About two years before my husband died of kidney disease, he reached the point in his health decline where we decided to hire an aide to help him. It took four tries before we found an aide who met our needs and our schedule ... someone who could take care of my husband's personal needs, and also drive him to his many medical appointments. One of the reasons it was so difficult was because there is such a serious shortage of healthcare aides, not just in our area but across the country. The demand for healthcare services has risen as the population has gotten older and healthcare needs have become more complex. This has resulted in a shortage of healthcare aides in both homecare settings and skilled nursing facilities. The problem has become so severe that a June, 2022 survey of 759 nursing home providers by the American Health Care Association showed that 60% of them have had to limit new admissions because of staffing shortages. They are competing against companies such as fast food restaurants, and stores like Target and Walmart for the same pool of employees. It is hard to attract employees because many young people would rather not work with the sick, elderly and dying.
This is especially unfortunate because healthcare aides play a vital role in providing essential care and support to individuals with physical or cognitive limitations. This is a serious problem for people who do not have a spouse or other relative who is able to help care for them. I do not think I could have handled all my husband's physical needs without our aide. Many other sick and elderly caregivers feel the same way. What is causing this shortage of healthcare aides, and what are some of the possible solutions?
High Turnover Rates: The healthcare aide profession often experiences high turnover rates. Factors such as physically demanding work, low wages, and limited career advancement opportunities contribute to this issue. Many healthcare aides find it challenging to sustain their careers over the long term, leading to increased vacancies and understaffing. I understand this problem. Our current aide works for us five hours a day, three to four days a week, but he also works nights several times a week in a skilled nursing facility. He is forty years old. How long will he be able to maintain a schedule like that? If a better opportunity becomes available to him, he is certain to take it.
Inadequate Training and Education: Inadequate training programs and limited educational opportunities also contribute to healthcare aide shortages. The lack of standardized training programs in different regions of the country reduces the availability of qualified healthcare aides. Many people do not want to pay to take the necessary basic classes to become a healthcare aide, when they can start work immediately at a department store or fast food restaurant without spending their own money to get trained.
Consequences of Healthcare Aide Shortages:
Increased Workload for Existing Staff: Staff shortages place an additional burden on the existing healthcare aides and other staff members, leading to increased workload and stress. Overworked healthcare providers may become more prone to burnout, potentially compromising their own well-being and job performance. They may also be more likely to leave their jobs, which will only make the staff shortages worse.
Higher Healthcare Costs: The shortage of healthcare aides may eventually drive up healthcare costs, because the higher demand for services can result in higher costs for both home care and skilled nursing services as they both compete for the same workers. This can increase the financial strain on individuals, families, and the healthcare system as a whole.
Increased Training Opportunities: One way to solve this problem is by expanding affordable, convenient training programs for healthcare aides. State and federal governments and healthcare organizations should work together to develop standardized training programs and increase funding for education in this field so that the necessary training is free and easy to obtain. Then, people who are interested in becoming healthcare aides can learn the skills they need to meet the growing demand.
Improved Pay and Benefits: Offering competitive wages and benefits to healthcare aides would enhance their job satisfaction and help keep them working in the field. Adequate pay would attract more people to pursue careers in this field and encourage the existing healthcare aides to stay in their jobs. In addition, skilled nursing facilities need to provide opportunities for career advancement, such as helping their workers obtain more education and specialized certifications, including working towards becoming vocational nurses. This would make the aides more useful to the facilities where they work, and help ease shortages in other healthcare positions.
Causes of Healthcare Aide Shortages:
Aging Population: The aging population is the major reason for our shortage of healthcare aides. We simply do not have enough young people to handle all the jobs expected of them, and most of them prefer to go into better paying occupations when they can. At the same time, Americans are living longer and the demand for long-term care services, including home care and skilled nursing facilities, has increased significantly. According to the U.S. Census Bureau, the number of Americans aged 65 and older is projected to reach 98 million by 2060, nearly doubling the current 2024 population in this age group.
High Turnover Rates: The healthcare aide profession often experiences high turnover rates. Factors such as physically demanding work, low wages, and limited career advancement opportunities contribute to this issue. Many healthcare aides find it challenging to sustain their careers over the long term, leading to increased vacancies and understaffing. I understand this problem. Our current aide works for us five hours a day, three to four days a week, but he also works nights several times a week in a skilled nursing facility. He is forty years old. How long will he be able to maintain a schedule like that? If a better opportunity becomes available to him, he is certain to take it.
Inadequate Training and Education: Inadequate training programs and limited educational opportunities also contribute to healthcare aide shortages. The lack of standardized training programs in different regions of the country reduces the availability of qualified healthcare aides. Many people do not want to pay to take the necessary basic classes to become a healthcare aide, when they can start work immediately at a department store or fast food restaurant without spending their own money to get trained.
