America Needs More Immigrant Workers to Address Our Growing Shortage of Caregivers

A new study in Wisconsin found a severe shortage of caregivers to staff assisted living facilities, home health care agencies, and nursing homes across the state. Pennsylvania is in the same boat according to state officials and the problem is even worse in Maine, the nation's "oldest" state. It's a national problem and it's going to get much worse in the coming years as the population ages. By 2030, 20% of all Americans will be 65 or older, and the number of individuals who are 85 or older will double in the United States by 2040. We need to consider solutions now before the shortage of caregivers becomes a crisis impacting the health and safety of elderly Americans.
There are a variety of reasons for the shortage. It's the fastest growing major job category, it's hard work and emotionally draining, and it pays poorly. The New York Times published a story last year that captures the life of a worker in the home health care industry. The subtitle to the story sums it up succinctly, "A home health aide for a 77-year-old man serves as social worker, diaper changer, dietitian, day planner, warden and more — all at dismal wages." It's a physically and mentally demanding job, and the median wage nationally is about $11.00 an hour, not much better than retail or the fast food industry.
The worker shortage is going to become a crisis in the next decade as our population ages and fewer native-born Americans enter the field.
Fsu.edu: "Meanwhile, the United States is facing a severe worker shortage in care workers, with a projected 7.8 million job openings by 2026, as millions of current care workers retire or find new professions, all while demand in the field skyrockets."
Today, almost a quarter of our caregivers are foreign-born, a mix of legal and undocumented immigrants, and the percentage has been growing. If we don't rethink our current anti-immigrant policies the situation will deteriorate further in the coming years.
Reuters: “We rely heavily on immigrants to care for the elderly and disabled, particularly in their everyday care,” said the study’s lead author, Dr. Leah Zallman, an assistant professor of medicine at the Harvard Medical School and director of research for the Institute for Community Health at the Cambridge Health Alliance. “Therefore, any policies trying to reduce immigration are likely to make what is already a workforce shortage worse.”
Usually supply and demand would address the shortage as wages increase to entice workers into the field, but that hasn't happened, partially because many families are already struggling to pay the cost of care for elderly relatives.
Politico: "Joanne Spetz, director of the Health Workforce Research Center on Long-Term Care at the University of California, San Francisco, says there are reasons the job is low-paid. If a family is paying the caretaker directly, “not a lot of individuals or families have the kind of resources to pay much above minimum wage for this kind of work.” State Medicaid programs generally support home care services for low-income patients, but states cap their reimbursement levels to care providers."
Increased immigration would seem to be our best solution, but that is politically difficult right now. However, it's difficult to see how we address the crisis if we continue to implement policies which reduce our pool of lower or moderately skilled immigrant workers.
Health Affairs, Research: "Addressing the direct care worker shortage will require a multifaceted approach, including better wages, benefits, and education and training programs to draw people into the labor force while reducing turnover. However, curtailing immigration will almost certainly move us in the wrong direction, worsening the shortage and the availability of high-quality care for elderly and disabled Americans."
By: Don Lam & Curated Content