How an Ever-Greying Population and Looming Immigration Rollbacks Endanger America’s Eldercare System (and How We Just Might Fix It).

How an Ever-Greying Population and Looming Immigration Rollbacks Endanger America’s Eldercare System (and How We Just Might Fix It).

One of the greatest concerns of developed countries today is the aging of populations at a faster rate than they are growing. The United States is no exception. In fact, America is poised to experience what is satirically dubbed the impending “gray tsunami.” Indeed, by 2060, the aging population in America will have grown roughly 105 percent in just forty-five years since 2015, compared with a total population growth of only 30 percent over the same period (Statista). Therefore, it is not surprising to note that the eldercare industry will have to grow accordingly. However, the industry will only grow weak and brittle as it currently stands, desperately unstable in the face of a population that is aging faster than it is growing. There simply will not be enough able-bodied Americans to fill the necessary positions in the eldercare industry. We all know what happens when extreme pressure is applied to a fragile thing. It shatters.

So, what are Americans to do? The most logistically friendly option is to enhance the current long-term care workforce by beefing up its wages, benefits, and training programs. Right now, the average direct care worker (the individual responsible for carrying out day-to-day activities with elders such as bathing and toileting) makes only fourteen dollars an hour. This is a paltry sum for the demanding and emotionally draining jobs they hold. As Osterman (a labor economist at MIT’s Sloan School) reports, increasing wages contributed by decreasing employee turnover in the eldercare industry. Moreover, adding benefits such as health insurance and making training mandatory and continual over a direct care aide’s career have also been shown to decrease employee turnover. Hopefully, taking these steps will not only help eldercare industry actors hold on to more employees than they do currently, but also make their jobs more attractive to those who are looking for a job.
In addition to increasing wages, benefits, and training programs for direct care aides to recruit more American employees, the United States must also consider creating an uninterrupted migration channel and path to citizenship for those foreign workers who wish to help take care of our elders. This type of channel does not exist currently, and as such there is unstable flow of foreign labor into the eldercare industry. However, a striking number of migrants (both documented and undocumented) already work in long-term care. Indeed, approximately forty-five percent of direct care workers are foreign-born. Despite their integral place in the eldercare system, the current presidential administration seeks to deport as many of them as possible. It is time to acknowledge their unreplaceable work in our eldercare system by allowing them to not only enter the country legally, but to set them on a path to citizenship so as to ensure continuity and quality of care for our elders.

In this paper, I will discuss these and the many other obstacles that exist to improving eldercare in the United States in greater detail. However, I will also review how other developed countries have successfully (and unsuccessfully) attempted to revitalize their own long-term care systems. From there, I will make evidence-based recommendations on how to improve our own system using the tools we already have in place. Though our current system is unstable, it is by no means unsalvageable.

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