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.
My mother has an undiagnosed mental illness that makes her incapable of accepting reality and that has caused her to be emotionally abusive my...