Workers have quit industry in droves due to low wages
Lula Slayton is a proud woman. A former pastor’s wife, she dresses well (a black dress and pearl necklace during a recent visit), cares about her hairstyle and isn’t shy about telling others what she wants.
“I call her, `boss lady,’” laughs her daughter, Berwick resident Patricia Carson.
Lula also is 84 years old, has dementia and uses a wheelchair. She can’t get out of bed without help.
Caring for her mother by herself is not possible for Carson, 64, who has some physical limitations of her own after a recent surgery.
The Ohio Department of Aging approved Slayton for 71 hours of home health care a week: 9 a.m. to 8 p.m. weekdays and 9 a.m. to 5 p.m. on weekends.
And Carson is fortunate to have an aide (the professional term is direct-service provider, or DSP) for 40 hours a week. Melinda Howett spends time with Slayton from 9 to 5 on weekdays.
But for nearly a year now, Carson has not been able to find someone to fill the gaps on evenings and weekends.
She spends hours with a spreadsheet of provider names, calling with no success. She has learned to be upfront, telling the provider her mother has advanced-stage dementia and physical issues.
“Most of them don’t want to spend the time and even come out,” Carson said. “On average, it takes me 14 calls just to get one agency to follow through and send someone out, and even then, you don’t have a solid deal. I had someone renege just yesterday.
“I’ve cried a lot.”
Around Ohio and the nation, Carson’s predicament is common. Amid an increased demand for home health care, DSPS are low-paid and in short supply.
According to PHI, a national directcare advocacy group, from 2009 to 2019, the median pay for the more than 155,000 DSPS in Ohio rose less than 2%, from $12.61 an hour to $12.80.
That meant that despite working full-time jobs, 20% of DSPS lived in poverty and 48% received some sort of government assistance.
Howett, who cares for Slayton, is paid $11 an hour.
“The work is generally undervalued,” said Stephen Mccall, a data and policy analyst for PHI. “We have historically under-invested in these workers, and now we’re paying the price.”
The COVID-19 pandemic only exacerbated the issue, as many DSPS left the field, not willing to risk infection in people’s homes for such low wages. National estimates vary as to how many workers left, from 5% of the workforce to as high as 22%.
The result?
“Ohio is experiencing the worst
home-health-care provider crisis in its history, that’s where we’re at,” said Hilliard resident Kim Kelly.
She should know. Kelly has been advocating for better pay and a better system to help care for people like her son, Joe, 33, who first was diagnosed at age 5 with cerebral palsy but later found to have a genetic mutation (the condition is called GNA01) that means Joe can’t speak or walk.
“He has the ability of a 6-month-old baby, that’s my son,” Kelly said. “He needs total care.”
Even with her determined involvement in finding DSPS, Kelly estimated she has had 150 people come and go over
the 28 years she has needed caregivers. Most stay about a year, she said, and move on.
Now 66 and retired, Kelly said coordinating Joe’s DSPS and accounting for every dollar spent on his care, as required by state agencies, is a 40-hour-aweek job.
She knows there are plenty of other people who struggle with finding care, and people going without care.
“We have people unable to get out of bed, sitting in their own feces and urine for hours on end because there’s nobody there to help them toilet,” Kelly said. “They can’t get meals. It’s to the point where some people are going to have to
go to a (nursing home) facility.”
Advocates and state officials say they are heartened by the recent announcement that the state and federal government will provide some relief and perhaps a boost in pay.
But they worry it will be temporary or just not enough of a boost. While private-sector employers can — and have — raised wages significantly to try to attract new workers, the DSP field is almost entirely reliant on legislative intervention.
Pete Moore, president and CEO of the Ohio Provider Resource Association, which represents 177 agencies, said the industry’s recent recruiting efforts to attract more workers, “has not made a dent at all,” and worries some agencies may soon have to close because of lack of staff.
Cindy Farson, executive director of the Central Ohio Area Agency on Aging, said it comes down to a lack of respect for the profession.
“These people are woefully underpaid,” she said. “The people taking care of our mothers don’t get the respect they deserve, and respect is pay.”
To people such as Kelly and Carson, it comes down to basic human dignity.
“My son deserves to have a life worth living.” Kelly said.
Meanwhile, one of Carson’s cousins has been staying with her and helping with Slayton, but that can’t last forever. Carson keeps calling potential DSPS and is growing increasingly frustrated.
“It’s your mother, you don’t want to put her in a nursing home,” she said. “But I can’t trust the system right now to take care of my mom. This situation is appalling.” kgordon@dispatch.com @kgdispatch