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ABSTRACT While the demand for direct care workers continues to rise, their real wages continue to fall, creating an unstable workforce that threatens continuity and quality of care. This situation continues because those paying for caregiving-policy makers, insurers, employers, consumers-are powerful stakeholders, while direct care workers are politically and economically powerless. But the landscape of eldercare in the United States is shifting, and the triple threat of increased rate of demand, constricted supply, and falling unemployment will create vacancies. To address this threat, direct care jobs must have competitive wages and benefits and stable, predictable hours. | key words: eldercare workforce, direct care workers, competitive wages, unemployment
Our new labor market requires stakeholders begin to compete for direct care workers through higher pay, benefits, predictable hours, training, and support.
Here is the conundrum: While the demand for direct care workers-home health aides, ing assistants, personal care workers-continues to surge, their real wages, adjusted for inflation over the past ten years, continue to fall (see Figure 1 on page 39).
The impact on elders is clear: An increasingly unstable caregiving workforce-with their already low compensation eroding more each year-will further threaten continuity and quality of care. As demand climbs precipitously in this coming decade (e.g., the number of elders older than age 85 is expected to increase from 6.3 million in 2015 to 7.4 million in 2025), long-term-care consumers will be forced to find more than one million additional paid caregivers nationwide. This sobering challenge will become even more difficult if the caregiving workforce is increasingly destabilized by a continued decline in real wages.
Currently, annual earnings for direct care staff average from $18,729 for nursing assistants, to as low as $13,361 for personal care workers (PHI, 2015b). The result? Forty-nine percent of direct care workers live in homes dependent upon some form of public assistance; 51 percent return from work each night to families living below 200 percent of the poverty line.
Consider the sheer scale of this caregiving workforce:
* Direct care workers number nearly 4.3 million in the United States today, making direct care work one of the largest cluster of occupations in our country;
* Personal care and home health aides are projected to add 1.3 million workers between 2012 and...