Home Care Aid Part 2: Exploring the Trends

Part two of a three-part series by Nancy Verdin, Graduate Assistant, SDSU Social Policy Institute

Addressing access to home care aid involves confronting two immense challenges: housing and healthcare. These critical domains represent two of the five factors within the social determinants of health that play a role in influencing health outcomes. The absence of support in these areas can be destabilizing for one’s financial, emotional and psychological well-being.

While many would like to have the opportunity to age in place, to receive care and support while in the comfort of their homes, there are many roadblocks home care aides and care receipts face – each unique, but intertwined. But what lessons can we learn from current trends and what steps might we take to lead us in a more effective direction?

Compensation and investment in home care aides falls short 

According to the U.S. Bureau of Labor Statistics, the average wage for a home health care aid is about $14 an hour. And notably, a significant portion of individuals in these roles are often women, people of color and frequently immigrants, demographics historically marginalized and undercompensated for their contributions to labor-intensive tasks. 

In an editorial for Improving Health Care Quality, Kezia Scales, a Ph.D., director of policy research at PHI– a nonprofit organization specializing in research and consulting, with a specific focus on the direct care workforce– highlights the limited opportunities for both earning potential and professional advancement once individuals enter this sector. This significantly hinders efforts to retain and cultivate the workforce. 

Soaring home care cost become a barrier to staying comfortably at home 

Even those who are eligible for Medicare home care health aid find themselves without coverage for full-time care. Adding to the stress, if ongoing assistance is needed for a prolonged period, it can force families to tap into their home equity, personal savings, or other assets, with the anxiety of potentially exhausting their financial resources. Sadly, this isn’t a hypothetical scenario, rather an unfortunate reality for many families who face the risk of losing life savings or even their homes.

Explored in the New York Times series titled, “Dying Broke: The High Cost of Help,” individuals seeking home care aides for their family members shed light on the financial hardships in securing suitable care for their loved ones. Family members share their fears of potentially losing the financial stability they built over the years, including the harrowing possibility of losing their homes. The fear is confirmed by the alarming data. According to CalData, the rates for homeless care services for individuals aged 65 and older has more than doubled, rising from 7,111 recipients in 2017 to 14,647 recipients in 2023. The statistics, coupled with firsthand accounts, emphasize the need to ensure individuals have access to dignified care without the looming risk of homelessness.