2. Establish a long-term care services innovation fund to help expand alternatives to institutional care.
  3. Support family members or loved ones who do this work unpaid. This includes a $5,000 tax credit for informal caregivers, Social Security credits, and professional and peer support for caregivers of active duty service members and veterans.

Senior home care workforce measures:

  • Ensure access to high-quality, affordable child care and offer universal preschool to three-and four-year-olds.
  • Make policy changes intended to support caregivers and early childhood educators. Proposed changes are pay increases, benefits access, training and career development. This includes the choice to join a union and bargain collectively, and other work-related rights and protections.
  • Add community health workers in underserved communities. The plan makes specific provisions for certain groups, addressing large scale health disparities and the opioid epidemic. Another goal is to remove barriers to fill Veterans Affairs facilities vacancies.
  • Engage in a national strategy to recruit, retain, and empower nursing professionals.

What does Biden’s plan for senior home care and caregiver support mean for you?

This will take some time to know. However, we hope there will be some relief for caregivers. If Medicaid waiting lists can be reduced, many families will be positively impacted. Critics worry about the cost of the plan or say it doesn’t go far enough. And some provisions, like unionization of workers and wage increases, may have unintended consequences. Stay tuned here on our blog and on our social media channels for updates and details.