Poor Job Quality, Low Wages Continue to Hurt Caregiver Recruitment in Home Care

Over the past decade, low compensation, inadequate training and limited career advancement opportunities have weakened job quality for caregivers. That, in turn, has limited the pool of hiring candidates for home care providers.

But in light of caregivers’ role amid the COVID-19 emergency, it’s more important than ever to take concrete measures that can improve the job for years to come.

“Home care providers should know that improving home care jobs can lead to various benefits, including increased job satisfaction, reduced turnover and better care with less costly health outcomes,” Robert Espinoza, vice president of policy at PHI, told Home Health Care News in an email.


PHI, a New York-based advocacy organization for direct care workers, released a new report highlighting the longstanding challenges caregivers face on Tuesday.

The home care market has been historically plagued with workforce issues, with providers in the space often struggling to recruit and retain caregivers. Between 2018 and 2028, there will be an estimated 8.2 million job openings in direct care.

Part of the reason recruitment can be a challenge in the industry is because caregiver wages cannot compete with other occupations, according to the PHI report.


Across the U.S., the median wage for caregivers is lower than that of other jobs with similar entry-level requirements, such as janitors, retail salespersons and customer service representatives.

In 2019, direct care workers earned a median hourly wage of $12.80, a meager improvement from $12.61 in 2009. As a result, 45% of direct care workers live in or near poverty, according to PHI data.

Another challenge for caregivers has been the training landscape.

“Direct care training requirements vary significantly by state, program and occupational role; personal care aides, for example, lack any federal requirements, and state laws for this segment of the workforce are thin and inconsistent,” the PHI report stated. “Furthermore, many training programs in this sector are topic-based and duration-based, instead of taking a competency-based approach that emphasizes workers’ acquisition of the right knowledge, skills and abilities.”

Additionally, there is a lack of career advancement opportunities for caregivers, according to PHI.

“The lack of career pathways within direct care jobs —and from direct care into other fields— prevents direct care workers from assuming new roles with elevated titles and higher compensation,” the report pointed out. “This scarcity of career paths also affects retention.”

In order to address these issues, there are five pillars PHI highlights for policymakers and industry leaders. These pillars include: quality training; fair compensation; quality supervision and support; respect and recognition; and real opportunity.

“This report makes clear that the workforce challenges we’re witnessing today in home care have been around for a long time and must be remedied by providing workers higher compensation, better training, increased career paths, and widespread recognition that they are essential to our care system and the economy,” Espinoza said.

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