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Massachusetts home care’s three biggest challenges

By Kevin Smith

Massachusetts home care agencies care for tens of thousands of clients in their homes. You, your families, or your friends might be connected to someone either delivering or receiving home care services.

What are the challenges that Best of Care — and other privately owned home care agencies across Massachusetts — face in providing quality services to the broadest number of people?

  1. The needs of our communities have never been greater.

The acuity of our homebound clients’ needs is at an all-time high. Instead of going to an assisted living or skilled nursing facility, people are now receiving a broad array of nursing home-level services in their homes. Our caregiving teams, which include skilled nurses, certified nursing assistants (CNAs), home health aides and homemaker-companions, together address our clients’ physical, mental, mobility and isolation challenges.  Our home health aides and homemakers visit multiple clients per day and sometimes 8 or 10 clients per week.

Luckily, Massachusetts has excellent medical centers and world-renowned hospitals that offer a safety net of preventive and emergency care for our most vulnerable clients. We also work closely with Massachusetts’ Aging Service Access Providers (ASAP network) to ensure that elderly and disabled clients with limited resources can remain safely in their homes.

  1. The demand for good home care workers is outstripping supply.

Recognizing this high level of need, Best of Care and our industry colleagues are constantly recruiting, hiring, training and educating a workforce that is qualified to serve our aging population.

The caregivers employed by our agencies drive and use MBTA in severe snowstorms to reach the frail and elderly. Their weekly schedules are subject to client hospitalizations, nursing home admissions, cancelations, and other emergencies. The availability of these workers is simply not keeping pace with the explosive number of people in need of high-level care at home. Finding ways to expand the number of qualified home care workers is critical to the future of our clients and our industry.

  1. Disconnected systems impede continuums of care.

Although Massachusetts boasts a unique, successful home care system comprised of 26 Elder Services agencies, other pieces of the state home care industry are fragmented. Patients discharged from hospitals may be eligible for Medicare-funded home care for a specific duration. Once that period elapses and the home care benefit is no longer available, many vulnerable seniors find themselves (or their loves ones) in a moment of crisis. The need for daily or weekly home care assistance often continues beyond expectations and, worse yet, funding availability.

In order to confront some of these problems, home care agencies aim to attract and retain the most caring, dedicated and professional caregivers as possible. Moving forward, many agencies will begin to train inexperienced workers and provide them with credentials. A willingness on behalf of the industry and the state of Massachusetts to embrace a “home care career ladder” would be a positive step towards bridging the chasm between available caregivers and a growing senior population.

To our state’s legislators, we have these final thoughts:

  1. Massachusetts home care agencies are one of our state’s largest job creators.

  2. The services we provide allow members of our communities to remain at home – where they want to be and where they are proud to be – while giving their loved ones peace of mind.

  3. Our clients and employees vote for those who enact policies that bring the biggest social benefit to the largest number of people. They trust their legislators to consider their best interests, including their ability to receive high quality home care when they most need it.

Kevin Smith is President and COO of Best of Care Inc., which provides home health care services to North Shore, Greater Boston, South Shore and Cape Cod communities.


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