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The New Caregiving Labor Market

I was recently asked to assume the reins of a home care company in North Carolina for a month while the owners took an extended summer vacation. As a former home care company owner, I expected to be stepping into a familiar environment.

While I certainly experienced some déjà vu while on this assignment, it frequently seemed more like I had entered a whole new world. This is the world of the “post-COVID” caregiving labor market.

For many years we have known about a potential shortage of caregivers in the workforce. We have also known that our aging population would produce an ever-increasing demand for supportive services for the elderly.

What we didn’t know—and certainly didn’t expect—was that a pandemic would turn the world upside down.

COVID-19 has accelerated some of the trends that were already emerging in the caregiving industry—such as the growth of telemedicine and the pursuit of innovative home-based solutions.

COVID-19 has also dramatically revealed a structural misalignment of the caregiving labor market. If there was ever any question about whether we have enough caregivers to meet the needs of our aging population, we now know the answer. Not only do we lack the sum total of caregivers required to provide for our elders, but we also do not sufficiently value the work of our existing caregivers.

The caregiving labor market has been historically driven by a demand for cheap and flexible labor. For this reason, direct care aides who are working on the front lines experience personal economic challenges that wouldn’t exist with better pay rates. Job turnover is high in the industry, and it negatively affects the quality of care provided to our elders.

In addition, COVID-19 has created new risks and demands for the direct care workforce. Caregivers on the front lines work under the weight of knowing that they could contract or transmit a deadly virus. COVID regulations—however well-intentioned—have introduced extensive, time-consuming safety protocols that add to the never-ending “to do list” inherent in caregiving. Many of our elders, especially those residing in senior living facilities, now live under restrictions that limit their ability to freely interact with friends and family members. With the increase in loneliness among such residents, it is usually left to the direct care staff to compensate for their residents’ lack of social interaction.

The COVID-19 environment has led to more staff call-offs and resignations, which ultimately heaps extra work onto the caregivers who choose to stay. These unprecedented stressors have made the tough job of caregiving even tougher.

Amid such circumstances, is it any wonder that recruiting new caregivers has become an even greater challenge than before?

Here is where the “post-COVID” labor market was so painfully evident to me: I had never experienced so many challenges in recruiting new caregivers as I did this summer when I was serving in North Carolina. I couldn’t believe how much effort it took for our team to successfully find and hire a single caregiver. It almost seemed like the company was losing more caregivers than it was hiring, even while new service requests were on the rise.

Unfortunately, my experience in North Carolina was not unusual. In local communities across America, there is a limited number of direct care aides. All care organizations in the community—assisted living facilities, nursing homes, home care and hospice agencies, direct service providers, hospitals—are competing with one another for access to the same limited pool of caregivers. In many localities today, there are more caregiving jobs than caregivers to fill them.

Changes will be required to promote the ongoing viability of the caregiving labor market. Here are three suggested changes that, in my opinion, will have a significant impact:

  1. Raise wages – front line caregivers must be paid in accordance with their worth. The days of cheap and flexible care-related labor are over. If we want to attract and retain caregivers who deliver quality care, we must offer commensurate compensation packages.
  2. Access to career advancement opportunity – direct care aides, certified nursing assistants, and home health aides can get pigeonholed as “unskilled” workers in the industry, which limits their earning potential and makes it more difficult for them to advance to higher-level positions in health and long-term care. Organizations and policy makers should create opportunities for such caregivers to more easily receive the education and training required for career advancement.
  3. Thoughtful technology solutions – there is a host of technological advancements that may be applied in caregiving situations. Artificial intelligence, robotics, and communication devices hold enormous potential to offer caregiving supports. At the same time, it will be imperative to use technology in a way that does not sacrifice the human element that’s so critical in caregiving.

Today’s circumstances clearly call for adjustments to how we manage the caregiving workforce. The assurance of quality care will involve increased labor costs and will be supplemented by emerging technology. Like it or not, it would be wise for us to recognize that the “post-COVID” caregiving labor market is here to stay.