By Mark Huffman

September 22, 2009
As the baby boom generation ages, many will do so at home, rather than an institution. But that requires someone to be on hand to provide needed care, and the way things are going, we could soon face a labor shortage.

For one thing, it doesn't pay all that well. Also, it's dangerous. That's right, dangerous.

"It's more dangerous to be a home health aide than it is to be a coal miner," said Howard Gleckman, senior research associate at the Urban Institute.

Gleckman cited Bureau of Labor Statistics figures that show the injury rate for coal miners is 3.6 per 100 workers. The official injury rate is 4.1 for home health aides.

Gleckman and others spoke Monday at a long term care symposium in Washington. They warn that aging baby boomers will put unprecedented demands on the nation's long term care resources and policy makers should act now to prepare for what appears to be an uncertain future.

Stress mounts

As most people who require long term care services prefer to be taken care of at home rather than in a nursing or assisted living facility, Gleckman said that it is becoming critical that society acknowledge and address the stresses being placed on caregivers, most of whom have no formal training in providing care. He noted that 80 percent of the long term care giving taking place in the U.S. is done by informal caregivers, often family members or close friends who receive no financial compensation.

Part of the emotional strain facing many home care givers results from low wages paid for providing these services. According to a 2008 white paper, 19 percent of home care aides and 16 percent of nursing home aides are compensated at a level insufficient for them to rise above the poverty line. The report adds that the typical working family caregiver loses approximately $110 per day in wages and health benefits due to care giving responsibilities.

"The wellbeing of family caregivers and direct care workers are inextricably tied together. As the wages of the latter go up, it makes it that much harder for family caregivers to purchase the services they need, said Suzanne Mintz, co-founder of the National Family Caregivers Association. The solution to this ironic situation is that easing the financial strain on family caregivers must go hand in hand with raising the wages of direct care workers."

Health care reform

With Congress attempting to address health care reform and its many components, Monday's symposium emphasized the need for a national long term care strategy including funding, education and support for the caregiver. Additionally, the event served to highlight the viability of numerous legislative proposals in support of caregivers aimed at helping to solve the nation's long term care challenges.

"We've got to do much more with regard to long term care and how it's provided, how it's financed," said Rep. Charles W. Boustany, Jr., (R-LA). He noted that "most seniors did not realize that Medicare doesn't do much in terms of providing for long term care."