Older adult speaking with caregiver

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Workforce challenges in long-term care are a global challenge, so solutions need to come from sharing best practices, policies and solutions on a global level.

That’s according to panelists discussing workforce challenges and opportunities facing the sector at a Tuesday webinar hosted by the Global Ageing Network and Aging in America.

Sixty percent to 80% of hands-on services in the long-term services and supports system are provided by frontline care professionals such as certified nursing assistants, personal care assistants and home health aides, said LeadingAge Senior Vice President of Research Robyn Stone, DrPH, who also is a co-director of the LeadingAge LTSS Center @UMass Boston.

Stone, who moderated the discussion, also noted that 30% of frontline professionals in the United States are immigrants. Although their countries of origin benefit from the remittances those workers send back to their families, they also are affected due to the drain of talent. 

The pandemic, Stone said, provided an opportunity to see this workforce as essential, opening avenues for future investments in staffing and supporting the delivery of those services. It also broadened thinking about how to share best practices, create policy issues and invest globally to address barriers, challenges and opportunities, she added.

“I’m optimistic,” Stone said. “COVID exacerbated worker shortages and challenges in recruitment and retention. On the other hand, with a growing and increasing demand for services, as well as a recognition of this essential workforce, we have the opportunity to do things differently.”

PHI Director of Policy Research Kezia Scales, Ph.D., said the caregiving gap is a population reality, service delivery issue, financing challenge and job quality opportunity.

The challenges of the direct care workforce are many — low-wage, high-poverty jobs with few benefits, disproportionate rates of occupational injury, little training, few advancement opportunities or career pathways, and lack of a voice on the team, she said. 

But those challenges, Scales said, present opportunities in the form of quality training, fair compensation, quality supervision and support, respect and recognition. Efforts will take on greater importance as the aging population significantly increases demand, she added.

“To avoid the caregiving gap, we need to recruit more caregivers and deploy them more effectively and efficiently to extend care coverage as far as possible,” Scales said. 

As countries struggle to cover risking long-term care costs due to growing demand, she said, the way long-term care is organized, delivered and financed makes a difference for people in receiving the services they want and need. And although most people prefer to receive services in the home, many countries remain oriented around delivering care in nursing homes and other long-term care settings such as senior living. Scales said she anticipates a shift to home- and community-based services, given consumer preferences.

Panelist Donna Duncan, CEO of the Ontario Long Term Care Association, agreed that it’s time to focus on community-based approaches and innovations. Caring for the aging population, she said, requires more systemic approaches to investment in prevention, a health workforce strategy, leveraging of technology and building services around client needs and wishes.