The Workforce Behind Aging in Place: Who Keeps It Running
Most people don’t realize that when older adults age in place effectively, a lot of people behind the scenes make it happen. While family does a lot, and family does help, the reality is that the effectiveness of aging in place relies upon a workforce that most people don’t think about—or need—until they need it.
These are not the medical professionals making monthly house calls. These are the people showing up daily, if not multiple times a day, to offer everything from reminders about medication to preparation of meals to just being present so someone isn’t alone. Without this workforce, aging in place becomes a distant dream for far too many families.
Who Does The Work, Really?
Those who provide hands-on care in the home come from all walks of life. Some have experience in healthcare beforehand while others have none. Some get into this work after they’ve raised their children and some get into this work after having decades established in other careers. The only thing they have in common is a desire to find labor-oriented work with emotional investment.
The at-home caregivers who provide hands-on care are numerous. Home health aides make up a large portion. They help with personal care, monitor health-related issues, assist with mobility, and provide companionship. The training depends on state requirements but typically, certification for this work occurs in weeks to months rather than years.
For anyone considering this type of work, opportunities exist in most areas where there’s an aging population. Positions such as direct care worker jobs in Philadelphia demonstrate how these roles are concentrated in urban centers with significant senior populations. The work offers stability in an industry that’s growing rather than shrinking, and many people find the one-on-one nature of home care more satisfying than institutional healthcare settings.
Home health aides can also operate alongside personal care assistants who provide general assistance within homes but are more focused upon daily living instead of health monitoring. Thus, they may be asked to help someone bathe or dress or do simple housekeeping and meal prep instead of monitoring their blood pressure or helping them get up and down steps. The distinction line between these two roles is not strict and instead, is determined based upon what the client needs.
The Coordinating Component
In addition, there exists a network that coordinates all of these movements from behind the scenes. Care coordinators manage appointments, communicate needs back to the family and pivot as necessary. They solve crises before they happen—finding coverage if someone calls out sick or recognizing when someone needs more care hours on their plan versus less now that they’ve passed a rehab stage.
While this work is largely invisible, it interconnects all caregivers to make everyone successful. A good caregiver with no coordination means gaps in coverage, miscommunication about medicational changes and families who feel as though they’re still doing it all on their own.
The Specialists Who Fill In the Blanks
Still, there are specialist levels who come into homes but not on a regular basis like daily caregivers. Physical therapists, occupational therapists, and speech therapists can make home visits as well but far less frequently. They’re working on goals, whether rebuilding physical strength after surgery, or teaching the practicalities of at-home functioning, or discussing swallowing concerns for dietary adjustments. These specialists tend to emerge from home health agencies instead and they’re time-limited versus goal-oriented with within-home care rather than ongoing standards.
Then there are those who fill in the gaps but aren’t necessarily available as non-medical caregivers. Someone has to drive them to appointments, pick up groceries, make home repairs or manage finances. This can be family, but often it’s paid workers with specific services.
Why People Work This Way
People who choose to do this work often feel similarly driven but with different perspectives about what they’d like to do in the professional world for themselves during this period of their lives. Some want to enter healthcare but don’t want hospitals, others appreciate the one-on-one consistency versus revolving door faces and many like flexible schedules because they have families of their own to look after during those daytime hours.
Compensation drives people, too—but less so competitively than hospitalized options. Home care presents steady hours for practical applications instead of shifting with inconsistent staffing.
Other reasons for working in home care provide emotional investment because people like seeing their efforts paying off and can appreciate building bonds. Many caregivers speak about how much different it is when they’re in someone’s home (unlike an institutional setting) which gives them autonomy over how they approach different tasks instead of bureaucracy.
The Hidden Struggles
But there’s a workforce behind this challenge and it’s ripe with challenges that many don’t pay attention to. Pay could be better across all levels—not every position has benefits and those that do have little interconnectivity between all levels of staffing. The work is physically demanding years later on one’s body; the emotional tax from witnessing decline or loss after fostering a relationship is always looming overhead.
Thus, turnover can end up being high when good people leave, especially when consistent faces make good impressions upon seniors who need face stability. Those agencies that value their staff with pay increases over time or training abilities or appreciation solutions tend to keep workers longer.
What This Workforce Makes Possible
Without these workers, aging in place becomes something exclusively for the wealthy who can afford full-time private nursing staff regardless of any other operation. Instead, aging in place is an option for so many more families because there’s a network already established.
The workforce behind aging in place deserves more recognition than it gets. These are the people making independence possible for seniors who would otherwise have no choice but institutional care.