A quality workforce in direct care—encompassing both home health care workers and those in long-term care—is essential to caring for the growing population of older adults. However, the high turnover and low wages of workers in this field need to be addressed in order to provide the best care. A recent article stressed the importance of overcoming key challenges for a workforce that will grow by about one million jobs by 2024. Challenges include low pay and few benefits, a high turnover rate, declining labor pool, and an increasing number of workers being drawn to retail or food industries.
To address turnover, the author argued for higher wages, more full-time position offerings, and better training for direct care workers. A change in Medicaid policy would allow providers to increase wages without the fear that funding would not match increased expenses. To give policymakers a better understanding of workforce-related issues, the author suggested enhancing data collection and tracking systems for these workers.
Better training for direct care workers has been shown to improve care and reduce emergency room visits for those they care for, but it also has the potential to create advancement opportunities, improve job satisfaction, and increase retention. Creating opportunities for workers to advance may allow them to develop skills necessary to provide better care and ultimately avoid costly treatments for their patients.
Some states have addressed these issues by increasing wages; others by increasing Medicaid reimbursement. Commissions and task forces have been formed in numerous states with the goal of studying issues faced by this workforce. New York in particular has made significant progress; in addition to increasing minimum wage, the state mandated a benefits package for home care aides, passed an act to allow workers to earn sick time, and offers paid leave of up to 12 weeks to care for an infant or relative.
Attracting and retaining direct care workers is becoming increasingly important, and while some progress has been made, there are many strategies that remain to be implemented. Wages are a commonly cited issue, but better training and more opportunities for workers may help improve quality of care.