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Toby Laping Associates www.WNYCareManager.com
Eldercare News |
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You Need To Know . . . Staffing Issues in Healthcare by Toby F. Laping, Ph.D., C.S.W. The crisis in the geriatric work force is real. You’ve read about the problem of finding enough people to care for our aging population, and you may have felt the problem as well. Many is the recipient of Medicare services at home who was told by the Medicare nurse that he would be approved for three hours of aide service, three times weekly, but unfortunately there’s no aide available to staff the case. Or, having complained about the poor quality of service in a nursing home, many is the patient who was told by the Director of Nurses that she’s very sorry but the facility is short staffed and people called in sick that day and there’s no one to cover. We can talk about minimum staffing levels and we can acknowledge that it’s unsafe to have insufficient numbers of staff. But, are we willing to pay the extra rates that nursing homes would charge if they could find and hire lots more aides who were willing to work for them? Are we willing to pay enough more for home care aides to make that line of work genuinely attractive as a career path? There are shortages of health care workers at all levels of care, but it’s often felt first when there’s a shortage of personnel at the aide level. Those are the folks who give the bed baths, empty the bedpans, straighten out the bed, and try to come as fast as they can when you call if you’re in a hospital or nursing home. In your own house, those are the folks who do your laundry, keep you clean and dry, make your meal, and wash your dishes, and then go on to do the same thing in someone else’s house. Aide work isn’t glamorous. It’s hard work and often thankless, and not well paid. Instead of being thanked for answering a call bell in a nursing home, aides are often told that they took far too long to come and in fact from the patient’s perspective, the wait was far too long. Or, when the aide is assigned to a home care case, she may have to leave home hours before her scheduled work time in order to make the bus connections. After that, it isn’t fun to be scolded for being five minutes late. This isn’t to suggest that all aides are good. As with any group of people in a career, some aides are genuinely wonderful, and some are thoughtless, careless, and insensitive. Most are somewhere in the middle. And, especially when you’re a really good aide, your financial reward isn’t very satisfying although there have been efforts to make career paths that provide incentives. In a recent study of nursing home workers in New York City, many of the workers worried about substandard care and blamed poor care on being stretched too thin. While sloppy work habits are part of the problem, it’s very accurate to say that insufficient staffing is a major difficulty. There simply isn’t enough time for staff in institutions to give the caring, unhurried attention that we all want and that makes us feel good. Medicaid pays for more than 75% of nursing home costs in New York State. Those payments vary greatly between facilities and regions of the state, but nursing home owners and administrators in Western New York say those payments are way too low to make ends meet, let alone hire more staff and pay them enough to attract large numbers of competent job applicants. Are we willing to pay more in taxes for Medicaid benefits? Probably
we’re not; ultimately we need to look at solutions that don’t focus
on reimbursement adequacy and fair state wide distributions. Governments
typically make incremental and not radical changes. Incrementalism
isn’t sufficient to solve this critical personnel and financial
need. We need more than a band aide quick fix.
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