Congress Is Choosing to Give Caregivers an Uphill Battle – Business Insider

  • Home care services are few and far between across the country, especially in rural areas.
  • Low wages and grueling work conditions are leading many home care workers to leave the profession.
  • Without adequate home care options, Americans are left with no other option than to accept defeat.
  • Beth is a caregiver and lives in Calhoun County, West Virginia.
  • This is an opinion column. The thoughts expressed are those of the author.

A couple of years ago, my 90-year old mother began showing symptoms of Alzheimer’s. I had no trouble recognizing the signs: I’d spent my professional life working as a home health aide and had had several patients with Alzheimer’s and dementia. I’d once built a career on caring for elderly people in their homes. Now I learned that my own mother would need to be on the receiving end of such care.

I reached burnout in home care about a decade ago, after years of being underpaid and overworked, and I could no longer do the grinding work of lifting, cooking, and cleaning all day, every day. But I continued working as a part-time caregiver, in addition to the unpaid care that I provided to my mother. 

Then, two months ago, my mother fell at night and ended up in the ER. In a flash, she became someone who needed 24-hour care. I knew it would not be easy to find home care for my mom because of a shortage of workers — people who left the profession for the same reason that I did. 

It’s no secret that healthcare for the elderly is hard to come by in America, especially in remote places like my little county of 7,000 inhabitants in West Virginia. There is a significant shortage of nursing homes and assisted living facilities that leave aging and ailing populations with few congregate care options.

But even if good nursing home options were available, my family can’t put my mom in one because she needs individualized care. If she is left alone, she loses her balance and falls. In the evening, she suffers the confusion of  Alzheimer’s “sundowners” and wanders away if she’s left alone. In a congregate care setting, she’d be at increased risk of injury, and the nearest hospital with geriatric care is an hour’s drive away.

In-home care enables elderly people like my mom to retain a measure of independence as they age. Although my career as a home health aide was exhausting, it was incredibly fulfilling to be the person who enabled my patients to age in place as they wished. This is one of the reasons that home care has become the preferred long-term care option for aging parents and the elderly over these past few years. 

As home care workers quit the industry over low pay and terrible work conditions, the situation worsens for those who remain in it, who are overworked with ever-expanding caseloads. Even though I left the profession because of the low pay and my mother’s increasing care needs, I still fill in from time to time, when my former patients find themselves in a bind because a caregiver didn’t show up to work.

There is so much that needs to be fixed in our industry. We are required to take entire days off to participate in training, but we are paid even less for this time. Workers like me in rural America, often have to drive miles and miles to get from one patient to the next, and are rarely compensated for our travel time or reimbursed for gas. Small wonder that there is an exodus from the profession.

Now I’m on the receiving end of the home care industry. If my experience has taught me one thing, it’s that finding good, competent, reliable care comes at a steep price. The only way we could even access workers was by going through private agencies, and paying $3,000 each month — more income than I bring home in pay. In the space of just several weeks, my family went through just about all of our funds. Ultimately, we had to move my mom across the country to Washington state, where she will have access to better care. I’m still here and it breaks my heart.

This issue is of central importance to my life right now, so I’ve been paying close attention to the reconciliation bill that the Biden Administration is proposing. One measure in it would expand access to home care services for families like mine, investing $400 billion to improve the pay, training, and benefits of home caregivers. Some 81% of Americans — including conservatives like myself — support it. 

My senator, Joe Manchin, has said he’s concerned about the Biden bill’s price tag, but investing in home care would actually save money for American taxpayers. Right now, it costs the Medicaid program about $90,000 a year to care for a person in a nursing home, but just about $29,000 a year to care for a person in their own home. 

One sign that a country has a flourishing economy is that it tends to the health and wellbeing of the people who live in it. Home care saves taxpayer dollars, and is supported by a significant majority of Americans. Our leaders should invest in as much funding as possible in the industry.  My family shouldn’t have to deplete our life savings, or move our mother across the country, to provide her the care that she needs.