The Emotional Toll on Caregivers: When my husband died, our caregiver told one of our daughters that he did not think he could ever take on another private patient. In the nearly two years that he worked with my husband, they had become very attached to each other. He would take my husband to Starbucks for a treat. Sometimes, he would take him for a drive along the beach. Our caregiver lost more than a part-time job when my husband died. He lost a friend. It was as devastating for him as it was for our family.
As a result of these problems, some people resort to hiring poorly trained or untrained aides, often just an unemployed friend who knows nothing about caregiving. This may be OK if the patient only needs someone to watch over them, help them dress, or fix their lunch. However, in an emergency, you need to be certain they will know what to do. You need to be sure they know CPR, how to take someone's blood pressure, keep track of medications, bath them, keep the patient from falling, be able to transfer them to a wheelchair, and when to call 9-1-1 when something seems wrong. For that, you need a trained healthcare aide, and they can be difficult to find.
Consequences of Healthcare Aide Shortages:
Decreased Quality of Care: The national shortage of healthcare aides can result in a lower quality of care for patients who need assistance, either at home or in a skilled nursing facility. With inadequate staffing levels, healthcare providers such as skilled nursing homes may struggle to meet the needs of their patients or residents, leading to compromised care and reduced patient satisfaction. While my husband has me, our daughters, and his aide to provide him with the care he needs, skilled nursing homes may have one aide who works with several different people. When they are short-handed, or a caregiver becomes ill and cannot show up to work, it creates a problem for all these patients.
Increased Workload for Existing Staff: Staff shortages place an additional burden on the existing healthcare aides and other staff members, leading to increased workload and stress. Overworked healthcare providers may become more prone to burnout, potentially compromising their own well-being and job performance. They may also be more likely to leave their jobs, which will only make the staff shortages worse.
Higher Healthcare Costs: The shortage of healthcare aides may eventually drive up healthcare costs, because the higher demand for services can result in higher costs for both home care and skilled nursing services as they both compete for the same workers. This can increase the financial strain on individuals, families, and the healthcare system as a whole.
Potential Solutions
Increased Training Opportunities: One way to solve this problem is by expanding affordable, convenient training programs for healthcare aides. State and federal governments and healthcare organizations should work together to develop standardized training programs and increase funding for education in this field so that the necessary training is free and easy to obtain. Then, people who are interested in becoming healthcare aides can learn the skills they need to meet the growing demand.
Improved Pay and Benefits: Offering competitive wages and benefits to healthcare aides would enhance their job satisfaction and help keep them working in the field. Adequate pay would attract more people to pursue careers in this field and encourage the existing healthcare aides to stay in their jobs. In addition, skilled nursing facilities need to provide opportunities for career advancement, such as helping their workers obtain more education and specialized certifications, including working towards becoming vocational nurses. This would make the aides more useful to the facilities where they work, and help ease shortages in other healthcare positions.
Seek Young, Healthy Immigrants Who are Interested in Healthcare Careers: Another option is to recruit immigrants from other countries who are interested in being trained and working in this field. Currently, 28% of U.S. doctors and surgeons, and 24% of U.S. nurses and home health aides are immigrants. This number may need to be expanded in order to provide enough caregivers for our aging population. We may need to actively solicit and recruit caregivers in foreign countries. Our caregiver was from the Philippines, and he was very compassionate and good at his job.
Utilizing Technology and Automation: Although many Baby Boomers and older Americans will groan and resist this suggestion, it could be helpful if more healthcare facilities and patients would embrace technological advances, such as assistive devices and remote monitoring systems. Automation can streamline many tasks, and allow healthcare aides to focus more on direct patient care.
Utilizing Technology and Automation: Although many Baby Boomers and older Americans will groan and resist this suggestion, it could be helpful if more healthcare facilities and patients would embrace technological advances, such as assistive devices and remote monitoring systems. Automation can streamline many tasks, and allow healthcare aides to focus more on direct patient care.
Using technology in homes and skilled nursing facilities would also increase efficiency and improve the quality of the care provided, potentially reducing the need for additional staffing. One example of this is giving patients a fall monitor they can wear. My husband wore one whenever I left the house if he was going to be left home alone. I would be alerted if he fell, and the device automatically would call 9-1-1, unless he was conscious and pushed a button to stop the alarm. This brought us both peace of mind.
Other types of technology include using Tiles or Apple tags on the belongings of senior citizens, so they can quickly be found if they wander away from their home or skilled nursing facility. Door alarms can also notify workers if an outside door is opened unexpectedly. Technology can make it easier for a senior citizen to be taken care of at home, or for one healthcare aide to supervise more patients in a facility at the same time.
By implementing these potential solutions, we can ensure adequate staffing levels, enhance the quality of care provided, and meet the growing healthcare needs of our aging population.
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Citations:
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