There has been a nursing shortage in long term care facilities for decades. The causes are neither mysterious nor very complicated. However, the solutions aren’t going to be simple and the timeframe to implement them is growing short.
The need for long term care workers is rapidly increasing due to the aging Baby Boomer generation. It’s estimated that by 2030, more than 20 percent of the entire U.S. population will be over 65 years old and by 2060 that will reach 25 percent or 95 million people.
According to the American Action Forum, the total cost of long term healthcare services in the U.S. was roughly $849 billion in 2018, but that could grow to as much as $2.5 trillion by 2030.
By contrast, the number of working age adults between 18 and 64 is only expected to increase by 14 percent between 2016 and 2060.This population disparity is going to have a serious impact on the quality of healthcare as the number of nurses and care-providers entering the marketplace will not be able to keep up with the demand. Today, more than half of adults over 65 will require long-term care services at some point, so it’s pretty clear we need to turn things around quickly.
How Can We Fix the Current Long Term Care Issues?
Since this is a systemic problem, it requires systemic solutions. Three areas that can be explored are: technology, organizational changes and immigration policies.
First, we must look to the emerging technologies of AI and robotics to help alleviate staffing issues in long term care. According to Research & Markets, the global smart home health-care technology market was $4.5 billion in 2017 and is expected to reach $30 billion by 2023.
New, voice-activated smart devices can help remind caregivers and patients of medication schedules and doctor appointments. They can also activate TVs, appliances and therapeutic equipment. Smart watches and other wearables can monitor vital signs and communicate with remote physicians and nurses. Telemedicine also facilitates video meetings between doctors and patients. And robots are now serving as companions and even dispensing medications.
It will be some time before technology will be able to fully replace human caregivers, however right now it can help nurses and aides who are spread thin to provide better care for more patients.
A second solution means rethinking the current organizational structure and duties of long-term care workforce to help move some duties off the nurses’ plates.
MIT professor Paul Osterman argues in his 2017 book, Who Will Care for Us: Long-Term Care and the Long-Term Workforce, that while wages and benefits must improve, another solution is to change the current scope-of-practice laws to allow personal-care aides the opportunity to receive the training and permission to take on some medical duties such as managing diabetes, Alzheimer’s care and physical therapy that are currently being performed by nurses and other skilled practitioners per individual state laws.
Of course, this is something each state will need to address, but Osterman argues that these changes could help raise the stature of the profession, increase compensation and address the labor shortage issues by attracting new hires. He also says it would save the healthcare system money by keeping people out of hospitals and nursing homes. And the money to pay for upgrading skills would come from those overall savings.
A third solution that needs to be considered is immigration.
As in other sectors of the economy, we must also look to foreign workers to help augment LTC staffing needs. According to the Paraprofessional Healthcare Institute (PHI), 25 percent of aides currently in the home healthcare market are from other countries.
As Robert Espinoza, PHI’s vice president of policy has said, “It is impossible to imagine that the [long term care] sector would survive without immigrants.”
But if a public anti-immigrant sentiment grows and proposed federal policies further restrict immigration among low-skilled workers, it would only exacerbate the current issues in long term care.
Instead, the federal government should consider implementing a policy similar to the H-2A program for the agriculture industry that allows foreign nationals to enter the U.S. to fill temporary agricultural jobs. This could also be structured to attract foreign students who will commit to pursuing an education and career at LTC facilities.
The current long-term care workforce shortage means that our present course is unsustainable. Paycor’s HR platform can help you manage through this challenging environment. Paycor HR and Analytics give you the insights needed to monitor employee engagement and boost retention. It can also help you track turnover by department and manager.
Change is inevitable. The only question is are you prepared for it?