Silver tsunami poised to overwhelm home care workers
By Katie Kerwin McCrimmon, Health News Colorado
Mary Brandell, 92, learned to drive at age 12, once worked at the Pentagon, loves crossword puzzles, makes a mean lemon pie, plays the piano and taught herself Spanish at 73.
“I vowed I was going to learn. I didn’t take classes. I love books. I love Spanish, so I learned myself,” Brandell said.
Aside from the lingering effects of a hernia operation that sometimes make her sore, Brandell is healthy and independent.
With three hours a week of help from a personal care assistant, Brandell can remain in the Denver home where she plans to stay “until I die.”
‘Silver Tsunami’ and a shortage of workers to care for them
Colorado always has been home to a relatively young population, but a demographic earthquake is beginning to cause temblors.
Between 2000 and 2010, Colorado’s overall population grew by 17 percent. At that same time, the percentage of people over age 64 grew twice as fast: 32 percent. Between 2010 and 2020, the population 65 and over is expected to increase by a remarkable 61 percent from about 550,000 to 892,000.
Demographers and policy experts call the swelling senior population a “silver tsunami.” Many older Coloradans are healthy, but about one third of people over age 64 have a disability and that percentage is expected to rise as seniors age.
While Colorado’s senior population surges and many may need help, the cadre of workers who can help retirees age in their homes probably won’t keep up. Most of these workers get little training and very low pay in Colorado, leaving the prospect of an ominous gap: a growing senior population and a shortage of workers to help care for them.
State Demographer Elizabeth Garner said the fastest growing group of seniors so far is the relatively young ones: ages 65 to 74. The greater need for help at home comes among those who are 75 and older, and especially among octogenarians. She says that surge is on the horizon.
“This is the perfect time to plan,” Garner said. “The most important piece is to plan before the crisis.”
A new study called Colorado’s Care Economy from the Bell Policy Center and a coalition of advocacy groups called Caring Across Generations echoes Garner’s assessment that now is the time to brace for change.
The coalition is calling on Colorado leaders to create a long-term care commission that can explore ways to boost worker training and pay while keeping care affordable and accessible for seniors. Many older adults like Brandell much prefer to stay in their homes, and taxpayers can save money if seniors who need government assistance stay out of nursing homes.
A ray of sunshine
“I don’t like the idea of being in a place where I have to take orders constantly. You never have any freedom when you’re in one of those places. They tell you what to do and I don’t like the idea of having to eat their food. I’d rather cook it,” Brandell said.
She delights in sitting on her own front porch and watching the leaves change on a maple tree across the street or enjoying the birds who visit her feeder in the back yard.
“I wouldn’t like leaving,” Brandell said. “I’d give them quite a bit of fight.”
In order to stay in her home, Brandell now pays about $66 a week to hire help for three hours every Friday afternoon from a personal care assistant. She planned, saved and affords the cost herself.
At 1 p.m., Tracy Turner, 50, comes to the door.
“I see her there and I say, ‘enter Sunshine.’ That’s what I call her,” Brandell says.
Turner glows like the sun with her bright smile and a thick mane of long blond hair.
“I hit the jackpot,” Brandell says of Turner. “She’s just a lovely person. She’s sweet and kind. She almost reads your mind. She knows what you want done next. She’s just a super person.”
As Brandell praises Turner, the care worker’s eyes fill with tears. The two have bonded over cooking and stories of life.
Turner used to work as a police dispatcher but craved face-to-face contact. So she began working for a home care agency.
“Instead of talking on the phone, I needed to look at people’s eyes,” Turner said.
“I really enjoy sharing their memories,” Turner said. “That’s the most fascinating and enjoyable part of my job. They all say, ‘I don’t have anything important to tell you.’ ”
Turner finds that everyone has a story worth telling.
“I love this humble generation.”
At Brandell’s home, Turner makes the bed, cleans the bathroom, does some dishes, sweeps, cooks and shops for groceries with her client.
On a recent Friday, they made biscuits together.
Along with essential help, Turner helps eases Brandell’s gnawing loneliness.
For 25 years, one of Brandell’s sons lived with her in her Congress Park home. But last April, he died at age 63.
He had been sick for a while, then went to the hospital with some blood clots and died three days later.
“That was a terrible blow because he was very good,” Brandell said.
“I managed on my own for a little while. I was really hurt, but you’ve got to do what you’ve got to do. I was all alone,” she said.
Last November, after recovering from surgery to repair a hernia, Brandell decided she had to hire help. She has other children and grandchildren, but they live far away or are too busy to help on a regular basis.
For Turner, the work fills her soul, but not her bank account. She did not want to say exactly how much she takes home. The agency takes its cut. So seniors stretch to pay what seems like a lot to them while many workers barely get by.
“I think there’s a lot of overhead for the companies,” Turner said. “The pay is the biggest challenge.”
‘We may be in denial’
Erin Bennett, Colorado director of 9to5, a group that represents workers, said Colorado has no training standards for home health and personal care workers. Many get paid low wages and those who aren’t U.S. citizens can receive less than minimum wage.
9to5 Colorado is part of the coalition that worked on the Caring Across Generations report.
Bennett said home care work can be hard and isolating, without opportunities to advance.
“The average wages for these workers are really low, not much above the poverty line,” Bennett said. “They’re in jobs without benefits like paid sick days or time off so they can care for themselves.”
If current workers don’t get better enticements to stay in the field, Bennett sees harmful shortages down the road.
“Unless Colorado does something to ensure that more jobs are created and job standards are created, we’re going to see an aging population that doesn’t have access to quality, affordable care,” she said.
Some states, like Hawaii, have created long-term care commissions, like the one the group is recommending for Colorado.
States need to prepare for the demographic changes and consider how best to support both workers and older adults.
“It’s ultimately about dignity and respect,” Bennett said. “Everyone deserves to live out their life with dignity, whether they’re aging or at the end of life. And from an economic standpoint, if we don’t create a good solution, more people will have to rely on a system where they’re going into nursing homes.”
Rich Jones, director of policy research at the Bell Policy Center, analyzed the data for the report.
He said low wages prompt high turnover.
“That’s the conundrum. You have low wages. You attract some people, but they will leave once they can get a better job. At the same time, seniors are making payments, but can only afford so much.”
Jones said raising the wages for home care workers would help professionalize the industry, boosting quality for seniors and ensuring that the field attracts enough workers.
“It’s preferable for seniors if they can age in their homes as long as possible. Most want to do that. And it’s certainly much cheaper for them to do that,” Jones said. “In most cases, it’s just a matter of providing some assistance to them: help with shopping, help getting around to appointments.
“We need more home care folks because we’re going to have more seniors needing services. The more we can keep seniors in their homes for longer, the better it is for all involved,” Jones said.
He hopes the report will be a wake-up call for policymakers to show them the equation doesn’t add up.
“Here’s what the demographics are. Here’s where the need is. Here’s where the work force is,” Jones said. “We may be in a bit of denial.”
He said more and more Coloradans now in their 40s, 50s and 60s are dealing with aging parents, some of whom are staying in their homes, but struggling.
“That’s raising awareness, particularly when folks are saying, ‘I may be in that same boat someday.’ ”
As Brandell looks forward to her 93rd birthday, she shares some simple advice for staying healthy. Feed the mind; teach yourself to play the piano or learn Spanish. Feed your body; she eats little meat and enjoys a Mediterranean diet. And care for one another.
“I want people to be kinder to one another,” Brandell said. “There is nothing like love and being kind and good to people. People don’t love each other enough.”