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New BPC Report Calls for Strengthening Direct-Care Workforce and Supporting Family Caregivers

Headshot of Joann Donnellan
Joann Donnellan

Washington, D.C.– People living with a serious or life-threatening illness, their families and caregivers often face daunting challenges accessing and navigating America’s health care system. With a rapidly aging population, workforce shortages and inadequate training and support for caregivers pose a threat to the quality of care delivered to our nation’s elderly and for caregivers themselves.

To address these challenges, the Bipartisan Policy Center released the second of two reports today that recommends new federal policy options for improving care for individuals and families coping with serious illness. These patients have conditions that carry a high risk of mortality, limit their ability to live independently, and cause them to rely heavily on caregivers to help them remain at home. Typically, they have multiple chronic conditions, like heart disease and diabetes, or struggle with a life-threatening disease such as cancer or dementia.

This second report offers an analysis and policy proposals that would create a stronger, more well-trained direct-care workforce through career growth opportunities. These paid workers, such as home health aides and personal care aides, provide many of the services that allow the seriously ill to remain in the home. Current data show there are more than three care workers for every retiree. In 12 years, that number will decrease by one-third, while baby boomers continue to age.

“We know that patients living with serious illness prefer to receive care in the home, rather than an institution like a hospital or nursing home,” said Katherine Hayes, BPC’s director of health policy. “Creating training opportunities for our direct care workforce, such as personal care aides, will give them important new skills so they can continue to work in the home. This is critical to meeting the rising health care demands of our aging population.”

Today, access to this type of care in the home is fragmented and provided through a number of different providers with their own eligibility requirements or simply by untrained family members. Across the United States, there are about 40 million family caregivers who provide an estimated 37 billion hours of care to adults with functional limitations. BPC’s report also provides recommendations for supporting these unpaid family caregivers through greater access to respite care benefits. Additionally, it focuses on improving patient and family-centered care plans and providing better support for family caregivers when transitioning loved ones from hospital to home.

Hayes added, “Historically, family caregivers have played a central role in improving the delivery of care for their loved ones. Caregiving can be rewarding but it can also be stressful. Without the proper support systems in place, caregivers and the individuals they care for can experience poorer health outcomes. The recommendations in BPC’s report offer the potential to improve the quality of care, as well as the well-being and quality of life, for caregivers and care recipients.”

Last month, BPC released its first report which proposed policy options to change Medicare payment and delivery models and to improve access to patient care through telehealth services.