Who will care for the baby boomers?

The nursing home industry has distinct labor problems of its own, with close to 100,000 vacancies for nurses and nursing aides, and an annual turnover rate of 70 percent as some nurses quit the profession and others take higher-paying jobs at hospitals.
The American Health Care Association, which represents thousands of nursing homes, says the cost of high turnover — notably recruiting, training and using temporary contract workers — exceeds $4 billion a year.
Ken Preede, the association’s director of government relations, hopes the current debate over immigration leads to changes that could ease the nursing shortage.

Already, thousands of nurses from India, the Philippines and elsewhere work at U.S. nursing homes despite sometimes cumbersome visa procedures. Preede would like to see immigration changes that would make it easier to fill such specialized, high-need positions and also to recruit guest workers for less-skilled nursing home jobs.

Pamela Doty, a policy analyst with the Department of Health and Human Services, said the caregiver gap often is most acute in rural areas with few immigrants. She cited Kentucky and Arkansas as states with notable challenges.

In areas short of caregivers, the consequences can be painful. Some elderly people must make do with ill-trained and overburdened helpers; others who would prefer to live on their own are forced into the more costly option of nursing homes. Even when family members step in, as millions do, there is a price emotionally, physically and often financially if career duties are disrupted.

“Many families are committed to keeping their relatives in the community, so they’ll do their utmost — but it takes a toll on them,” Doty said.

There are some optimists.

Patricia Kappas-Larson, a nursing expert with the Evercare health plan, believes caregivers can be trained to be more skilled, more motivated and more flexible in finding ways to serve the elderly outside of hospitals and nursing homes. Emily DeRocco, the Labor Department’s assistant secretary for employment and training, predicts the baby boomers — many of them now caring for aging parents — will ensure that the market economy produces enough qualified caregivers for their own retirement era.

But Dr. Richard Butler, president of the International Longevity Center-USA, is less confident — fearing that severe problems will persist until America figures out a way to include long-term care as part of basic, affordable health care coverage.

“My impression is that baby boomers haven’t really addressed the issues of aging yet — they’re more absorbed with how to avoid aging,” he said. “We’re facing a historic demographic change, and we do not have an adequate, well-trained work force — from doctors down to basic in-home caregivers — who know the details of aging.”

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