by Candi Helseth
Beyond funding, the other challenge in providing in-home care for seniors is finding an adequate supply of trained caregivers, especially in rural areas.
“Finding and obtaining and keeping caregivers in rural areas is a challenge and the distance that caregivers travel to provide a visit is sometimes in excess of 50 miles one way,” said Sherrie Petersen, director of the Good Samaritan Society’s LivingWell@Home program.
An inadequate workforce and personnel shortages continue to increase nationwide, said Lenard W. Kaye, Director of the University of Maine Center on Aging, noting that this year the Institute of Medicine (IOM)* highlighted the urgency of expanding and strengthening the geriatric health care workforce. “The IOM indicated that the breadth and magnitude of inadequate workforce training and personnel shortages have grown to enormous proportions,” Kaye said. “In Maine, our Department of Labor projects the need for increased numbers of gerontological specialists as well as generalist care providers who possess up-to-date knowledge, skills, and abilities in the care of older adults. Go to any other state department of labor as well as the U.S. Department of Labor and you will find similar warnings. It’s difficult to find geriatric specialists in rural areas and there is no guarantee you’ll be able to find a funding source to recognize and pay for case management services.”
In its chapter on “Home and Community Based Care for Rural Seniors,” the 2010 NACRHHS Report found that, “Allowing seniors to age-in-place is more difficult because the existing infrastructure and available resources are concentrated on supporting nursing home care.” It also reported, “The greater supply of nursing homes in rural areas, along with a lack of home and community-based options for rural seniors, may result in increased nursing home placements.”
But it’s not just a matter of finding people to fill the slots. Caregivers must be trained adequately before they are sent into homes to care for seniors. Before Mississippi agencies providing HCBS services can send employees out as caregivers, noted Sandra D. Bracey-Mack, a Deputy Bureau Director at the Mississippi Division of Medicaid, they must provide training that includes caregiver responsibilities, emergency preparedness, disability awareness, ethical relationships, need for respect of individual’s privacy and property, Vulnerable Adults Laws, boundaries of a caregiver, managing care of a difficult client, basic elements of body functions, infection control, maintaining a clean and safe environment, personal hygiene and grooming, bladder and bowel routines, transfers, equipment (i.e., wheelchairs, lifts, etc.), use and maintenance, and meal preparation.
Meeting the challenge of finding and training qualified caregivers is especially needed now. “This generation seems to be more empowered to demand alternatives to the usual institutional way of life,” Bracey-Mack commented. “Providing alternatives in home and community settings provides the individual with independence and quality care that, at this stage of life, is invaluable.”
Back to: Fall 2012 Issue