Home care and garbage collectors: who's worth more to us when we age? Reflections on the IOM study
By Jane Sarasohn-Kahn on 15 April 2008 in Uncategorized
The U.S. health system is poorly structured to meet the needs of aging Americans, especially the millions of Boomers who are beginning to turn 65 years of age.
The IOM’s Committee on the Future Health Care Workforce for Older Americans looked at the health needs of Americans over 65 years of age. They conclude that the health care workforce includes everyone involved in a patient’s care: beyond the traditional definition of workers such as health professionals and “direct care workers” (such as nurse aides, home health aides, and personal care aides), the IOM add informal caregivers — that would be family and friends — and the patients themselves.
The IOM prescribes that all of these “health workers,” both formal and informal, need to have tools, knowledge, and data to care for a patient. The 3 recommendations are to:
1. Enhance the geriatric competence of workers, as part of licensure, certification, and standards, and training for informal caregivers;
2. Increase recruitment and retention of geriatric specialists and caregivers, through financial incentives and programs to provide loan forgiveness for professionals who undergo extra geriatric training; and,
3. Improve care delivery to older people, specifically through disseminating proven models of care that have been shown to be effective and efficient for older adults.
The IOM also recommends that agencies provide support for technology advancements that improve care for older patients, including assistive and home monitoring technologies. My blog on consumers’ embracing such technologies bolsters this IOM recommendation.
Health Populi’s Hot Points: As you can see from the chart, meter readers and trash collectors earn more on an hourly basis than home care workers do. As the nature of the family unit morphs into smaller clusters with fewer children, single-heads, and children fleeing the coop for education, jobs, and greener pastures, aging Boomers will increasingly depend on other caregivers outside of the family to help them age at home. Assistive technologies will surely help those who understand their value and can afford to pay for them. For those who do not or cannot, funding agencies will find that with some education, people will be able to do more for themselves at home with these technologies. Many will be labor-saving. Still, technologies in and of themselves will not fill the huge gap of caregiving labor that the IOM forecasts. Here’s another instance of us having a clear crystal ball view onto the future. The IOM’s work on medical errors has led to some real action addressing patient safety. Let this report do the same for re-engineering and financing care for an aging America.