Aging baby boomers face home health care challenge
CLEVELAND (AP) - For the past three years, Taura Tate's mornings have revolved around caring for a woman who suffers from the effects of a stroke and diabetes. She cooks her oatmeal for breakfast, helps with showers and makes sure she takes the right medicine.
Without the help of a home health aide, the woman, who's in her 70s, would be in a nursing home instead of living on her own.
But Tate has her own struggles. Up until a recent promotion, her pay amounted to what she could make at McDonald's. She doesn't get health or retirement benefits and has worked at five agencies in the Cleveland area, some simultaneously, to guarantee she'll have enough clients.
"If they go into the hospital or go on vacation, you don't get paid," she said.
Demand for home health care workers is soaring as baby boomers - the 78 million Americans born between 1946 and 1964 - get older and states try to save money by moving people out of more costly nursing homes. But filling more than 1 million new home care positions over the next decade will be a challenge.
Most home health aides are paid about the same as maids and manicurists and don't get sick days or health insurance themselves. Many who are self-employed must pay for their own gas for driving to appointments and cover their own medical bills if they're hurt on the job.
The U.S. Labor Department projects that home health and personal care aides will be among the fastest-growing jobs over the next decade, adding 1.3 million positions and increasing at a rate higher than any other occupation. If those jobs can't be filled, many older Americans are likely to face living with relatives or in nursing homes, which will only cost families and taxpayers more money.
Some aides say they have no choice but to say no when people call looking for help because they can't afford to take on someone else.
"It's hard because I love helping people, but at the same time I've got three kids," said Kimberly Ingram, a home health aide in Lancaster, S.C. "When you add up your miles, your gas money, you don't make nothing."
Her part-time job delivering newspapers pays better when you factor in the time and travel some home care jobs need, she said.
Nearly half of all home care workers live at or below the poverty level, and many receive government benefits such as food stamps, unions and advocacy groups say. The median pay a year ago was $9.70 per hour - 4 cents less than fast-food workers and short-order cooks, according to the most recent statistics from the Labor Department.
Agencies that supply home health workers blame states and the federal government for failing to increase reimbursement rates for Medicaid and Medicare patients at a time when costs are going up.
Home health services are an easy target for cuts because they're not required by federal law, and legislators in states with big deficits say they have no choice but to cut Medicaid spending, the second-costliest item for states behind education.
At the same time, some states, including Ohio, are changing how they coordinate medical care and trying to move some of the most expensive and hard-to-treat patients into home and community-based settings instead of nursing homes.
The result, home care agencies say, is that there's little room for them to make a profit. And that means they can go only so far to attract new workers.
"We compete with McDonald's, Wendy's and the discount stores," said Jennifer Witten, owner of Imani Home Health Co. in Cleveland. "You can't afford to raise your salaries, yet you want to hire the best people."
Home care agencies say trying to fill jobs will become even more difficult in a few years if the economy improves and job options increase.
"The real staffing challenge is 10 years away," said David Tramontana, president of Home Care by Black Stone in Cincinnati. "If we can't pay them more than they get at McDonald's, we're in big trouble."
The qualifications and training for home care aides varies. A high school diploma isn't usually a requirement, and some states call for only on-the-job training, while others insist on more formal instruction about basic nutrition and personal hygiene at community colleges or elder care programs. Home care agencies that are reimbursed by Medicare or Medicaid must hire aides who have passed a competency test or received state certification.
Despite the relatively low pay, many aides say they like the flexible hours and find the work rewarding.
Tate, a home care aide since 1999, doubts she could get by if it weren't for her husband, a truck driver who also has health insurance. She could make more money at a nursing home or hospital but relishes the connections she makes in home care.
"I get attached to the people," said Tate, who made $8.50 an hour until she received a promotion and a $2 raise earlier this summer. "How could you not if you're with them every day? Sometimes you're the only person they see."
Retired hospital nurse and home health aide Judith Mezey-Kirby, born a few years ahead of the baby boom, said she worries about who will take care of boomers in the coming years.
Home health care workers need not only better pay, she said, but also better training on how to take care of basic needs. She had good and bad experiences with aides who help her with the laundry and chores that require heavy lifting around her home in Fairview Park, a Cleveland suburb.
"It needs attention bad," said Mezey-Kirby, 73. "You just can't take people off the streets."
Wittens' company considered adding a 401(k) plan for its workers but decided it was too costly. Home aides she hires start at $8.50 per hour and can earn up to $10. Most work 30 to 40 hours a week, and all but a few have other part-time jobs, Witten said.
Jareese Mitchell, a personal care attendant in Manchester, Conn., spends 30 hours a week with two quadriplegics, helping them eat, dress and bathe. He also goes to school and works three nights a week at a clothing store.
