The cost of professional caregivers

Some of you may have read or heard about Caregiving In America, a comprehensive report released by the ILC and the Schmieding Center for Senior Health & Education published Fall 2006, which stated there is a crisis looming due to the increase in aging baby boomers, a severe (and worsening) shortage of professional caregivers, and family caregivers who do not identify as such.

To add to this crisis, hiring a professional home health aide through agencies in Manhattan can cost approx. $150K/yr, according to The New York Times article, "New Options (and Risks) in Home Care for Elderly." This rate is staggering – even for a professional physician as described in the article. Just imagine--- if it's too much for a physician at a prestigious medical institution, what about those who are in the lower middle class, or lower class? What about those still earning minimum wage? What are they to do?

Those who can't afford to hire home health aides through the agencies, hire them through the gray market -- "an over-the-back-fence network of women [who ] are usually untrained, unscreened and unsupervised, but more affordable without an agency's fee, less constrained by regulations and hired through personal recommendation."

Although there is a high cost to hire a professional health aide from the agencies, only about "$9 of the $20 hourly fee goes to the aide. In a gray-market arrangement, the aide might get $12, a 33 percent increase — although sometimes without benefits, worker's compensation or Social Security…' According to the graphic in the article, "since 1999, the number of home health aides in the United States has grown 15.8% [not including aides from the gray market], while their median hourly wage has fallen 4.4% after adjusting for inflation." It seems as if both parties -- the professional caregivers and the families needing these caregivers--are losing out in the current arrangement with the agencies. The professional caregivers are barely making above minimum wage (which accounts for the high turn over) and the families needing caregiving would have to exhaust their savings in order to pay for such services.

Boomers need to focus on getting long term care insurance--- especially one that will pay you, the caregiver -- and not the agency-- so that you are free to choose the home aide of your liking. (The government does not pay for them unless you are poor or unless it is immediately following a hospital stay).

In aid of the professional caregiver's plight, "the Service Employees International Union has been at the cutting edge of creating a more stable pool of workers. In New York, Local 1199 unionized 60,000 home-care employees. Unionized aides, many of them former welfare recipients, get a full array of benefits, rare in this industry, and opportunities to master English, study nursing or learn computer skills.

One of the union's newest offerings is a sort of consciousness-raising group, focusing on self-esteem and a sense of community among otherwise isolated workers."

We salute 1199SEIU in helping the professional caregivers get the support, aid, and benefits they need. There is a crisis looming and we need more professional caregivers --- however, first we need to respect them and their work by raising their wages and providing benefits so more people can choose professional caregiving as a career. At the same time however, we need to tell our governments --both local and national -- that it is more economical to have home health aides than to have our loved ones in nursing homes (which the government does pay for under certain circumstances).