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Eldercare Workforce Alliance
Who We Are
The Eldercare Workforce Alliance is a group of 28 national organizations, joined together to address the immediate and future workforce crisis in caring for an aging America.
The Institute of Medicine, in its critical report "Retooling for an Aging America: Building the Health Care Workforce," called for immediate investments in preparing our health care system to care for older Americans and their families. In response, we formed the national Eldercare Workforce Alliance-representing consumers, family caregivers, the direct-care workforce, and healthcare professionals-to propose practical solutions to strengthen our eldercare workforce and improve the quality of care.
Our Mission
To address our nation's worsening eldercare crisis, the Alliance will build a caring and competent eldercare workforce, joining in partnership with older adults, their families and other unpaid caregivers-to provide high-quality, culturally-sensitive, person-directed, family-focused care, and improve the quality of life for older adults and their families.
Our Shared Vision
We believe that:
- An essential step in addressing our fragmented health and long-term care system is to adopt care models that provide well-coordinated, person-directed and family-focused services across settings.
- All unpaid caregivers - including family, friends and other caregivers-should be supported and have opportunities to acquire the needed skills, knowledge, and information to care appropriately for older adults.
- Resolving the workforce crisis requires addressing recruitment, retention, training and compensation issues across the direct-care and professional health care workforce-which is essential to improve the quality of care and quality of life for older adults.
Challenges
Our nation is ill-prepared to meet the health and social needs of older adults and their families. By 2030, one in five Americans will be age 65 or older-75 percent of whom will have at least one chronic condition, with 20 percent having five or more chronic conditions.
Our challenges include:
- Unsupported Direct-Care Workforce: Our nation's three million direct-care workers-home health aides, certified nursing aides and personal care attendants-are often poorly compensated, trained, and supervised, contributing to heavy workloads, and dangerously high rates of vacancies and turnover.
- Clinician and Faculty Shortages: Too few providers are pursuing careers devoted to caring for older adults, creating shortages not only of providers but also of faculty with the knowledge and expertise to educate others.
- Inadequate Training: Too few public resources are invested to ensure that all care team members-family and friends, direct-care workers and professionals--are provided the geriatrics and gerontology information and training necessary to care for older adults.
- A Fragmented System: Our nation's health care system all too often provides care that is episodic, overly siloed, and poorly coordinated.
Proposed Solutions
Eldercare employs millions of individuals in the United States, and is projected to be the fastest-growing employment sector within the health care industry. Strengthening these caregiving occupations not only is vital to our social infrastructure and improving the quality of care, but also has the potential to drive long-term economic growth, particularly within low-income communities.
Alliance members believe that we can and must create a health care workforce that meets the needs of older adults and their families. As recommended by the IOM, our proposed solutions include:
Strengthen the Direct-Care Workforce
- Require a minimum of 120 hours of training for certified nursing aides and home health aides, including explicit geriatric care and gerontological content; and create minimum training standards/competencies for non-clinical direct-care workers.
- Increase compensation for direct-care workers through means such as: a) establishing minimum standards for wages and benefits paid under public programs, and b) targeting reimbursements to ensure that public funds directly improve compensation for direct-care workers.
Address Clinician and Faculty Shortages
- Increase compensation for clinical professionals and educators with geriatric and gerontological expertise-they will be needed to care for our frailest elders and their families, and to help educate the rest of the workforce.
- Increase funding for federal and state programs that support development of geriatrics faculty and clinician training-such as Title VII and Title VIII.
- Implement federal and state programs that provide incentives-such as loan forgiveness-to those entering careers caring for older adults.
Ensure a Competent Workforce
- Encourage agencies and organizations that certify and regulate the eldercare workforce to require demonstrated and continued competence in the care and treatment of older adults.
Re-design Health Care Delivery
- Disseminate and adopt cost-effective, comprehensive care coordination models that are evidence-based, and fully fund care coordination components that have demonstrated measurable success.
Quality Care for Older Adults
We believe that quality care for older adults begins with a focus on the whole person, their family, friends and other members of the care team, often requiring an interdisciplinary team with expertise in geriatrics and gerontology-particularly for those who are frail or have multiple health conditions. High-quality eldercare includes a focus on physical, mental, cognitive and behavioral health, and on ensuring that social supports are present. Care for older adults-who often have multiple complex chronic diseases-should be delivered in a seamless fashion across settings, starting in the home. Our goal is to maximize function and quality of life for all older adults, enabling them to remain independent for as long as possible.
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