I worked with a man in a nursing home with dementia name was Harold. He had lost his Medicaid and needed to sign the form to get it back. He repeatedly said, “Why should I sign this? Who are you? Why should I believe you? What are you going to do to me?” Two young female nursing home employee caregivers commented to me on my way out, “We have to deal with him all the time!”
These front line caregivers are critical to the care of individuals in long term care facilities and in their homes. And the job is very difficult emotionally and physically demanding. Pay is low and workers are underappreciated.
There is currently a shortage that is only expected to get worse as baby boomers age. It is referred to as the caregiver cliff. Most funding for personal care services comes through Medicare or Medicaid, so wage increases are unlikely. The best that can be done speaking in practical terms are improving supervision training and opportunities for advancement. One out of five personal care workers are immigrants, raising even more questions about the stability of this workforce with recent immigration limits.
The future of community based care relies on the availability of workers.