By Geralyn Magan
The LTSS Center recommends that you put these 5 articles on your reading list for March.
GROWING RISK TO AMERICA’S SENIORS: THEMSELVES
An increasing number of older Americans are developing serious health problems and even dying because they are unable to care for themselves, according to a recent article in The Wall Street Journal.
“So-called self-neglect cases generally involve the inability to perform essential self-care, such as providing oneself with food, shelter, personal hygiene, medication, and safety precautions,” writes Yuka Hayashi.
Hayshi shared this data:
- In 2018, self-neglect cases involved 144,296 people across the country, and constituted more than half the reports of alleged elder abuse or neglect investigated by adult protective services programs.
- Self-neglect cases rose by 18% in Virginia, 60% in the District of Columbia, 55% in Iowa, and 19% in Ohio over the past 2-5 years.
Illness, dementia, depression, poverty, and loss of a spouse can trigger self-neglect. The key to reducing such cases is “providing services to enable seniors to remain in their homes safely, such as reliable transportation for medical appointments and grocery shopping, as well as affordable home help with chores and regular monitoring,” writes Hayashi.
SOCIAL ISOLATION AND LONELINESS IN OLDER ADULTS
Older adults who are experiencing social isolation or loneliness may face a higher risk of mortality, heart disease, and depression, according to a new report from the National Academies of Sciences, Engineering, and Medicine. Yet, the health care system remains an “underused partner” in preventing, identifying, and intervening to reduce social isolation and loneliness among adults over age 50, says the report.
The report outlines 5 goals the health care system should adopt to help address the health impacts of social isolation and loneliness:
- Develop a more robust evidence base for its effective assessment, prevention, and intervention strategies.
- Translate current research into health care practices to reduce its negative health impacts.
- Improve awareness of those impacts among workers and among members of the public.
- Strengthen ongoing education and training for the health care workforce.
- Strengthen ties between the health care system and community-based networks.
PHI BEGINS SERIES ON AMERICA’S DIRECT CARE WORKFORCE
Every day, nearly 4.5 million direct care workers support older adults and people with disabilities across the U.S. From 2018 to 2028, the long-term care sector will need to fill 8.2 million job openings in direct care. Turnover among direct care workers has generally been reported at 40-60% or higher.
These are the key takeaways from It’s Time to Care: A Detailed Profile of America’s Direct Care Workforce a new report from PHI. The publication is the first installment in a yearlong series of reports examining the importance and impact of the direct care workforce. A final, comprehensive report—Caring for the Future: The Power and Potential of America’s Direct Care Workforce—will be released in January 2021.
The current report defines the direct care workforce and describes how the direct care role is evolving in response to changes in the health and long-term care systems and among consumers.
“In short, direct care workers are supporting individuals with more complex needs in every setting, particularly in private homes and communities, and these workers require more technical, interpersonal, and linguistic and cultural competencies than ever before,” says the report. “Despite the changes in their roles and responsibilities, compensation for direct care workers—who are primarily women, particularly women of color and immigrant women—remains notoriously low, leading to high rates of poverty in the workforce.”
The report highlights 2 immediate opportunities to strengthen the direct care workforce:
- Improve hourly wages and annual earnings to ensure workers are fairly compensated.
- Build the workforce pipeline by targeting new populations of potential workers and addressing the harmful effects of recent immigration policies on workforce recruitment and retention.
Other essential strategies, which will be explored in upcoming PHI reports, include “remedying the inadequacy of the financing system, improving training and career development for direct care workers, ensuring that direct care workers are well-supported on the job, and more.”
CAN IMMIGRATION HELP SOLVE WEST VIRGINIA’S WORKFORCE SHORTAGE?
In 1965, Charleston, WV, was home to about 85,000 residents. Now, there are about half that many state residents, and most of them are older people who are white.
“And as they age, those older folks need someone to care for them,” reports Kara Leigh Lofton of West Virginia Public Radio. “But across the United States, there’s a direct care worker shortage.”
Lofton asked several experts—including Robyn Stone, co-director of the LeadingAge LTSS Center @UMass Boston, and Sean O’Leary, senior policy analyst for the West Virginia Center on Budget and Policy—to identify solutions to the crisis facing West Virginia and other states.
One potential solution suggested by O’Leary and endorsed by Stone would entail hiring more immigrants to care for older West Virginians.
Lofton points out a potential barrier to this solution. Less than 2% of West Virginia’s population is foreign born, and the state’s political environment may not support increasing that percentage. A 2018 Dominion Post poll of West Virginians found that 60% of respondents agreed that “a growing number of newcomers from other countries threatens traditional American customs and values” and “immigrants today are a burden on our country because they take our jobs, housing, and health care.”
ORGANIZATIONAL-LEVEL CONSUMER ENGAGEMENT: WHAT IT TAKES
Patients, families, and caregivers bring valuable insights to health care organizations. But health care organizations don’t always have the resources to ensure the voice of the patient is both meaningful and influential.
To address these challenges, the Center for Consumer Engagement in Health Innovation at Community Catalyst and the Health Care Transformation Task Force took an in-depth look at 3 different health care organizations: Children’s Mercy Kansas City, Hudson River Health Care, and Trinity Health. Three new case studies, funded by the Robert Wood Johnson Foundation and co-authored by LTSS Center fellow Erin McGaffigan, examine:
- The array of engagement structures each organization employs.
- What it takes for organizations to implement and sustain these structures.
- The impact of engagement structures on the organizations and the people and communities they serve.