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“Building a direct care workforce for an aging population”

By: Cathy Rowe
June 6, 2022

This article was originally published on njbiz.com and is posted here with permission.

At New Jersey Advocates for Aging Well, we are always looking at the numbers. So, consider these statistics. The population age 65+ was the fastest growing group in New Jersey between 2010 and 2020, increasing 26.8%, according to usafacts.org/data. This number means the 65+ population increased from 13.5% in 2010 to 17% in 2020. And the trend is expected to continue. The U.S. Census Bureau projects that by 2030, those aged 60 and older will make up 24.5% of our state’s population.

This trend in aging is a good thing. It represents not only baby boomers reaching retirement age, but also increased longevity. Not only are more people “older” but they are also living longer than ever before. The hope is that these seniors will lead vibrant and interesting lives for many years. However, an estimated 70% will need some type of support as they age. And so, our aging population will increase demand on our care infrastructure.

That is why NJAAW has partnered with PHI, a national organization focused on the direct care workforce, to bring the Essential Jobs, Essential Care initiative to New Jersey, and to build on recent progress in the state to support the direct care workforce. This workforce – which includes certified home health aides, certified nursing assistants, and direct support professionals – provides essential care to thousands of residents in their homes, community settings and in-patient facilities. As the COVID-19 pandemic has made clear, direct care workers provide critical support to older adults and people with disabilities across the state. With our aging population, we know the need will increase just as the workforce is shrinking.

Inadequate compensation, limited training and advancement opportunities, and other challenges are pushing direct care workers away from this sector. With recent increases in minimum wage and demand for workers in other sectors, people can choose to work in easier settings for the same or more pay DCWs need to pay for classes, training and to receive certification from one of several state offices before they can earn their first paycheck in patient care. In addition, nearly 40% of New Jersey’s direct care workers live in or near poverty, and 41% access some form of public assistance. This results in workers paid through Medicaid being eligible to receive Medicaid – an unsustainable situation.

Caring for seniors
The U.S. Census Bureau projects that by 2030, those aged 60 and older will make up 24.5% of our state’s population.

The U.S. Census Bureau projects that by 2030, those aged 60 and older will make up 24.5% of our state’s population.

It is becoming more and more difficult for providers to meet current and growing demand. So, we are committed to building a strategic road map for recruiting, training and retaining direct care workers that will benefit all New Jersians, both now and in the future.

Currently, there are just over 101,000 direct care workers in New Jersey. PHI estimates that long-term care employers here will need to fill nearly 179,000 job openings in direct care by 2030, which includes new jobs to meet growing demand and jobs that must be filled when existing workers transfer to other occupations or exit the labor force. Our seniors are relying on this workforce to support them; we must do more to ensure it is there for them.

There has been some great progress in recognizing the need for and the needs of direct care workers recently. The Long-Term Care Ombudsman’s Office secured higher pay for nursing home workers under COVID. The New Jersey Health Care Quality Institute produced a comprehensive report on the need for an across-the-board strategy to expand and prepare the health care workforce in the state. The Coalition for a DSP Living Wage made great strides in helping workers serving people with disabilities. Programs including NJ Pathways and Schools that Can are opening training and establishing career pathways to bring more people into this important field.

In addition, the state has committed funds to this effort – Gov. Phil Murphy earmarked $240 million last July to wage increases for a range of direct care workers; early this year, he signed into law a bill that dedicates $1 million to creating pipeline and career advancement opportunities for direct support professionals. These are great starts. What we need now is to work together to build a strategy that will see us through the current worker shortage, find commonalities, and create advocacy road maps with concrete and achievable policy goals and activities that will work for the long term.

Over the next 18 months, we will continue bringing together representatives from a wide range of providers and services in N.J. for a common goal – to increase and improve the direct care workforce. As we learned in the first convening of the PHI Coalition on May 23 and 24, DCWs have unique skills and character traits. This is a hard job, both physically and emotionally. Older adults deserve a workforce that is qualified to care, and also bring patience, compassion and dedication to their patients.

I invite stakeholders to join us in this effort. We are striving for a strategy that benefits all sectors of health care services. With a well-trained and fairly compensated workforce, all health care and service providers can benefit – whether inpatient facilities or home-based services.

