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Opinion: Put focus on home health care

An elder care nurse holds the hand of

An elder care nurse holds the hand of an woman in a wheelchair (Feb. 25, 2008) Credit: AP

The Rev. Ralph Sommer is pastor of St. Brigid's Catholic Church in Westbury. Eric Schulmiller is the cantor and social justice liaison of the Reconstructionist Synagogue of the North Shore, in Manhasset.

There is hardly a day when we don't have a conversation with someone about an elderly relative who needs care. Who among us on Long Island isn't touched by seniors in the family who can no longer cook a meal or shower unaided, or who prematurely move to a nursing home because they can't afford or find a qualified home health aide?

The number of seniors on Long Island is quietly growing larger by the year, and the challenges in providing quality home health care and the workforce to deliver it are growing too.

Through several hundred individual conversations with congregants of different faiths and backgrounds, those of us at LI-CAN (Long Island Congregations Associations and Neighborhoods, a multifaith, nonpartisan citizens' organization) have heard the frustration of those unable to find qualified aides. Demand for home health aides far exceeds the number available, even though thousands of Long Islanders are unemployed.

Other congregants are immigrants, working as home health aides, who are frustrated by how little dignity they are afforded because they are "foreign." They are often taken advantage of by employers, whether a family or an agency. Aides speak of receiving inadequate supervision, and there is little or no ongoing training to care for seniors with special conditions such as Alzheimer's and diabetes.

Some aides spend as much time traveling to a two-hour shift as the shift itself. Many do not have cars, and public transportation is insufficient and expensive. Government-regulated reimbursements to home health agencies for home care are shrinking, leaving those agencies that do provide quality care with fewer dollars to deliver it.

Often aides are asked to perform intimate acts of care for our beloved family members but are paid way below the minimum wage -- indeed, some agencies take the bulk of the fees a family pays for an aide, leaving the worker with less than a living wage.

A related problem is the lack of comprehensive, coordinated home care involving the patient, family, doctor and home-health aide. During a fact-finding conversation, one doctor lamented that she was unaware of her patient's skin infection because the aide didn't have training to recognize danger signs. In another, an aide told us that her repeated attempts to alert the family that her senior patient wasn't eating and drinking enough fell on deaf ears.

LI-CAN has also met with industry professionals and has begun crafting potential solutions with government and business partners. One approach involves recruiting potential home health aides from our members' congregations, along with other unemployed or underemployed residents. They could be hired by an agency and matched with seniors who live close by.

The Town of North Hempstead/Project Independence and two local taxi companies have committed to helping to provide more affordable taxi fares for aides who care for seniors.

We believe that a culture of respect for aides and an emphasis on problem-solving and communication are keys to quality home care. To that end, we are exploring the creation of a team-based, coordinated approach to home care by a suitable agency partner, an approach that involves the aide, the senior and his or her family, the doctor, nurse, and social worker.

Now is the moment for leaders in the home health industry and elected officials to work with their customers and constituents, as well as community groups like ours, to ensure quality care at the lowest possible cost. It will take a coordinated effort to prevent a crisis of home health care for seniors on Long Island. But our welfare, and the welfare of our parents and grandparents, is at stake.

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