Aging in Place in Question?

A national shortage of healthcare workers threatens decades-old policies aimed at allowing older adults to age in place.

According to the Washington Post, competition from other industries has shrunk the pool of available workers and lured away current workers. The article follows a recent report by the Maryland Hospital Association (MHA) regarding a severe shortage of nurses and health technicians in hospital settings.

Regarding hospital worker attrition, MHA noted “the stress of acute care, an aging workforce/early retirement, competitive wages from other industries, a choice of roles outside of acute care and additional remote work alternatives, capped reimbursement models, and violence against hospital personnel.” Both pieces cite COVID-19 as an aggravating factor concerning worker shortages.

An AARP survey cited by the Post states, “about three-quarters of those 50+ would like to stay in their current homes or communities for as long as possible.” Likewise, the federal government has prioritized aging-in-place policies dating back to the Great Society. The Older Americans Act, enacted in 1965, created much of the framework for these policies through “grants to states for community planning and social services, research and development projects, and personnel training in the field of aging.” Moreover, the United States Administration for Community Living (ACL), established in 2012, works to ensure “that people with disabilities or functional limitations of any type, regardless of age, have… access [to] home and community-based supports and services.”

In Maryland and across the country, Area Agencies on Aging (AAAs) are responsible for carrying out the priorities outlined in the Older Americans Act and by the ACL. Most are a “unit of local government or a private, nonprofit corporation.” These agencies “provide a variety of adult services, incorporating assisted living, protective services, and temporary disability programs.” In addition, depending on how the AAA is structured, it may assist with transportation services.

Both AAAs and the private agencies with which they contract are experiencing worker shortages that are expected to worsen – primarily attributable to the reasons discussed by the Post:

Workers at the lower rungs of the home-care industry — mostly women and people of color — are among the lowest paid in the United States. The median pay for personal care aides was just $14.27 an hour in 2021, according to PHI, a nonprofit that publishes annual reports on the national home-care workforce.

Workers can earn equal or higher wages at Home Depot or McDonald’s — performing jobs that are a lot easier than bathing, dressing and feeding seniors.

PHI estimates that the home-care workforce nationally numbers around 2.6 million. About 1 million more home-care workers will be needed by 2030 as the baby-boom generation finishes aging into retirement — what demographers call the ‘Silver Tsunami.’

As reported by the Washington Post, a failed effort at the federal level might have provided some relief to address the widening issue:

The Biden administration in 2021 sought $400 billion in new spending for home- and community-based care, channeled through Medicaid, to states. Access to care would have been expanded and workers would have received raises and benefits.

With the ‘Silver Tsunami’ impending, Marylanders might soon face disaster. Healthcare industry-wide worker shortages, from RNs to home-care aides, are expected to worsen without significant intervention and investment by the federal government and the State of Maryland.

Read the full Washington Post article.