At NJAAW, we advocate for what it takes to age well, encourage people to think ahead about where and how they want to age, and what they need to do to prepare. But no matter how strategic we are, we will never know what support we need until we need it. As they say, “the best laid plans of mice and men…” So, we must plan for a future where a significant portion of our population will need supportive services to age in the great state of New Jersey. This future needs a strong workforce.

Cathy Rowe is executive director of New Jersey Advocates for Aging Well. The Essential Jobs, Essential Care NJ initiative is supported by The Henry and Marilyn Taub Foundation.

“2020 Vision for Successful Aging”

aging elders seniorsNJ Foundation for Aging is honored that the North Jersey Alliance of Age-Friendly Communities, a partner organization, wrote about their impressions of our 22nd annual conference and shared them with us as a guest blog.


Mornings on the golf course. Weekends with the grandkids. Vacations to dreamed-of destinations.

These are the visions of “successful aging” in many people’s minds, reflections of the one-dimensional view of growing old that is all too pervasive in our culture.

Not that those pretty images of retirement life aren’t experiences that people should desire. But without taking a deeper look at all the potential challenges and opportunities of growing older, many individuals will fail to anticipate later-in-life needs and desires.

In its advocacy work, the New Jersey Foundation for Aging routinely seeks to widen the lens that society trains on the lives and livelihoods of older adults, and the organization’s annual conference this year succeeded in doing just that.

Titled “2020 Vision for Successful Aging,” the conference, held virtually on Aug. 13 and 14, featured presentations on how aging intersects with a range of other policy issues from climate change to LGBTQ rights to immigration policies.

The conference also sought to open attendees’ eyes to the ways in which ageism is so widely normalized and internalized that it can often lead to us making uninformed individual and societal decisions that limit older adults’ choices in later years.

LONGEVITY COSTS

In a keynote address, Cynthia Hutchins, director of financial gerontology for Bank of America Merrill, said people shouldn’t avoid thinking about uncomfortable questions such as how long they might live and whether they will need some form of caregiving at some point.

“Longevity has changed the way we plan for our health and our health-care needs,” Hutchins said.

prolonged health care

Previous generations didn’t envision living decades in retirement, but Baby Boomers and the generations that come after them will need to have a better understanding of such things as the limits of Medicare, the different options for long-term care, and how the financial and lifestyle choices they make early on can affect future health and happiness, Hutchins said.

In her presentation, Hutchins pointed out that, although one’s future health might be an unknown, there are useful projections individuals need to be aware of, such as that out-of-pocket health care costs between the ages of 65 and 80 can equal $114,000, and then grow to $247,000 by age 90 and $458,000 by age 100.

Figures like these might seem unbelievable to the average individual, but failing to adequately discuss and plan for future scenarios is what often leads to individuals having inadequate plans, and our government institutions having inadequate policies for the aging of the population.

At the root of our society’s unpreparedness for aging is often ageism, which includes the “prejudice against our future selves” that many of us possess.

Ageism was a focus of several workshops at the two-day conference, some of which examined how it can evolve into elder abuse or translate into a lack of advocacy on key issues that older adults and their advocates should be speaking about more often.

CLIMATE CHANGE + AGING

Climate change is foremost among those issues. Often portrayed as an issue of more concern to younger people worried about the future, what’s often overlooked is the fact that older people are the ones who tend to suffer the most harm from the severe storms and climbing temperatures that are already the result of our warming planet.

climate change and agingJeanne Herb of the New Jersey Climate Change Resource Center at Rutgers University shared data showing that older people are at more risk of heat-related hospitalizations and more likely to have chronic conditions exacerbated by severe weather and the power outages and service interruptions that can result from them.

Similarly, older adults and their advocates need to be aware of how immigrants and people in the LGBTQ community are subject to more discrimination and barriers to housing and supportive services as they age, other panelists at the conference argued.

AGEISM/STEREOTYPES

In addition, the coronavirus pandemic has brought to light the way ageism, and bias toward disenfranchised groups, can lead to alarming disparities in disease exposure and treatment outcomes and to the many gaps and weaknesses in New Jersey’s long-term care systems, many speakers pointed out.

Organizers of the conference hoped that it would serve as a call to action, and ideas were shared on how to combat ageism with intergenerational programming and through the arts.

