The Role of Older Workers in Caring for Older People in the Future

Abstract

If there is any question the baby boomers should be asking themselves, it is, Who will take of me in my old age? The most fortunate among them will die in their sleep at an advanced age after a vigorous game of tennis. The less fortunate but still very lucky ones in need of long-term will get that at home from a spouse or other family member. Even they, however, are likely to find themselves in their later years in the grip of the formal healthcare system, if for no other reason than to seek help for the chronic conditions associated with aging. And many millions of boomers may find themselves dependent for an extended period of time on formal providers in their homes and in assisted living facilities, continuing retirement communities, nursing homes, or other settings. It is not only boomers who have cause for concern. Though boomers' huge numbers promise to place unparalleled demand on the healthcare system, rapid aging of the older population itself and expanding employment opportunities for low-wage workers have already created a caregiving crisis. As it stands, over onethird of today's older people with activity limitations are not getting the help they need (National Academy on an Aging Society, 2000). THE AGING WORKFORCE It is inevitable that a growing number of workers formally engaged in for older people will themselves be older. In fact, some caring occupations are already relatively old when compared to the workforce as a whole. Nearly zo percent of workers in the health-diagnosing occupations (physicians, dentists, optometrists, and podiatrists) tracked by the Bureau of Labor Statistics, but less than 13 percent of all workers, were aged 55 or older in 1999 (U.S. Department of Labor, 2000a, and unpublished data from the Bureau of Labor Statistics). Only 22 percent of doctors were younger than 36 in 1998, down from 31 percent in I970; men and women aged 55 and older will probably account for most of the increase in this occupation over the next twenty years (Center for Health Policy Research and Ethics, 2000). Registered nursing has become a profession of the middle-aged. Some 40 percent of registered nurses, but only 34 percent of the total workforce, are at least 45 years old. Buerhaus, Staiger, and Auerbach (2000) report that the average age of working RNs rose from 37.4 to 41.9 years between 1983 and 1998; the proportion younger than 30 fell from about 30 percent to 12 percent over this same period, a drop that appears to be due to the decline in younger women choosing nursing as a career. Other health occupations have yet to age to the same degree. For example, about I4 percent of health aides and nursing aides are 55 or older, while health technologists and technicians are on the whole still quite young. However, all of these occupations will age along with the total workforce. By 2015, just under 20 percent of the labor force-or one out of every five participants-may be 55 or older, up from about one in eight in 1999 (Fullerton, 1999). If current projections prove close to the mark, another 22 percent will be between the ages of 45 and 54. Although long-term-care institutions and homecare agencies may well seek a relaxation of immigration restrictions to ease their staffing burdens-and immigrants tend to be young-it is doubtful that legal immigrants will be in sufficient supply to meet the huge and varied need for care workers in an aging society. This demand will be for more than the frontline workers such as nurses, home health aides, and personal workers who first come to mind when caregivers for the elderly are mentioned. Indeed, an aging society will increase the demand for workers in a wide range of occupations, including nursing home administrators, managers of assisted living facilities, various therapists, dietitians, and janitors and cleaners, among others. Financial and legal advisors, consumer advocates, ombudsmen, social workers, and the clergy will all play a role in protecting frail and vulnerable elderly people and enhancing their quality of life. …

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