National shortage of home-care workers threatening the option of aging at home (70+, graduating)
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I would counter that a staffed facility is able to send 2 or 3 aids to help get a patient situated safely. Assisted Living/Rehab/Nursing homes also have bathrooms that are wheelchair friendly - wide doors, hand rails, zero entry showers, rails on the side of the toilet for easier transfer, etc. Whereas in a regular home, a caregiver may be trying to heft a person into a regular tub. Even trying to get a wheelchair bound person over the threshold into a regular shower is not that easy - and that's assuming that the wheelchair can fit through the shower door so that they can transfer to a shower seat. Sometimes a sponge bath is the only feasible way for them to bathe.
In a facility, the food is delivered to the facility and it is cooked by kitchen staff. It is then served to the residents by staff, either in the residents' rooms or in a large dining room. In a home environment, the caregiver has to leave the house to grocery shop and possibly has to figure out a way to bring their patient with them (some can not be safely left alone). That may require getting a wheelchair in/out of the house via a wheelchair ramp, the person transferred safely into the car, the wheelchair collapsed and hefted into the trunk, then once they arrive at the store, the wheelchair is hefted back out of the trunk, the person is transferred to the wheelchair and then pushed into the store. Then there is the logistics of where you put the groceries as you shop - you are pushing a wheelchair so pushing a cart, too, is difficult.....once you're done there's the transfer back into the car, the hefting of the wheelchair into the trunk and then, of course, more hefting and transferring to get back inside the house. Oh, and then there is the meal prep...
Long term care facilities are absolutely set up for this kind of care. Regular homes are not.
I experienced that last year as my S.O. began to deteriorate. We went to the grocery store with me pushing him in this borrowed travel wheelchair and him pushing the shopping cart. Certain rickety displays were in danger, but we managed to not knock anything over. But yeah, it's a lot of lifting and/or letting them lean on you. My partner has the strength to stand, but because the world constantly spins for him, he has no balance. At least he could grab the door and get a foot into the car and haul himself in with me hanging on to make sure he didn't fall over. And another difference between most women and me is the fact that I am six feet tall and inherently stronger than most females. But still, I'm 64, and the reality is that I am not as strong or unbreakable as I once was, either.
No choice, though. I could not leave him home alone and drive 15 miles each way into town to shop without my heart in my throat. By then he had lost the coordination in his fingers to even dial 911 if the house caught on fire. Eventually the government sent a PSW for a four-hour stint once a week to sit with him so I could run errands, and then when we realized this was not something that could be fixed, we had to go elsewhere.
Wages were only a small percentage of my total compensation; most of my total compensation was in equity (stock options & grants) and bonuses earned for exceptional performance in the workplace.
Probably true, because I'm retired. At the same time, I'm currently an adjunct professor in a graduate business school (part time & just for fun - it was on my bucket list). I spend a fair bit of my recreation-time reading articles published in scholarly, peer-reviewed academic journals. Oh - also, just for fun, I'm on Board of Directors of one public company and one pre-IPO company (its prospects for a liquidity event do not look great right now). So I do try to keep my toes wet.
Nevertheless, each of us are responsible for keeping our skills fresh, don't you think?
In retirement, each year my largest expense line item is my federal income tax obligation. Here's this years obligation:
Oh I agree completely. Academically speaking, inflation can be viewed as a tax. Our nation did some extraordinary things in response to the pandemic, and inflation is one of the ways we collectively pay the bill. I won't go into detail on this, as it is off topic.
Well, it is good to know I still come across with words you interpret as brash & youthful.
You might enjoy reading a book published just before the Great Recession, titled While America Aged: How Pension Debts Ruined General Motors, Stopped the NYC Subways, Bankrupted San Diego, and Loom as the Next Financial Crisis It is written by famed financial journalist Roger Lowenstein, and is carefully researched. About 95% of the book is the historical record of the problem of financing those of us who are seniors. It is quite accurate, and Roger writes in a way to make this financial history quite interesting. The final 5% of the book is his prescription of what to do. Sadly, there are no great insights there.
As one of my favorite mathematics professors used to say, "not all problems have solutions. You have to know what you can solve, and what you cannot solve. The penalty for incompetence is eternal calculation."
I'm clear on the difference, but that wouldn't solve the issue of not being able to find a worker to do the work that the 70-year-old would have to take on. If neither of these are a possibility, refer to post #210 on what your options are.
