By Robyn Stone
The coronavirus is showing us why we must support a workforce that older adults literally cannot live without.
We’ve heard many stories over the past few months about the large number of direct care professionals who have left their jobs due to COVID-19.
At the beginning of the pandemic, these stories gave us important glimpses into how the coronavirus was affecting the men and women we rely on to provide hands-on care to vulnerable elders.
But we needed more than just stories. We needed hard data.
We got that data from a recent investigation led by health economist Christian Weller, a professor at the University of Massachusetts Boston. Working in collaboration with researchers at the LeadingAge LTSS Center @UMass Boston, Weller took a careful look at workforce data that the Bureau of Labor Statistics collects through the Current Population Survey (CPS).
The CPS data confirmed our suspicions.
About 3.5 million people were working as direct care professionals between December 2019 and February 2020, before the coronavirus began its deadly rampage across the country. About two-thirds of those caregivers were home care aides and the rest were working in nursing homes and assisted living communities.
During the first 3 months of the pandemic—from March to May 2020—the number of aides in these care settings dropped to 3.2 million. The largest portion of that decrease—the loss of 232,000 workers—occurred among home care aides. The number of aides working in residential care settings dropped by 50,000 during the same 3-month period.
Our deeper dive into the reasons behind these employment declines revealed a disturbing portrait of home care aides that providers and policymakers should examine carefully.
We calculated that more than half of the decline in employment among home care aides—121,000 out of 232,000 workers—was due to the fact that these direct care professionals were shouldering a host of conflicting obligations. They left their jobs because they were caring for children, had other family obligations, or were dealing with their own health issues or concerns during the early months of the pandemic.
And what about the workers who stayed on the job? Here’s where the analysis gets troubling.
We found that, on average, aides were more likely to have left the workforce if they were healthy, younger, and white. But many aides with elevated risk for COVID-19—those who were 55 and older, or were Africa American or Latinx—stayed on the job during the first 3 months of the pandemic.
These workers could not have supported their families without a steady paycheck. So they kept working, despite their vulnerability to COVID-19, and despite the heightened risk that they could transmit the virus to others. They had to choose between their own health and paying their bills. And they chose the bills.
That’s a sobering thought.
As a nation, we could help direct care professionals reduce the COVID-related risks that staying on the job presents to their own health and to the health of others.
We could make sure personal protective equipment is widely available and easily accessible. We could institute widespread testing and tracing. We could offer aides better access to safe transportation options so they wouldn’t have to risk infection while using public transportation. We could provide affordable and adequate health insurance. We could support, financially and otherwise, the workers who are infected by or exposed to the virus and need to safely isolate.
Some LeadingAge members are providing these and other important wraparound services to the direct care professionals who work for them. But not all nonprofit providers of aging services have access to the financial resources they need to provide these services. That’s why policymakers must step in to help.
COVID-19 is shedding a new, bright light on direct care professionals by reinforcing how much this nation depends on them to provide quality care to an aging population. We can no longer ignore the fact that our government’s inattention to and lack of investment in this workforce has been damaging to the workers, to the older adults who depend on them, and to our organizations.
We’ve arrived at the moment of reckoning. We have the facts. We can’t plead ignorance about the plight of our direct care professionals. But we can—we must—rethink and reform the environments in which they work.
The coronavirus is showing us all too clearly that we can’t wait any longer to support a workforce that older adults literally cannot live without.
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Robyn I. Stone, DrPH, is senior vice president of research at LeadingAge, and co-director of the LeadingAge LTSS Center @UMass Boston. Her widely published work addresses long-term care policy and quality, chronic care for people with disabilities, the aging services workforce, affordable senior housing, and family caregiving.