Personal care aides are the fastest-growing job in Maryland as health care needs increase for the state’s aging population, but there are also concerns about the quality of that work.
The number of personal care aides in Maryland has grown 330% over the last 10 years according to CommercialCafe. It is also the fastest-growing occupation nationally, growing 251%.
That trend coincides with Maryland’s changing age demographics. The 80- to 89-year-old bracket is the fastest-growing segment of Maryland’s population and the boomer generation has mostly aged into retirement.
As that population grows, more people want to stay at home as they age and avoid going to the hospital or the nursing home. And that aligns with Maryland’s health care reimbursement system, which favors more efficient care at lower costs.
All of this means that there is a growing demand in health care for workers who can take of people as they age at home, including nurses, certified nursing assistants, home health aides and personal care aides.
The need for these workers will grow 40% between 2014 and 2024, according to a report from PHI, an organization that supports home care workers. According to the same report, they have a median salary of around $22,700.
David Rodwin, an attorney at the Public Justice Center who represents home care workers in disputes with their agencies, said the number of workers is growing, but the quality of the work is troubling.
“The issue from my perspective here at the Public Justice Center is that most of these jobs are lower-quality poor-paying jobs that have a lot of workplace violations, ranging from health and safety to wage violations,” he said.
The labor issues tend to lead to a lot of turnover in the field, which can be troubling for both workers and patients, Rodwin said.
“That leads not only to costs to the home care agency associated with turnover, but it also reduces the quality of care,” he said. “Because these jobs require such intimate work… when you have different people, it takes time to learn the nuances and the particularities of what an individual might need or want.”
He also believes that given the strong labor market right now — the state’s unemployment rate is 4% — it can be hard for these types of low-paying jobs to compete against stronger positions.
But these positions will be necessary as Maryland’s aging population grows.
“We are at a crisis in terms of what kind of jobs a lot of these jobs are right now and how we are going to fill them as more and more people want to age in place in their communities,” he said.
Much of the home health care services in Maryland are paid for through Medicaid, which means the state sets a lot of the reimbursement policies. Rodwin hopes these policies are addressed at the state level.