Homes can be renovated or remapped for "basic" assisted living.
You can remodel the bathroom to put in a safety tub or walk-in-tub. If there is money for a home aide or an ASL, there would be money to do this if independent living is still desired. Wheel-chair ramps can be made to fit the home as well, and so on.
Steal this idea: create a gig app that uses non-medical, on-call people movers. The app company provides all the malpractice insurance just to cover all bases, but this is strictly for moving the elderly when needed. Since these calls would be for non-emergency yet needed moving, like other types of delivery apps, these gig workers can decide to take an order that comes up in the pooling orderflow, or not take an order if they want. Hospitals, medical facilities and individual homes all would have access to "brawn." There are gyms everywhere, and you can market this there, as well as generally, giving both fit men or women who aren't otherwise in the medical profession an extra avenue to make some money. This cost could be prohibitive if a person utilizes this constantly, or needs it daily, but it would be there.
First off, when a person suddenly becomes wheelchair bound it's not like you always get a ton of notice that it's going to happen. A person can go from walking to being wheelchair bound in an instant. Scary but true. It happened to us when my husband was injured in an accident. Thankfully he recovered over the course of 3 months, but the experience made a believer out of me. I didn't even have a chance to get a portable wheelchair ramp before the hospital sent him home in a taxicab. No way could I just snap my fingers and get our house magically wheelchair friendly.
And people aren't going to want to call some random person on a phone app to come help them lift their loved one off of the floor or help them get them safely out of the house and into the car for an errand or appt.
If there was an easy way to do this, believe me, people would have figured it out by now. The truth is, it can be overwhelming, if not downright impossible, for a caregiver to manage.
I experienced that last year as my S.O. began to deteriorate. We went to the grocery store with me pushing him in this borrowed travel wheelchair and him pushing the shopping cart. Certain rickety displays were in danger, but we managed to not knock anything over. But yeah, it's a lot of lifting and/or letting them lean on you. My partner has the strength to stand, but because the world constantly spins for him, he has no balance. At least he could grab the door and get a foot into the car and haul himself in with me hanging on to make sure he didn't fall over. And another difference between most women and me is the fact that I am six feet tall and inherently stronger than most females. But still, I'm 64, and the reality is that I am not as strong or unbreakable as I once was, either.
No choice, though. I could not leave him home alone and drive 15 miles each way into town to shop without my heart in my throat. By then he had lost the coordination in his fingers to even dial 911 if the house caught on fire. Eventually the government sent a PSW for a four-hour stint once a week to sit with him so I could run errands, and then when we realized this was not something that could be fixed, we had to go elsewhere.
Unless you have done this sort of thing yourself, you have no idea what it's like for sure. The logistics of it all are complex and A LOT to handle by yourself.
I'm 5'5" and my husband is 6'0". His injuries only impacted his ability to stand/walk. Otherwise he was very strong and was able to heft himself in and out of his wheelchair using his upper body strength. I figured out ways to sort of "jerry rig" our house to make things more doable for him. I would not have been able to lift him or transfer him all by myself. I was more there to steady and helped him as needed. It was definitely an eye opening experience to put it mildly. I could leave him for short stretches but I didn't want him trying to transfer without me there.
The balance issues that your S.O. is having can be very scary. It's good that you are being cautious with him. Falls can be game changers and you definitely want to avoid a fall if at all possible. My heart goes out to you.
You are right, I always think I should be able to do everything by myself and that we shouldn't ask for help unless absolutely necessary. It has been hard to have to admit I can't take care of him by myself. I did all last year until I couldn't anymore.
But we are on a lake 15 miles from town, and there just aren't many people around in the winter. Some people have only three-season houses and the nearest neighbors, who aren't any younger than I am, are snowbirds who bail to Florida for the winter.
One night the winter before last, my bf went to the burb house to see his sons for their February birthdays, leaving me here with the pets. I stepped outside to marvel at the stars and realized the nearest person to me was probably in the one house I could see across the lake that had a light on. You can hear wolves howling here at night in winter. I fell in love with winter here, but now I just have to hang on to those memories. I thought we'd have a few years here, but no. Eh, I'm not the first person to have their dreams squashed like a bug because of age and illness.
