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TUCSON OPINION: Long-term care in need of a reboot

The following is the opinion and analysis of the writer:

If you’re an older adult, you should know — and care — about the crisis in the longterm care industry, because it could impact you personally. I’m talking about the dire shortage of direct care workers.

These caregivers provide nonmedical support for frail seniors and less-abled individuals.

Some serve in their clients’ homes, helping with meal preparation, personal care, transportation and other activities of daily life.

Others work in group homes or nursing homes.

Every day, 10,000 U.S baby boomers turn 65. According to a 2019 CNBC report, three out of four have serious, chronic health conditions such as diabetes or dementia.

Others are healthy but frail. Many need support to live safe, independent lives at home (and avoid costly, disruptive stays in hospitals or other facilities). Their needs drive an exponential growth in the demand for direct care.

Direct care workers (plus overburdened family members) meet those needs. Who are they?

According to the Paraprofessional Healthcare Institute (PHI), the nation’s leading expert on direct care issues, almost half are 45 to 64 years old, 87% are women and 59% are people of color. Some 27% are immigrants.

That workforce (now totaling 4.6 million, including home care workers, residential care aides and nursing assistants) is being overwhelmed by the rising demand, and no wonder.

Median hourly pay is $12.80, while entry-level jobs in other industries may offer a startingpay of $15 — for easier work and less responsibility. Many direct care workers hold two or three jobs, but even so, almost half depend on public benefits such as ‘nutrition assistance’ (i.e., food stamps) and Medicaid. The lack of a career path doesn’t help, nor do the many barriers to legal immigration.

As a consequence, the longterm care industry is struggling to recruit workers.

PHI projects 7.8 million direct care job openings from 2019 to 2029. How can we possibly fill those positions, especially since annual turnover is around 50%?

PHI has just released a white paper detailing 47 recommendations for the White House, Congress and key federal departments and agencies. Federal Policy Priorities for the Direct Care Workforce offers action plans under eight headings:

. Reform Long-Term Care Financing to Strengthen Direct Care Jobs

. Increase Compensation forDirect Care Workers

. Strengthen Training Standards and Delivery Systems for Direct Care Workers

. Fund, Implement and Evaluate Direct Care Workforce Interventions

. Improve Direct Care Workforce Data Collection and Monitoring

. Center Direct Care Workers in Leadership Roles and Public Policy

. Rectify Structural Gender and Racial Inequities for Direct Care Workers

. Shift the Public Narrative on Direct Care Workers The full 44-page plan is at: Federal Policy Priorities for the Direct Care Workforce — PHI ( It’s a lot to digest. In a nutshell: Direct care workers are compassionate and caring. They answer the call to help others.

Many have raised families and have the skills to prove it. If we treat them with the respect they deserve, train and pay them as professionals and acknowledge their vital role in supporting older adults and less-abled individuals, we can build and retain a robust, capable, sustainable workforce.

These ideas are hardly new. Generations of elected leaders have known about the problem, but they’ve avoided the heavy lifting required to fix it. I’m hopeful the current administration will see the need, and the need for action.

As PHI notes, ‘quality care is rooted in quality jobs — now is the time for a federal strategy that brings this mission to life.’

I couldn’t agree more. The system we have now is collapsing. We’ve discussed this issue for years; now it’s time for action.

Please join me in demanding our leaders begin to take this important issue seriously.

Judith B. Clinco, RN, BS, is founder and president of Catalina In-Home Services Inc. and founder of the CareGiver Training Institute.