The Shortage of Homecare Workers

I remember my first semester in graduate school over 6 years ago and my response to the question: “what could we do to meet the needs of the booming aging population?” There are so many issues around elderly care, and my thoughts centered on the needs of the 100s of families and seniors and homecare workers I have worked with over the last 20 years. Was there a way to meet the rising demand for home care workers with the use of technology? It took 2 years of research and a final project that led to the development and launch of the Phlex65 platform that connected families and seniors directly to caregivers or homecare workers.

Is there a need for homecare workers? For the majority of the aging population, remaining at home and aging or staying in place was a no-brainer and is feasible. Not only is there a stigma around living in long-term nursing care facilities, but research shows that the cost of skilled nursing care is double that of home care [$100K vs. $52K, US Census Bureau, 2020]. This cohort of aging adults 65 years and older will double to 88M in 30 years and will more likely live into their 80s, increasing the demand for services at home.

Who is the homecare worker? This is a personal care attendant, caregiver, or home health aide. Information collected on the average worker is a minority or recent immigrant whose native language is not English, works full time, is most likely single and head of household, raising their own children, relying on government assistance for housing, food, and healthcare. Not only is the home care worker in the home, but can be employed at Skilled Nursing Facilities (SNFs), Assisted Living Facilities or Residential Care Facilities for the Elderly (RCFEs), or Continuum Care Retirement Communities (CCRCs) and Independent Living Facilities for the Elderly.

The older adult is more likely someone who is recently discharged from an SNF or hospital and will need help with personal and daily tasks for the short or long term. The fastest growing cohort, 85 years and older, are more likely to live with a chronic and/or debilitating disease and will need care for longer periods.

The “silver tsunami,” or the tidal wave of the aging baby boomer population 65 years and older, is here, and the service needs for seniors has grown exponentially. The increase in demand for home care workers are evident in both residential and skilled nursing facilities. According to the Bureau of Labor Statistics (BLS, 2020), caregivers for the elderly are the largest and fastest growing workforce across the service industry. We will need to employ workers from other services like janitorial, retail, restaurant, and hospitality to meet this demand for care. In California alone, we will need 200,000 new caregivers a year by 2026.*

The caregiver workforce has seen some of the highest turnovers across all community and healthcare facilities in recent years. Reasons behind the high turnover are around the lack of compensation, benefits, and flexibility in work hours. The national average for a homecare worker is approximately $12* with little to no benefits for sick leave, family leaves, vacation, retirement, and healthcare. The average workweek is less than 20-32 hours, with the caregiver juggling 4 and 8-hour increments for one or two clients. The cost of inflation has made an impact in record turnovers as transport has become an added burden along with the increase in living expenses.

The rising cost of gas has deterred some workers who find it more to their benefit to remain unemployed and rely on government assistance to meet household and daily expenses. Caregivers are also juggling their role as mothers and heads of households and may have to deal with caring for young children and/or aging relatives.

The high turnover in caregivers has affected home care organizations that are dealing with the lack of caregivers. Staffing has become a nightmare, and companies are scrambling to find ways to solicit and employ caregivers.

What I realized as a gerontologist and businesswoman is that caregivers needed flexibility in their schedules. Work when they want to work, and placing their times of availability on the Phlexplatform would be ideal. Phlex65, as a 2-sided labor market platform, makes it easier for seniors and their families to find a caregiver within a given time slot from 2 to 24 hours and convenient for caregivers who want to find and connect with new clients (family members or seniors) - reducing the stress for care.

Compensation is directly correlated to how much we as a society value caregivers and their role in supporting older adults. If caregivers are being compensated at the minimum wage and at or below the poverty level - what does this mean for us as a community, the homecare worker, and the homecare industry?

Do we not see the value in the work they do to support older adults? It is important to figure out a viable and comparable above the living wage for the caregiver. Once this is done, can we address other issues that will reduce turnover and the shortage of homecare workers across the senior care industry?

*Bureau of Labor Statistics, BLS, 2020

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