First off, when a person suddenly becomes wheelchair bound it's not like you always get a ton of notice that it's going to happen. A person can go from walking to being wheelchair bound in an instant. Scary but true. It happened to us when my husband was injured in an accident. Thankfully he recovered over the course of 3 months, but the experience made a believer out of me. I didn't even have a chance to get a portable wheelchair ramp before the hospital sent him home in a taxicab. No way could I just snap my fingers and get our house magically wheelchair friendly.
And people aren't going to want to call some random person on a phone app to come help them lift their loved one off of the floor or help them get them safely out of the house and into the car for an errand or appt.
If there was an easy way to do this, believe me, people would have figured it out by now. The truth is, it can be overwhelming, if not downright impossible, for a caregiver to manage.
They would also be required to be licensed by the state for that, and that would not happen unless they were trained in some capacity and transporting people. You can’t just have random people go in and pick up a elderly person they’d have to know how to safely transfer people properly. They’d have to have some training. They’d have to know if they have an old rotator cuff tear and how to modify the technique, etc. Without training and most probably some kind of state certification, they wouldn’t get a business license and without a business license they couldn’t get liability insurance. I think it’d be hugely expensive liability insurance, too.
Unless you have done this sort of thing yourself, you have no idea what it's like for sure. The logistics of it all are complex and A LOT to handle by yourself.
I'm 5'5" and my husband is 6'0". His injuries only impacted his ability to stand/walk. Otherwise he was very strong and was able to heft himself in and out of his wheelchair using his upper body strength. I figured out ways to sort of "jerry rig" our house to make things more doable for him. I would not have been able to lift him or transfer him all by myself. I was more there to steady and helped him as needed. It was definitely an eye opening experience to put it mildly. I could leave him for short stretches but I didn't want him trying to transfer without me there.
The balance issues that your S.O. is having can be very scary. It's good that you are being cautious with him. Falls can be game changers and you definitely want to avoid a fall if at all possible. My heart goes out to you.
Oh that was last year before the neurological effects hit rock bottom. If they have. For example, in August he had a seizure. That was a new thing. They sent him home from the hospital last December as "bedridden", but we have him sit in a chair or a wheelchair and go outside for a few minutes sometimes. It's tiring and uncomfortable for him, though. Most of the time he is in a hospital bed. Which he has fallen out of, so now we shove a couch on one side and have boards wedged on the other side so he can't fall out of bed.
They do send a nurse once a week, and then we remove the board so she has access to him. It's a brightly painted thing that we found in the garage that had belonged by my bf's grandmother. Flowerpots with babies in them. The nurse is amused.
But anyway, to the topic, on the bright side I get some home health care coming in to assist because that's how things work with socialized medicine. Not a perfect system, and they have shortages just like the States, but it took a lot off me to not have to try to figure out how to get this type of help by myself. They called us.
Oh that was last year before the neurological effects hit rock bottom. If they have. For example, in August he had a seizure. That was a new thing. They sent him home from the hospital last December as "bedridden", but we have him sit in a chair or a wheelchair and go outside for a few minutes sometimes. It's tiring and uncomfortable for him, though. Most of the time he is in a hospital bed. Which he has fallen out of, so now we shove a couch on one side and have boards wedged on the other side so he can't fall out of bed.
They do send a nurse once a week, and then we remove the board so she has access to him. It's a brightly painted thing that we found in the garage that had belonged by my bf's grandmother. Flowerpots with babies in them. The nurse is amused.
My roommate took care of his mom for several years. She was bedridden. He would take her to all of her appointments.
They had a Hoyer lift to move her from her bed to her wheelchair.
My roommate took care of his mom for several years. She was bedridden. He would take her to all of her appointments.
They had a Hoyer lift to move her from her bed to her wheelchair.
My sister bought one of those lifts off Facebook Marketplace to move her husband. He has PPMS, a late-life form of MS, and after ten years, he can't even move his feet anymore or put weight on his legs to help her. She went through getting a lawyer to wade through the Medicaid process to get some home care help. There's a shortage there, too, same as here.
My BF has no medical appointments to go to. He is on palliative care. The palliative care doc will come to the house if need be, but we've only had him there twice. A nurse comes once a week to check BP/pulse/any pressure sores, catheter, etc. A few times when a pressure sore was flaring up, she came every three days to dress it.
I guess this is the equivalent to "visiting nurses" in the USA.
A lot of the home health care aides and nurses are immigrants, who I presume are working to get permanent residency.
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