Caregiver Crisis Memories

I've been talking to a lot of people lately about two issues that are on my mind: The coming caregiver workforce crisis and the need for caregiver respect as a profession.

The projections on the coming caregiver crisis are dire; they make the shortage we experienced in the 1990s seem insignificant. I recall only too clearly what those days were actually like for an owner and operator of several senior care communities, which was my work at that time.

Before that time we had policies against hiring multiple persons from one family. During the shortage, we began asking every employee if he or she had a brother, sister, aunt or mother who would be interested in this work.

Before that time, we could keep our staff roster full with only periodic advertising. During that time, we put sandwich boards on the sidewalks that said “Now Hiring Caring People” – and left them there week after week.

Before that time we’d put two-line ads in the local newspaper and actually have applicants to interview and choose from. During the shortage, we got creative in our descriptions (“seeking people with a sense of humor only”) and ran ads in everything from the daily paper to the Nickel Ad sheets.

While we were trying everything we could to find people to fill positions, we were working every staff member overtime – lots of overtime. I worried constantly about fatigue and the results on the quality of care that a caregiver provided, not to mention the increase in abuse potential when a caregiver was exhausted.

And I have to admit we hired a few doozies, too. I remember a couple of people with tattoos from head to toe - neatly covered during the interview - that had colorful language and questionable motives for applying in the first place. Some got hired, and almost always we regretted the hiring choice.

Our managers worked night shifts, then came in the next day to do their own jobs bleary eyed and fatigued. We had residents who simply needed 24 hour care, and we had committed to providing that care to them, whatever it took.

Looking at the demographics, that experience was nothing compared to what is coming just ahead. Better Jobs Better Care reports:

Shortages of qualified, committed paraprofessionals are likely to worsen. In the coming years, the U.S. will experience a tremendous increase in the size of its­ elderly population as baby boomers age. At the same time, the number of middle-aged women who have traditionally filled these jobs is not growing fast enough to meet the increased demand for services. The result of these demographic shifts is an emerging "care gap" that could severely curtail our nation's ability to provide long-term care.

Tomorrow I’ll address the second part of my recent conversations: how to enhance the role of caregivers as professional. I can’t help thinking that these two subjects are directly linked, and are essential to our understanding if we’re going to make a real difference in the care we provide – and the care we receive.