"Everybody has a job outside; you pretty much have to," said Mitchell, who until recently was receiving food stamps. He said he might look for different work if the pay doesn't increase.
That's not unusual. The turnover rate among home health aides is estimated to be anywhere from 30 percent to 50 percent, sometimes higher.
The revolving door is especially tough on those who depend on home aides for help throughout the day.
"My mom gets nervous when she has brand-new people. There's always a trust issue," said Beth Cramer, who lives with her 74-year-old mother in the Cleveland suburb of Willowick. An aide comes to the house to help her mother with dressing and cooking while Cramer is at work.
"They're doing the most intimate of intimate things," she said. "Imagine a stranger walking into your house and giving you a bath."
Gail Williams, a personal assistant in Tampa, Fla., said many people have no one else.
"You just can't quit the job because these people need you," she said.
Chris Hradisky, who relies on a personal assistant to help him with meals and clean his apartment in Waukegan, Ill., said he wouldn't be on his own without help.
His aides, he said, are like family. "You build a bond with them."
Without the help of a home health aide, the woman, who's in her 70s, would be in a nursing home instead of living on her own.
But Tate has her own struggles. Up until a recent promotion, her pay amounted to what she could make at McDonald's. She doesn't get health or retirement benefits and has worked at five agencies in the Cleveland area, some simultaneously, to guarantee she'll have enough clients.
"If they go into the hospital or go on vacation, you don't get paid," she said.
Demand for home health care workers is soaring as baby boomers - the 78 million Americans born between 1946 and 1964 - get older and states try to save money by moving people out of more costly nursing homes. But filling more than 1 million new home care positions over the next decade will be a challenge.
Most home health aides are paid about the same as maids and manicurists and don't get sick days or health insurance themselves. Many who are self-employed must pay for their own gas for driving to appointments and cover their own medical bills if they're hurt on the job.
The U.S. Labor Department projects that home health and personal care aides will be among the fastest-growing jobs over the next decade, adding 1.3 million positions and increasing at a rate higher than any other occupation. If those jobs can't be filled, many older Americans are likely to face living with relatives or in nursing homes, which will only cost families and taxpayers more money.
Some aides say they have no choice but to say no when people call looking for help because they can't afford to take on someone else.
"It's hard because I love helping people, but at the same time I've got three kids," said Kimberly Ingram, a home health aide in Lancaster, S.C. "When you add up your miles, your gas money, you don't make nothing."
Her part-time job delivering newspapers pays better when you factor in the time and travel some home care jobs need, she said.
Nearly half of all home care workers live at or below the poverty level, and many receive government benefits such as food stamps, unions and advocacy groups say. The median pay a year ago was $9.70 per hour - 4 cents less than fast-food workers and short-order cooks, according to the most recent statistics from the Labor Department.
Agencies that supply home health workers blame states and the federal government for failing to increase reimbursement rates for Medicaid and Medicare patients at a time when costs are going up.
Home health services are an easy target for cuts because they're not required by federal law, and legislators in states with big deficits say they have no choice but to cut Medicaid spending, the second-costliest item for states behind education.
At the same time, some states, including Ohio, are changing how they coordinate medical care and trying to move some of the most expensive and hard-to-treat patients into home and community-based settings instead of nursing homes.
The result, home care agencies say, is that there's little room for them to make a profit. And that means they can go only so far to attract new workers.
"We compete with McDonald's, Wendy's and the discount stores," said Jennifer Witten, owner of Imani Home Health Co. in Cleveland. "You can't afford to raise your salaries, yet you want to hire the best people."
Home care agencies say trying to fill jobs will become even more difficult in a few years if the economy improves and job options increase.
"The real staffing challenge is 10 years away," said David Tramontana, president of Home Care by Black Stone in Cincinnati. "If we can't pay them more than they get at McDonald's, we're in big trouble."
The qualifications and training for home care aides varies. A high school diploma isn't usually a requirement, and some states call for only on-the-job training, while others insist on more formal instruction about basic nutrition and personal hygiene at community colleges or elder care programs. Home care agencies that are reimbursed by Medicare or Medicaid must hire aides who have passed a competency test or received state certification.
Despite the relatively low pay, many aides say they like the flexible hours and find the work rewarding.
Tate, a home care aide since 1999, doubts she could get by if it weren't for her husband, a truck driver who also has health insurance. She could make more money at a nursing home or hospital but relishes the connections she makes in home care.
"I get attached to the people," said Tate, who made $8.50 an hour until she received a promotion and a $2 raise earlier this summer. "How could you not if you're with them every day? Sometimes you're the only person they see."
Retired hospital nurse and home health aide Judith Mezey-Kirby, born a few years ahead of the baby boom, said she worries about who will take care of boomers in the coming years.