Katie York, director of Lifelong Montclair and the township’s senior services department, described the results of a study she helped guide on how performing arts programs can help lessen age stereotypes among young and old.

ageism, age-friendly communitiesThe study entailed recruiting 72 individuals – ranging in age from 20 to 82 – to perform in skits that reflected age stereotypes. Afterward, participants were surveyed on whether the performances had altered their perceptions of aging and generational differences.

As director of Lifelong Montclair, a now-five-year-old age-friendly community initiative, York said she has come to “recognize the need for culture change as a foundational element of age-friendly efforts.

“As more people understand the scope and value of our work on culture change, I believe our work will be that much more significant, and those battles we face along the way will be that much easier,” York said.

Julia Stoumbos, director of aging-in-place programs for The Henry & Marilyn Taub Foundation, said the NJFA conference provided many useful insights into how the leaders of age-friendly communities can help change views of aging, and also the steps that community leaders take to support the goal of aging in comfort, dignity, and safety.

“Often, the approach that communities take in addressing the needs of older adults is compartmentalized. There’s a big emphasis on leisure and recreation – planning Zumba classes and bus trips to Atlantic City.  There’s also a tendency to medicalize old age, with programs focused on how to combat it or treat it like a disease.” ~ Julia Stoumbos, director of aging-in-place programs for The Henry & Marilyn Taub Foundation

“Often, the approach that communities take in addressing the needs of older adults is compartmentalized,” Stoumbos said. “There’s a big emphasis on leisure and recreation – planning Zumba classes and bus trips to Atlantic City.  There’s also a tendency to medicalize old age, with programs focused on how to combat it or treat it like a disease.

“Those narrow approaches can sometimes lead to older adults being treated as if they are separate from the rest of the community, as if they are less invested in issues that affect all people at all ages,” Stoumbos said.

“Older adults have no less of a stake in the major issues of the day. They need to be empowered to stay engaged on these subjects, and communities need to make sure they are bringing the generations together in conversations about the weighty issues that affect quality-of-life for all.”


The age-friendly movement was first envisioned by the World Health Organization in 2005 as a way to find local strategies to prepare for the global challenges and opportunities of an aging population. The North Jersey Alliance of Age-Friendly Communities is supported by The Henry & Marilyn Taub Foundation and the Grotta Fund for Senior Care. Together those foundations are funding age-friendly initiatives in 16 communities in five counties – Bergen, Essex, Morris, Passaic and Union – which together have a population of more than a half-million people. The alliance also works in partnership with NJFA, AARP New Jersey, New Jersey Future and Rutgers University.

Announcing NJFA’s 18th Annual Conference!

Announcing NJFA’s 18th Annual Conference!

NJFA will hold its 18th Annual Conference on Thursday, June 2nd at the Crowne Plaza Monroe. The 2016 Morning Keynote Speaker will be Ruth Finkelstein, ScD, who is an internationally recognized leader of inspiring and creating strategies for aging friendly communities. She is Assistant Professor of Health Policy and Management at Columbia University Mailman School of Public Health where she also serves as the Associate Director of the International Longevity Center-Columbia Aging Center (ILC-CAC). At the Columbia Aging Center she currently leads the translation of interdisciplinary scientific knowledge on aging and its implications for societies into policy-focused practice in order to maximize productivity, quality of life, and health across the life course. The Luncheon Keynote is Karin Price Mueller. She writes the Bamboozled consumer affairs column for The Star-Ledger which often addresses senior scams. Karen is also the founder of a personal finance web site that offers smart and objective advice on everything money, NJMoneyHelp.com. She is the recipient of many national and local journalism awards.

The 2016 conference workshop speakers will include policy makers, direct care & clinical practice specialists. Topics include Hearing Loss, Dementia, Older Worker Programs and more.

More information and registration can be found on NJFA’s website at www.njfoundationforaging.org Limited vendor space and sponsorships remain, call us at 609-421-0206, email at office@njfoundationforaging.org  or check out the website for details.

The New Jersey Foundation for Aging (NJFA) is a public charity with the primary goal to empower elders to live in the community with independence and dignity.

 

To learn more about the work of the Foundation visit www.njfoundationforaging.org or call 609-421-0206. The New Jersey Foundation for Aging was established in 1998, its mission is promote policy and services that enable older adults to live in the community with independence and dignity.