While today’s seniors are healthier than the elderly were a generation ago, aging eventually leads to the loss of some ability to live independently.
If an elder can no longer safely take a shower or grocery shop by themselves, what are their options?
As the last resort, moving to a nursing home is an option but, when asked, most seniors strongly prefer to age in their own home.
Besides being unappealing, nursing home care is expensive! In Massachusetts, a high cost of living state, the median cost of a semi-private room in a nursing home is $12,600 per month. Nationally, the median cost is $9555, which translates to $114,660 per year.
Staying at home instead of a nursing home means that help in the home will be needed. This can be provided by some combination of friends, family and paid caregivers.
Long-term, the U.S. must make policy decisions about how to cope with its aging population. In the immediate future, we need to provide more, and more affordable, help at home.
In 2024, some 3.2 million people worked as home health aides and personal care aides. To meet the demand, experts say that another 750,000 will be needed over the next decade.
Who are these people caring for our frail elders? Not surprisingly, almost 90% are women. About 30% are foreign-born, many from low-income countries such as the Dominican Republic, Jamaica, Haiti and the Philippines.
Home health workers are poorly paid, averaging $17/hour, and there is very high turnover. At the same time, the cost to care-recipients is high, averaging $34/hour. The difference is the money made by the agencies that employ the workers.
The agencies play a key role in vetting the home care workers. Given the possibility of physical abuse or theft by unknown individuals in the home of a dependent elder, hiring someone “off the street” is risky, yet keeping half of the cost seems excessive. If you or a loved one needs help at home, what are your options other than going through an agency?
The ideal option would be word of mouth. If a friend or neighbor has had a home aide that has been reliable, hiring them directly is an option. You can pay them more than they would get from an agency and still save money.
A better option would be for your state to set up a registry of vetted home health and personal care aides that individuals could access. The state could assume the responsibility for doing background checks and listing any complaints.
Massachusetts has such a registry, but it is only accessible to employers, not the public. Ask your state legislators to open the registry for public access.
The best fallback would be to call your local Visiting Nurse agency. They will either provide vetted home health aides or be able to direct you to a trusted local agency
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