There’s A Shortage Of Home Health Aides For The Elderly, And It’s Getting Worse

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Students at a training program, Cooperative Home Care Associates in New York, practice basic skills like a bed-bath on each other. Home health aides, provide basic, day-to-day support for elderly and disabled people, allowing them to age at home.

Kavitha Cardoza


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Kavitha Cardoza


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In fact, there are more projected job openings for home health aides in the next decade than for any other occupation. One study estimates that 70% of adults age 65 and older are expected to need some form of basic assistance. The demand and supply is very imbalanced.

Kezia Scales is the director of Policy Research at PHI, a national nonprofit organization that advocates for home health aides. She says these jobs are exhausting, with low wages, little respect and almost no career growth.

«And so we end up having a fairly unstable workforce with high levels of turnover and job vacancies, not because people don’t want to do this work, but because they can’t afford to do this work,» she says.

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Tashawna Vivas and other students at Cooperative Home Care Associates, a home health aide training program, requires students to take classes that include nutrition and skin care as well as how to use specialized equipment to turn or transfer a client.

Kavitha Cardoza


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Kavitha Cardoza


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Vivas looks proud of herself. «My back is a little busted but it’ll be OK!»

Vivas will also learn how to safely turn someone to prevent bedsores, what a normal blood pressure reading is, and when changes in urine color might indicate a health problem.

The work deserves a higher wage but Medicaid reimbursements lag

The four-week full-time training course is free, which is unusual. Matt Sigelman, CEO of the job market analytics company Emsi Burning Glass, says the median wage for a home health aide is $24,000 a year.

«For perspective, that’s only about $500 more per year than your average fast food cook. So the notion of taking out a loan [and] going into debt, to get into a job that pays you the same as you would make in a fast food restaurant is pretty hard to swallow.»

Cooperative Home Care Associates also provides benefits. But even here, aides make only minimum wage. CEO Adria Powell says that’s because reimbursement rates from Medicaid and Medicare are so low. «The work is deserving of a higher wage, we are unable to do that because of the reimbursement structure,» she says.

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Juhaley Abrau, a student at Cooperative Home Care Associates, practises how to safely give her fellow student, Tashawna Vivas, a bedbath. Abrau says a lot of the programs she looked at were all «insanely expensive,» in some instances, charging up to $2,000. She chose this program because it was free, paid for through government and private money.

Kavitha Cardoza


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Kavitha Cardoza

Juhaley Abrau, a student at Cooperative Home Care Associates, practises how to safely give her fellow student, Tashawna Vivas, a bedbath. Abrau says a lot of the programs she looked at were all «insanely expensive,» in some instances, charging up to $2,000. She chose this program because it was free, paid for through government and private money.

Kavitha Cardoza

Paul Osterman, author of the book, Who Will Care for Us? says home health aides are very restricted in what they can do for their clients. For example, they can only remind a client to take their medication, they can’t actually give it to them.

Osterman argues for better training and expanded duties for home health aides, which he believes will help clients better manage chronic conditions and stay out of hospital.

«That would also save money and to some extent, take over some of the work from much higher paid nurses. So that would then create savings, which could then be used in part to pay for the higher wages,» he says.

Cooperative Home Care Associates has career counselors who help mentor students if they want to study further and move up the career ladder with higher paying jobs such as certified nursing assistant (CNA) or licensed practical nurse (LPN). Tashawna Vivas hopes to be a nursing assistant one day.

«I enjoy helping people, taking care of people, ’cause I’m going to need somebody need to take care of me, too!» Vivas says.

  • home health
  • home health aides
  • elderly care
  • home health care

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