(C) Common Dreams
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The Crisis Facing Nursing Homes, Assisted Living and Home Care for America’s Elderly [1]
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Date: 2022-07-28
Working 16 hours straight is not uncommon for long-term care aides, says Nazareno, citing the average shift of care workers in her study at 16.6 hours. But putting in this kind of labor must come with basic protections, like a living wage, health insurance and a path to citizenship, she says. After all, why not work at Amazon, which at least comes with health benefits?
Finding more workers to do these jobs is only half the solution: Higher pay and opportunities for career advancement are critical for retention. In fact, the root of what plagues the long-term care industry is not a worker shortage but a wage shortage, says Charlene Harrington, professor emerita of sociology and nursing at UC San Francisco. Most direct care aides are paid on par with fast food restaurants, at $13- $15/hour, and live below the federal poverty line. Many lack health insurance. The workloads are too heavy — a CNA should be responsible for seven residents, but many are responsible for 12 or even as many as 25, says Harrington. Burnout creates turnover, as employees depart for fast-food and housekeeping jobs with similar wages but fewer stressors, she says. And it’s not just up to the industry to self-correct. The government can play an important role in instigating changes.
Earlier this year, the Biden administration proposed a slate of executive reforms that could help. The new measures call for increased oversight of nursing home ownership, financial transparency and minimum staffing standards — found to be low in almost every state. “Seventy-five percent of all nursing homes have inadequate staffing,” says Harrington, an “appalling” reality that research has shown for 20 years but which the pandemic made obvious. She notes that lower RN staffing led to increased nursing home Covid infection and deaths. Harrington is glad some action is taking place at the federal level, but more needs to be done, she says, and she finds some of the most promising initiatives coming from states, which have more room to regulate how a nursing home spends its money.
Several states like New York, New Jersey and Massachusetts have set “direct care ratios,” which ensure a limit on profits so that more expenditures are directed to care, in an industry where 70 percent of nursing homes are for-profit. Since the onset of the pandemic, five states have adopted permanent increases to nursing home staffing requirements, and four have adopted laws or regulations for increased nursing home wages. “The nursing homes need to step up and start paying decent wages, and I don’t think they’re going to do that until they’re required to do it,” says Harrington. “You can’t have a decent, stable workforce unless you increase the wages and benefits.” And even so, all these changes relate to nursing homes, which represents only a fraction of all elder care; of 14 million elderly adults currently receiving some form of care, approximately 1 million are in nursing homes.
Wolapaye earns more than most nursing assistants, at $20.50 per hour, with medical, dental and life insurance, a 401(k) and paid time off. Tuition assistance is provided for up-training. And the facility covers the $750 U.S. citizenship application fee for employees who have worked six months or longer, arguing it helps retain workers.
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[1] Url:
https://www.politico.com/news/magazine/2022/07/28/elder-care-worker-shortage-immigration-crisis-00047454
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