Expert: Michigan Needs 32,000 Home Health Care Workers By 2020

Sep 10, 2018

September is Healthy Aging Month, and today, Scott reports that an increasingly important factor in healthy aging is the care our elders receive while still living at home.

Clare Luz is a Ph.D gerontologist in the Michigan State University College of Osteopathic Medicine department of Family and Community Medicine. In a recent PBS Newshour story, she painted a stark picture of the shortage of home health care workers in Michigan. “In Michigan alone,” Luz says, “we’re going to need 32,000 more direct care workers by 2020.”

Note, of course, that 2020 is only a year and a half away.

Luz tells me that those numbers come from PHI, a national organization that works on behalf of home health care workers. The explanations are many, including a rapidly aging population that is living longer, some with long-term chronic conditions like Alzheimers disease. Staying at home requires assistance.

Luz continues that there’s more going on here, though, than the aging of the baby boomer generation. “In addition to the aging of the population, the people that historically took care of older adults were women in the homes,” Luz continues. “Now, we have families that are smaller, they’re dispersed, and many women are in the workforce. We just don’t have as many caregivers as we once had.”

It’s difficult to attract people to the home health care field for a variety of reasons, but Luz explains that tough working conditions and low pay may be the most important. “With an average wage of about $10 an hour, some people will say $10.40, we also have very few benefits, if any,” Luz states. “They don’t have guaranteed hours so they don’t have income that they can depend on, and they don’t have good training, and they don’t get respect.”

That lack of respect is especially challenging, says Luz. Through a Library of Congress fellowship, Luz recently interviewed 30 personal home health care workers around the state. A common complaint was how often they are referred to as unskilled, adding that “almost every single one of them said they get referred to as glorified butt-wipers, they get referred to as the maid, the housekeeper.”

These workers also say that they’ve been spit on, hit and touched inappropriately by the elders in their care. It isn’t surprising that there’s a high turnover rate.

Luz tells me that the state of Michigan has no formal infrastructure for training home health care providers, but through a recent grant, a new organization called Impart Alliance has been established to create and expand a person-centered care training program. As that effort expands, Luz hopes they’ll soon be training more trainers.

In the meantime, there is a lot of on-the-job training. Patience and being non-judgmental are important attributes, along with what Luz calls “McGyver-like problem solving skills.”

So how do we attract 32,000 new people to go into this kind of work in Michigan by 2020? Luz says that starts with better pay and training, and she has some other ideas, starting with raising the Medicaid cap. “These programs like MI Choice and Home Help, those workers are paid through Medicaid, and there’s a cap on what the agencies get for Medicaid reimbursement. It’s too low. We have to recognize family members as employed caregivers. We need in increase the pipeline by appealing to high school students and men.”

Luz adds that more men are needed in the field, concluding with the notion of professionalizing this field along the lines of the National Association of Social Workers. Such an association is only now being established.