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Long-term Care Services for Elderly Facing Shortages


A worker shortage in long-term care services for America’s burgeoning elderly population verges on a crisis, said a former U.S. Department of Health and Human Services official at Fordham University on May 24.

Robyn Stone, D.P.H., executive director of the Institute for the Future of Aging Services and former deputy assistant secretary for disability, aging, and long-term care policy, said that long-term care remains one of the most labor-intensive sectors in all of health care, and while the field now employs more than 1.4 million nurses aides and some 700,000 home health care aides, the turnover rate ranks among the highest of any profession.

Robyn Stone, D.P.H. Photo by Michael Dames

“Not only do we have a problem with turnover and vacancies, but we are also going to see a significant shortage of actual bodies in the next 15 years …,” said Stone at conference on “Preparing for the Elderboom” sponsored by the New York Southern Area Aging Network and Fordham Graduate School of Social Service’s Ravazzin Center on Aging. “We are seeing nurses and social workers aging … and we’re not recruiting into those fields. So this is a disaster waiting to happen, just as the Baby Boom departs through that python.”

The conference came just a day before The New York Times reported, in a lengthy front-page article, that poor-paying positions in health care and social services, such as home-health aides for the elderly, account for much of New York City’s job growth over the past 15 years. In fact, the newspaper’s analysis cited data from the U.S. Bureau of Labor Statistics that show that in Brooklyn and the Bronx, the sector now supplies “about one-third of all private-sector jobs and wages.”

The long-term care sector, which includes everything from nursing homes and assisted-living facilities to care provided one-on-one in an elderly patient’s home, suffers from a litany of problems, Stone said, not the least which are low pay and a dodgy image as a barren outpost in the research-intensive and dynamic world of medicine.

Frontline care workers, such as home-health aides, make on average $8 or $9 an hour, Stone said, and doctors and nurses are also underpaid compared to their counterparts in private practice or at hospitals.

Stone outlined some steps she believes must be taken to alleviate the crisis. A key, she said, is expanding the supply of personnel entering the field by tapping new sources, including older workers, who because of financial reasons are not able to retire. Another potential source is family members who are already providing care for their elderly parents. In addition to recruitment, she said that a focus on retention is needed and called for better working conditions and workplace training and continuing education.

And she said that the image of jobs providing health care services to the elderly must change, and health care providers and others in the sector should make a better effort to reach out to university programs in social work, medicine and nursing to encourage professors to expose their students to the geriatric field.

“I really believe that if we don’t do something about this crisis, it is going to come back to bite us,” she said. “But it is also an unbelievable opportunity to really professionalize our sector and to be proud of it because it is a fabulous place to work.”


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