Future Demand For Long-Term Care Workers Will Be Influenced By Demographic And Utilization Changes

Abstract

A looming question for policy makers is how growing diversity of the US elderly population and greater use of home and community-based services will affect demand for long-term care workers. We used national surveys to analyze current use and staffing of long-term care, project demand for long-term care services and workers through 2030, and assess how projections varied if we changed assumptions about utilization patterns. If current trends continue, the occupations anticipated to grow the most over the period are counselors and social workers (94 percent), community and social services workers (93 percent), and home health and personal care aides (88 percent). Alternative projections were computed for scenarios that assumed changing racial and ethnic patterns of long-term care use or shifts toward noninstitutional care. For instance, if Hispanics used services at the same rate as non-Hispanic blacks, the projected demand for long-term care workers would be 5 percent higher than if current trends continued. If 20 percent of nursing home care were shifted to home health services, total employment growth would be about 12 percent lower. Demographic and utilization changes would have little effect on projections of robust long-term care employment growth between now and 2030. Policy makers and educators should redouble efforts to create and sustainably fund programs to recruit, train, and retain long-term care workers.

Client history and violence on direct care workers in the home care setting

“…In a survey conducted in Oregon, case managers responded that 51.5% of the home care workers had reported that they were quitting their job because the client or someone else in the home was violent toward them [Nakaishi et al, ]. National shortages of long‐term care workers, including direct care workers in the home settings (DCWHs), have been well recognized, yet still remain a major challenge [Institute of Medicine of the National Academies, ; Spetz et al, ].…”

Policy choices in dementia care—An exploratory analysis of the Alberta continuing care system (ACCS) using system dynamics

“…Other mechanisms such as investing in education and development of the LTC workforce and increasing the competitiveness of jobs in this sector might motivate more people to consider a career in LTC. In terms of decreasing the demand, the implementation of new care delivery models that optimize the involvement of informal caregivers in the care of people with dementia can shift the burden from formal (institutional) to informal caregiving . Nevertheless, this approach needs to be carefully evaluated in terms of availability and effectiveness of resources in the community that can support informal caregivers .…”

“…In terms of decreasing the demand, the implementation of new care delivery models that optimize the involvement of informal caregivers in the care of people with dementia can shift the burden from formal (institutional) to informal caregiving. 49 Nevertheless, this approach needs to be carefully evaluated in terms of availability and effectiveness of resources in the community that can support informal caregivers. 10,50 In this context, an SD model that includes variables describing care processes in all 3 main settings (home-based care, SL, and LTC) is an ideal approach to forecasting LTC staff requirements.…”

The Financial Burden Of Paid Home Care On Older Adults: Oldest And Sickest Are Least Likely To Have Enough Income

“…Home care could soon become less affordable as the available workforce shrinks. [11][12][13] To attract high-quality, committed workers, home care agencies may have to raise wages and provide more training opportunities, and these would entail costs that would likely be passed on to consumers. Between 2013 and 2018 the average rate charged for one hour of home care increased 16 percent, from $19 23 to $22 8 -twice as fast as inflation.…”

“…There is a mounting shortage of high-quality workers to provide paid hands-on care to the nation's rapidly growing older population. [11][12][13] This work, performed mostly by paraprofessionals with little training, is physically and emotionally demanding, pays low wages, and offers few benefits. 14 To attract a competent, committed workforce, home care agencies may have to raise wages and provide more training and career advancement opportunities, 15 which would likely force them to charge more and increase the financial burden on care recipients.…”