Will There Be Enough Care for the Elderly?

The elderly-care industry is facing a human resources problem. As the number of aging Americans grows, the ranks of elderly-care professionals -- from registered nurses to paraprofessionals who make home visits -- remains stagnant, and is even shrinking in many areas.

Low wages and hard working conditions make it difficult for nursing homes and home-care providers to recruit and retain qualified employees. With the baby boomer generation approaching 60 and life spans expected to grow, some fear the industry is not prepared to handle the influx of aging patients.

"We all know the boomer demographic is aging and that life spans are lengthening, and I think there is a crisis coming," said Ann Marie Cook, chief executive officer of Lifespan, a nonprofit agency in Rochester, N.Y., that helps older adults and families find elderly care. "The crisis might not happen immediately, but it would be ill-advised to not address the problem now."

Many hope that aggressive recruiting and incentive programs will attract a new generation of professionals into elderly care. And the introduction of home-care technology, including caring for patients through teleconferencing, could allow nurses to see more patients and relieve some of the industry's staffing problems.

Americans are Living Longer

In 1900, the average American life span was about 47 years, according to Jeanette Takamura, dean of Columbia University's School of Social Work and former assistant secretary for aging in the U.S. Department of Health and Human Resources. The average life span is 78 today; by 2030, there will be double the number of Americans over the age of 65, pushing today's number to 72 million. With better medicine and technology, Americans are expected to continue living longer, healthier lives.

That's a daunting concept for a traditionally cash-strapped industry. Long-term elderly care, particularly for nurses, has historically been a low-paying field. Providers often are unable to compete with the salaries offered by hospitals or other health care organizations.

Some companies are aggressively recruiting nurses and paraprofessionals, offering small bonus incentives, educational benefits or ladder programs that eventually move nurses into management positions. One home-care nursing company, Visiting Nurse Service, also in Rochester, instituted a program in which one year of paraprofessional service earns workers full tuition to a college program that trains them to become Licensed Practicing Nurses.

"We're telling people who are interested that this can be a career rather than just a job," said Victoria Hines, CEO of Visiting Nurse Services. "It's become a recruiting tool."

But financial constrictions along with the negative stigma of working with frail elderly patients have made it difficult to recruit and retain staff. Hines noted that even with increased enrollment this year, the new paraprofessionals in the program only replaced the ones who dropped out in early 2005. The annual turnover rate for paraprofessionals in the elderly-care industry is about 40 percent to 50 percent nationwide, Hines said, and the nursing turnover is about 15 percent.

"Paraprofessionals still only make about $8 an hour, and that's for visiting five homes a day doing hard, physical labor. They could make the same amount of money working at a retail store," she said.

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