Home health care workers need not only better pay, she said, but also better training on how to take care of basic needs. She had good and bad experiences with aides who help her with the laundry and chores that require heavy lifting around her home in Fairview Park, a Cleveland suburb.
"It needs attention bad," said Mezey-Kirby, 73. "You just can't take people off the streets."
Wittens' company considered adding a 401(k) plan for its workers but decided it was too costly. Home aides she hires start at $8.50 per hour and can earn up to $10. Most work 30 to 40 hours a week, and all but a few have other part-time jobs, Witten said.
Jareese Mitchell, a personal care attendant in Manchester, Conn., spends 30 hours a week with two quadriplegics, helping them eat, dress and bathe. He also goes to school and works three nights a week at a clothing store.
"Everybody has a job outside; you pretty much have to," said Mitchell, who until recently was receiving food stamps. He said he might look for different work if the pay doesn't increase.
That's not unusual. The turnover rate among home health aides is estimated to be anywhere from 30 percent to 50 percent, sometimes higher.
The revolving door is especially tough on those who depend on home aides for help throughout the day.
"My mom gets nervous when she has brand-new people. There's always a trust issue," said Beth Cramer, who lives with her 74-year-old mother in the Cleveland suburb of Willowick. An aide comes to the house to help her mother with dressing and cooking while Cramer is at work.
"They're doing the most intimate of intimate things," she said. "Imagine a stranger walking into your house and giving you a bath."
Gail Williams, a personal assistant in Tampa, Fla., said many people have no one else.
"You just can't quit the job because these people need you," she said.
Chris Hradisky, who relies on a personal assistant to help him with meals and clean his apartment in Waukegan, Ill., said he wouldn't be on his own without help.
His aides, he said, are like family. "You build a bond with them."
You do realize that no baby boomer is yet in their 70's, right? The demographic is "those born between 1946 and 1964. The oldest of these would be 66 this year (and the youngest 48). Most boomers including 66 year olds are still working their butts off and active, productive members of society. Yes, the home health industry and the whole health care industry do need some serious changes - not arguing that. I just wanted to point out the misleading information in this article. The old woman in the picture is not an accurate representative of the baby boomer population, none of whom are older than 60's.
Being a growing and largely unregulated industry the home health care and aid providing industry will generate some real horror stories over the next few years. As for wages, look to the sprouting private "agencies" taking no small amount of money and then only passing on a poverty level wage to the person doing the home care. That is where the story lies.Â
It's really tragic that the people who are caring for our parents and grandparents are living in poverty. I wish some solutions were offered here.Â
Its Ok since the boomers can just reverse-mortgage their debt-free homes and tap all that equity they built up to supplement their retirement savings to pay for their long term care.
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Of course, this is a joke. For the most part, they fell into the "I want it all, and I want it now" trap and spent all the savings, and tapped all the home equity for the boat/rv/SUV/serial vacations. For those that did manage to save, the banksters have dropped the (self-)interest rate to near zero so no low-risk income is to be had. Notably, they did this to rescue the banks from those that mortaged their homes for the boat/rv/suv/serial vacations and then defaulted; and don't even speak of the wall that most pension funds are heading toward as they burn capital to pay current obligations without enough investment return nor contributions to make the numbers work out for the long term "obligations".
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That's a pretty generalized statement about 78 million people. Those born during and right after the war had a whole different mindset than those born in later years. Your assumption that we all fit into one nice neat little bundle tells me that you are really putting more out there
than you know anything about.
There is something wrong when people think they are entitled to help staying in their homes and taking care of themselves, but won't pay their aides enough to live on. Self-sufficiency is not a right when you put the other person helping to wipe your behind, wash your armpits and change your multiple cat box into literal poverty for the privilege of doing so.
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If this is the fastest growing job in the country--making less than a teenager in their first job at McDonalds it says something about our "first world" status.
@chandler the elderly aren't paying for it - Medicaid and/or Medicare is - government health care in action. And not everybody over the age of 65 is in this desperate a strait - many are full-time workers who can work circles around most people plus very active in their life.
People who are on medicare also pay a monthly premium to be on it. They take part of your social security benefit to make the payment.
 @Elaine2  @chandler Chandler-It's cheaper to pay an RN to come out to somene's home once or twice a week for a couple hours and 3-4 full time caregivers to provide around the clock care than it is to stick them in a nursing home. The system is broken. Medicaid/Medicare can't afford/doesn't allow for home health care aides, only hospitals and nursing homes. It's easier for medicare/medicaid to pay for grandpa to be stuffed in some nursing home than to create a network of in home health care services to keep said grandpa at home for as long as possible.
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It's cheaper over the long term to keep someone at home with a network of home health care services than a nursing home.