Some of the hardest conversations I have in my work involve telling families managing the debilitating chronic illness of a loved one at home that they are essentially on their own. Most do not realize that medical insurance does not pay for long-term home care. Though the aides themselves are typically paid little, for-profit agencies can drive the cost of a home health aide to roughly $4500 a month. And the demand for quality home care services is expected to explode over the next decade.
A survey that spanned from 1995 to 2014 showed that nearly half of Americans turning 65, about 48 percent, will require some form of paid long-term care to keep them in their homes and communities. Most of the current workable solutions to what is commonly called a caregiver crisis are implemented at the state level in isolation from one another, often with thin margins and underfunded mandates. What’s missing is a national partnership that prioritizes funding for community-based elder care services.
I learned the value of direct-care workers as health care providers during my years as a hospice director in a nursing home.
While nurses and other frontline professionals have always understood the importance of excellent bedside care delivered by a trained direct-care worker, the health care system itself has been slow to recognize their value.
Soon after my 50th birthday, 10 years ago, I started keeping a list of “Things I will do/things I won’t do when I get old.” It was a highly...