Home-based care advocates say they are confident measures outlined in President Joe Biden's now-stalled Build Back Better Act will move forward in some form.

The legislation aims to expand access to services to older adults and people with disabilities, as well as boosting pay for workers who provide home-based care. Currently, more than 3.5 million people rely on Medicaid's Home and Community Based Services (HCBS).

Connie Garner, national policy director for Easterseals, explained demand for home care has outpaced resources, and as a result, more older adults end up in nurse homes.

"That costs more money, that causes more isolation, and that's not what we should have in this country," Garner asserted. "We should have the ability to have people be able to be taken care of correctly at home. And we have to be able to pay and support the providers of that care. They become an essential member of that family."

According to the research firm Paraprofessional Healthcare Institute, more than two million home care workers earn around $16,000 per year, and one in six live below the federal poverty line.

A report by the ICA group found West Virginia is facing a troubling home-caregiver shortage with one caregiver available for roughly every 11 clients.

In Washington, lawmakers say portions of the Build Back Better Act will likely pass this year, but it remains unclear whether the $150 billion earmarked for Medicaid HCBS will remain intact.

According to the Kaiser Family Foundation, in 2020 more than 2.5 million people nationwide received Home and Community Based Services, with hundreds of thousands more on wait lists.

Amber Christ, director of health policy and advocacy for Justice in Aging, said families are forced to make tough choices.

"From an older adult perspective, this lack of investment in home and community-based services in effect pushes older adult into nursing facilities unnecessarily," Christ contended.

A survey by AARP found 76% of Americans age 50 and older say they prefer to remain in their current residence as long as possible, but just 46% anticipate they will be able to stay in their current home.

Older Idahoans have an opportunity to speak with Governor Brad Little next week.

AARP Idaho is hosting a telephone town hall with the governor, providing an opportunity for members to ask questions ahead of the 2025 legislative session.

State Director of AARP Idaho Lupe Wissel said people could have questions about health care, housing affordability, or property taxes, for instance.

"It's a very unique opportunity and one that is not offered to everyone," said Wissel, "and we do this regularly because it is very important that the elected officials do hear the voices of the 50+ community in this state."

The Idaho legislative session starts on January 6. The town hall will be held on November 25 at 3 p.m. Mountain time, 2 p.m. Pacific.

People can join at 866-767-0637 or online at AARP Idaho's Facebook page.

Wissel said AARP Idaho holds town halls with the state's leaders on a regular basis. She said elected officials know it's important to hear from older Idahoans.

"They know that this is a big constituency, large constituency," said Wissel. "They really pay attention to what's happening and they want to make sure that their voices are heard, and they want to listen to what they have to say."

Wissel noted that older Idahoans make up a large voting bloc in the state. She said in the 2022 election, people age 50 and older were 64% of the electorate.

Nearly 630,000 Idahoans are 50 and older.

The Iowa Alzheimer's Association chapter is making new resources available to caregivers during November, a month set aside to educate and help people with the disease and those who care for them.

Nearly 100,000 Iowans are family caregivers, helping more than 62,000 people living with this form of dementia.

Erica Eikern - program manager with the Alzheimer's Association, Iowa chapter - said the group is making a huge effort this month in particular to get resources to those caregivers, letting them know they are not alone.

"We have approximately 50 local caregiver support groups, in many communities across the state of Iowa," said Eikern. "We also have a virtual support group that we just started for young adult caregivers who are taking care of a parent or older family member."

Nationally, nearly half of all caregivers who provide help to older adults are doing so for someone with Alzheimer's disease, according to data on the association's facts and figures website.

Eikern said the association is working at the state level to give those caregivers some respite options.

Eikern said caring for a person with Alzheimer's can take a heavy physical and emotional toll. So, she said the association is trying to make sure they know help is available.

"At our Iowa chapter, we're averaging about 30 programs that we're doing per month, out in various communities throughout the state," said Eikern. "We have a goal of trying to reach everyone in all 99 counties through our awareness presentations, through support services."

Those resources are also available on the association's website.

More than 11 million people in the U.S. are providing unpaid care to a person living with Alzheimer's or other form of dementia. Last year alone, that care was valued at more than $346 billion.




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By Eduardo Miranda Strobel / Broadcast version by Farah Siddiqi reporting for the Kent State NewsLab-Ohio News Connection Collaboration.

Adults 55 and older compose 23% of Ohio's workforce, according to the Ohio Department of Job and Family Services.

This population will peak between now and 2030, said Kelly Fuller, senior vice president of the Columbus Chamber Foundation.

"The number of older workers are increasing in Ohio," Fuller said. "In fact, when you look at Ohio compared to other states across the nation, we skew a bit higher."

Older workers benefit the state in several ways, said Jamie Carmichael, chief program officer of the Ohio Department of Aging. They contribute expertise gained over years of life and labor. They have developed qualities like patience, a strong work ethic and a high level of motivation driven by personal achievement.

"Employers in Ohio really do have an opportunity to leverage those strengths together to support their business goals," Carmichael said. "So older adults, that baby boomer generation, is really known for valuing hard work. They work well with leaders who are coaches. They have really strong interpersonal skills and value that interpersonal communication."

Carmichael said there are myths regarding older adults in the workforce that can harm their employment. She said that a misconception is, for example, that older workers are frequently sick and less productive, but in reality, they use fewer sick days than their younger counterparts.

"There's a number of, I think, misconceptions that we're working here at [the Ohio Department of Aging] to help people overcome," she said.

Fuller said employers may need to consider creating accommodation policies to address how aging affects people's bodies differently. She said they could adapt a job done standing to be done seated through part of it or an on-site position to be done remotely or hybrid.

"A lot of older workers are looking for very much the same thing all-age workers are looking for, which is that flexibility in the workforce, in the workplace, which we saw really go into overdrive from 2020 to the present time, where regardless of what age we are, that flexibility is really important because it allows us to maintain a good life-work balance," Fuller said.

As retirement-age Ohioans choose to return or continue to work, some resources can help them adapt.

The Senior Community Service Employment Program (SCSEP) provides paid training to Ohioans 55 and older who want to return to the workforce, said LaTasha Johnson, the Youngstown regional workforce development manager for VANTAGE Aging.

The program is a partnership between VANTAGE Aging, the Ohio Department of Aging and other organizations. SCSEP places participants in part-time roles at local non-profit and public organizations, earning minimum wage while gaining work experience.

"Most older workers want to only work part-time, and I think there's nothing wrong with that," Johnson said. "They've put in their work for many years, and more employers could be more accommodating with just being a little bit more flexible and less rigid with the traditional work hours."

Johnson said the program updates older adults' skills and assists them with obtaining recent work experience to make them more qualified for employers.

"Our hope is that everyone would leave our program with resume, job search skills, things like that," she said. "So they're job-ready when they do eventually leave our program and find employment."

Johnson said she found through her research that some benefits of hiring older workers are their communication skills, reliability and willingness to learn. She said these workers tend to switch jobs less than younger workers.

Carmichael said employers should learn to recognize that those later in their careers have years of experience to offer and can help mentor younger workers. She said putting older workers in mentorship is an effective strategy that helps them feel connected to the workplace.
"Employment isn't just about income, right? It's about the dignity of work," Carmichael said. "It's about social connectedness and mental health. And so we want to create those opportunities as much as we can."


This collaboration is produced in association with Media in the Public Interest and funded in part by the George Gund Foundation.


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