As the population ages in Connecticut and states across the country, there will be a bigger need for long-term care — for things like disabilities, injuries and illness. And that’s going to lead to a bigger need for people who are trained to help them.
But the supply of these skilled workers is not keeping up with demand. Here's what you should know about the issue:
Why demand for long-term care at home is expected to increase in Connecticut and beyond
It comes down to demographics: Connecticut’s population is aging, particularly the baby boomer generation. By 2060, the number of people 65 or older in Connecticut is expected to double, according to the state’s long-term care plan.
But Connecticut’s home care workforce is already in a “crunch,” said State Rep. Jane Garibay, a Democrat who co-chairs the Aging Committee and represents Windsor and Windsor Locks.
“We're lacking nurses. We're lacking every population,” Garibay said. “But it's not only just bad policy, it's dangerous.”
In addition to the increase in the aging population, there’s also a desire for people to age in place. The state’s long-term care plan includes having fewer people getting care living in institutional settings, and more getting help at home. In order to make that happen, the state will need more skilled workers, like home health care providers. This also includes personal care assistants and homemaker companions; these are people who help with non-medical tasks like housekeeping, meal prep, and transportation.
Home care workers aren’t paid well, which leads to issues with recruitment and retention
Direct caregivers are not paid enough for the physical and emotional work they do. And these workers are disproportionately women, people of color and immigrants.
In Connecticut, the minimum pay rate for unionized personal care assistants is $23 an hour, but that’s still not a living wage in an area like Hartford county.
Workers will take multiple jobs to try and make ends meet, said Tracy Wodatch, president and CEO of the Connecticut Association for Healthcare at Home, a group that represents medical and non-medical home providers.
“Many of them, this is their niche, this is their calling,” Wodatch said. “They want to care for people at home, but they just can't make the money.
The low pay can lead to people leaving the industry altogether.
Wodatch says the pay for home and community-based services doesn’t compete with wages at some of Connecticut’s hospitals and nursing homes.
One other factor: Medicaid, which is the biggest source of payment for long-term care both in Connecticut and nationwide.
Wodatch says the state’s Medicaid reimbursement rates haven’t kept up with inflation. That, in turn, contributes to the stagnant wages for workers who provide care for Medicaid patients in nursing homes or at someone’s home.
Other issues factor into the future growth of skilled workers
One issue is that the workers —typically called direct care workers — are getting older themselves. More than one-third of Connecticut’s direct care workforce is 55 or older, so experts say there’s a pressing need for younger generations to join this sector.
The state needs to be intentional in its efforts to get more people engaged in this work, particularly with younger people, said Michael Werner, an aging policy analyst for the state's Commission on Women, Children, Seniors, Equity and Opportunity.
One way to do this is through local boards of education, colleges and state universities.
“We need to let them know that it's dignified work to work across the generations to help provide these different services,” he said. “And to say this is legitimate, real work, it's meaningful work, it's satisfying work, and it also helps our older adults and it helps our communities.”
Informal caregiving
There are also efforts aimed at providing support and compensation for informal caregivers like family and friends. The Connecticut state legislature is considering some measures, including a caregiver tax credit.
Caregiving in Connecticut
This story is part of our Caregiving in Connecticut series. Explore the stories and conversations.
