BUSINESS

Seniors are stuck home alone as health aides flee for higher-paying jobs

While more elderly seek home care to age in place, low-wage workers are finding easier jobs with equal or better pay in retail and restaurants

By Christopher Rowland
September 25, 2022 at 8:00 a.m. EDT

RICHFIELD, Minn. — Racked with nausea and unable to leave the bathroom, Acey Hofflander muttered in confusion. Her husband tried to press a damp washcloth against her neck, his hands trembling and weak from Parkinson’s disease. ... “What’s happening? What’s going on?” Acey mumbled. ... Their roles had unexpectedly reversed. At 85, Acey is the healthy one, the organized, energetic caregiver for husband, Tom, 88. But when a grueling day of showering, dressing, feeding and transporting him to medical appointments pushed Acey beyond exhaustion in July, she wound up in the emergency room — a health crisis the Hofflanders blame in large part on a lack of professional, in-home care.

Amid a national shortage of home-care workers that deepened during the covid-19 pandemic, the couple spent much of this year on a private agency list waiting to be assigned a professional home-care aide. But over four months, from April to August, no aides were available, leaving Acey to carry the load on her own. Many nights — after an hour-long bedtime routine that included giving Tom his pills and pulling on his Depends before tucking him into his recliner — she lay sleepless in bed. ... “He needs a lot of care, and it’s wearing, not only physically but mentally,” Acey said in one of several interviews. “It makes you worried about what’s going to happen. How long can I do this?”

The Hofflanders’ story is becoming increasingly common as the country’s shortage of home-care workers worsens, jeopardizing the independence of a generation of elderly Americans who had banked on aging in place rather than spending their twilight years in nursing homes. ... Polls say an overwhelming majority of people older than 50 want to remain in their homes as long as possible, and studies have shown aging in place can promote quality of life and self-esteem. But Acey Hofflander’s health scare — she stayed in the hospital overnight with a form of migraine — reveal the dangers when elderly people are forced to go it alone.

The shortage predates the pandemic but has been exacerbated by it, according to industry and government experts. Demand for home services spiked as lockdowns, uncontrolled infections and deaths frightened people away from nursing homes, where the number of residents declined nationally from about 1.3 million in 2019 to 1.1 million in 2021 and has only partially rebounded in 2022. At the same time, because of the tight labor market, the low-paid workers have quit for less taxing jobs in Amazon warehouses and as Uber drivers. ... The lack of services also is affecting disabled people under 65 years old who are dependent on others for daily needs. ... The result is that an increasing share of elderly and disabled people are living at home but having difficulty finding the help they need to do it safely. A fall or an exhausted caregiver could mean they are forced into a nursing home or a bedroom in their adult child’s home.

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By Christopher Rowland
Chris Rowland joined The Washington Post business team in 2018 after serving as the Washington bureau chief for the Boston Globe, leading coverage of two presidential elections and overseeing political enterprise reporting. He previously covered health care for the Globe in Boston. Twitter https://twitter.com/PostRowland