Planning for Life

Pandemic Highlights Caregiver Crisis, Biden Bill a Step to a Solution

Posted by Harry S. Margolis on April 20, 2021

By Harry S. Margolis

As we have discussed before, the number of Covid-19 deaths in nursing homes has brought to light the ongoing crisis in how we care for our ailing seniors. In short, the problem is that we've always been trying to do so on the cheap through the Medicaid (MassHealth in Massachusetts) program. As a result, caregivers in nursing homes are underpaid and most facilities are understaffed.

Low Pay Affects Quality of Care

A recent report, which is summarized in The New York Times, describes how the low pay and stress leads to turnover of nursing home staff. That turnover affects care both because it means that most caregivers are inexperienced and they and the nursing home residents don't know one another. This can be especially confusing for those residents who suffer from dementia.

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Topics: nursing homes, Caregivers, home care

GAO Reports Home Care Workers Still Underpaid Despite New Protections

Posted by Harry S. Margolis on November 9, 2020

By Harry S. Margolis

GAO-report-caregiver-living-wage-elder-law-baby-boomer-Wellesley-MA-02481

Over my 30-plus years practicing elder law, the nature of elder care has changed dramatically, from one that was nursing home-based to one where care is largely provided at home or in assisted living facilities. (Of course, then and now, most care is provided by family members at no cost. Actually, "no cost" is wrong. No dollars may change hands, but the care is often provided at great cost to the caregiver.)

A great weakness of our "system" for providing elder care is that despite its great cost, most care providers are drastically underpaid. This has detrimental effects on them as well as on the people for whom they care due to the resulting stress and fatigue on caregivers and their turnover as they seek other ways to earn a living. One result has been the huge number of coronavirus deaths in nursing homes across the United States, but especially in Massachusetts. (See Deaths in Nursing Homes: How We Let Down Our Older Citizens.)

In an effort to ameliorate this situation, in 2015, the U.S. Department of Labor, for the first time, extended minimum wage and overtime protections to home care workers. Unfortunately, a new Government Accounting Office (GAO) study reports that this has done little improve the income of most home care workers, in part no doubt to the low federal minimum wage of just $7.25 an hour in 2020. Home care workers in 2019 earned a median income of just $400 a week—just $10 a week more than the average income for jobs with similar education and training requirements. Median means that half such workers earned less than $400 a week!

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Topics: baby boomers, home care

Enhanced Unemployment Benefit Protects Caregivers and Families

Posted by Harry S. Margolis on July 28, 2020

By Harry S. Margolis

coronavirus-unemployment-benefits-caregivers-essential-workers-Wellesley-MA-02481

As you no doubt know, the Cares Act enhanced unemployment benefits of $600 a week are slated to end on Friday, July 31st. There's a debate about whether to extend them based on many factors, including the need to keep the economy functioning during the pandemic, the risk that many renters will no longer be able to pay rent and many homeowners will default on their mortgages, what the nation can afford, and the argument that some workers are staying home because they're making more from unemployment than they would from working.

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Topics: caregiving, home care

Should Seniors Downsize or Age in Place?

Posted by Harry S. Margolis on May 7, 2019

By Harry S. Margolis

seniors-downsizing-estate planning-attorney-Wellesley-MA

While everyone's desires and circumstances are different, most people upon retirement or later face the issue of whether to stay in their homes or move, whether to a smaller house or apartment, to a 55 and over community, or to get out of northern winters. Some people want relief from the headaches and expense of maintaining a house, not to mention the lawn in front, while others don't want to leave the home or community where they've lived for decades and raised their families.

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Topics: the accessible home, housing policy ,, home care

Home Care Benefits and Risks

Posted by Harry S. Margolis on October 2, 2018

By Harry S. Margolis

home-care-for-seniors-caregivers-elder-law-attorney-Wellesley-MA

In recent years, home care for disabled seniors has grown tremendously with absolutely no regulation. For the most part, this has been good, with millions of seniors being able to stay in their own homes as they age. But a recent series of articles in The Boston Globe highlights the risks inherent to the system both to those receiving care and those providing it.

There has been a proliferation of individuals and companies, small and large, either providing in-home care or connecting families with caregivers. Two of the biggest are Home Instead Senior Care, which franchises home care agencies, and Care.com, which has expanded its child care referral services to include senior care as well.

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Topics: Caregivers, elder care, home care

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