The Direct-Care Workforce Belongs on the National Agenda

By PHI National Policy Research Director Abby Marquand, from the White House Conference on Aging Regional Forum in Boston

Every day, 10,000 baby boomers turn 65 — a demographic shift that will require changes in the structure of our social safety nets, our health care system, and our economy. The 2015 White House Conference on Aging (WHCOA) has recognized this seismic shift, providing the opportunity to discuss what older Americans need to live with dignity, independence, and support.

As leaders in aging and health, government officials, service providers, the public, and advocates gather in Boston today for a WHCOA regional forum, it is critical that we focus on the direct-care workforce that supports older adults and assists them in maintaining their health and well-being. We cannot ensure quality of life for older adults without investing in the workers who care for them.

The White House has already — and rightfully — highlighted the importance of direct-care workers in its brief on long-term services and supports (LTSS). Below are a few more ways that the direct-care workforce can play a vital role in the key issue areas identified by WHCOA as essential to the dignity and security of elders across the nation.

• Elder Justice: Direct-care workers are in a unique positon to promote the safety and well-being of their clients, working to prevent and report elder abuse. But they too face risks associated with abuse and exploitation: the rate of on-the-job injuries for nursing assistants due to intentional violence is 11 times that of the average American worker.
• Retirement Security: Because of the high cost of long-term care, many families are forced to spend down their savings to qualify for Medicaid. But, the most affordable and preferable option — home care — is plagued by high turnover because home care workers struggle with their own financial insecurity. Home care workers earn an hourly wage that is 15 percent less than aides working in facilities, are less likely to work full-time hours, and less likely to be offered health insurance.
• Healthy Aging: The health of many older adults hinges on their access to a stable and well-trained direct-care workforce, competent enough to support their needs. Today’s direct-care workers are the eyes and ears of our nation’s long-term care system, but to benefit from their unique position we need to provide better training to manage complex conditions and opportunities to acquire competencies in specialized areas, such as disease management, dementia, and palliative care.
• LTSS: The expected surge in demand for long-term care services will require innovations in how care is delivered, as well as a better-funded system of delivery. For direct-care workers, this means improved wages, labor protections, and training. For consumers, it means improved access to affordable, person-centered care options. Overall, the system needs dedicated funding that keeps essential care providers afloat and stabilizes the workforce.

PHI applauds the White House Conference on Aging for bringing local communities together to explore critical areas of concern for older Americans. Direct-care workers belong on that agenda.