Since the Covid-19 pandemic, it has become increasingly hard for people to get the care they need at home. The Wall Street Journal reports on a woman with ALS who needed to rely on seven different caregivers over six months because of the shortage of home aides.  This home health aide shortage undermines people’s ability to age in place, and it’s not likely to end any time soon.

Mary Barket has ALS. She struggles to manage with activities of daily living such as cooking, cleaning and bathing. On some days, she could not get her home health agency to send an aide to help her. She has no family or other volunteer caregiver.

Without a home aide, the situation can be dire for Barket. She can barely use her hands. And, she can’t go out on her own for food.

When people must rely on multiple aides, it jeopardizes continuity of care. In order to get the home health care they need, patients and their families have to teach each new aide about their daily habits anew. When do they wake up, nap, go to sleep? What do they eat at each meal? What do they wear? How do they like to spend their days, and more?

Unfortunately, we are facing home health aide shortages and significantly high turnover rates. The supply chain is inadequate to meet needs for the large number of people who rely on home health care to age in place. Covid-19 has increased demand for aides, making it harder for people to hire them.

Home health agencies have been increasing wages for home care workers, expanding their benefits, offering training and giving signing bonuses. Agencies are looking to ensure job satisfaction and reduce turnover rates.

But, annual income for home health aides still averages under $30,000. Average pay remains under $15 an hour, though the agencies generally charge double that or more for their time. The work can be quite difficult both physically and emotionally and the hours unpredictable.

The US has seen a doubling of home health aides in the 10 years between 2008 and 2018. There were 2.26 million in 2018, up from 900,000. And, the numbers should grow another 550,000 or so by 2033.

The home health care industry is growing much faster than other industries. But, it is not growing fast enough. Demand for home health care far exceeds supply.

Do you need to hire home health aides? Medicare covers home health aides to a limited degree for some people needing physical therapy or skilled nursing, who are homebound, for whom leaving home requires a considerable effort. Otherwise, unless you also have Medicaid, you will likely have to pay out of pocket.

If you’re hiring home health aides, you should look into hiring two, one as backup. You might also want a geriatric care manager to coordinate care and help find back-up aides when a caregiver is not available.