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For years, Louise Shaackett had trouble walking or standing for long periods, which allows him to clean his house in the south-east of Maine or to do the laundry. Shaackett, 80, it's no longer readers, making it difficult to access the grocery store or the doctor.

Its low income, however, qualifies it for a state program that pays a personal help of 10 hours a week to help housework and races.

"It helps keep me independent," she said.

But the visits were inconsistent because of the high turnover and the shortage of aid, leaving it sometimes without assistance for months at a time, although a cousin helps to take care of her. "I should have the help I need and I'm eligible," Shaackett said, who has not had help since late March.

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The Maine home home care program, which helps Shaackett and more than 800 others in the state, has a waiting list of 925 people; These candidates sometimes lack aid for months or years, according to Maine officials, who has the oldest population in the country. This leaves many people at an increased risk of falls or not having medical care and other hazards.

The problem is simple: here and in a large part of the rest of the country, there are too few workers. Yet the solution is anything but easy.

Katie Smith Sloan, CEO of the foreground age, representing non-profit aging service providers, indicates that labor shortage is a national dilemma. "Millions of older adults are unable to access the affordable care and services they desperately need," she said at a recent press event. State rates and federal repayment at the elder care agencies are insufficient to cover the cost of quality care and services or to pay a living wage to caregivers, she added.

President Joe Biden has allocated $ 400 billion in her infrastructure plan to develop long-term home and community care services to help people stay at home and from retirement homes. Republicans have rejected, noting that the care of the elderly did not match the traditional definition of infrastructure, which usually refers to physical projects such as bridges, roads and such as the bipartisan contract reached last week among senators. centrists dealt solely with these traditional projects. But the Democrats say they insist to fund some of Biden's "human infrastructure" programs in another bill.

As legislators arguing on the proposal, many seniors care advocates that these $ 400 billion will be considerably reduced or eliminated.

But the need is undeniable, emphasized by mathematics, especially in places such as Maine, where 21% of residents are 65 years old and over.

Betsy Sawyer-Manter, CEO of Seniorsplus in Maine, one of two companies who exploit that the assistance program, said, "We are looking at the time of the workers because we have more than 10,000 hours per week of care staff that we did not find coverage workers. "

For at least 20 years, national experts have warned the disastrous consequences of a shortage of nursing assistants and home aids like tens of millions of baby boomers struck their senior years. "Low salary and benefits, difficult working conditions, heavy labor charges and a job-stigmatized employment make the recruitment and retention of difficult workers," concludedA 2001 report From the Urban Institute and the Robert Wood Johnson Foundation.

Robyn Stone, co-author of this report and senior vice-president of the foreground, said that a lot of workers' shortage problems identified in 2001 are only deteriorated. The risks and obstacles facing the elderly during the pandemic have highlighted some of these problems. "Covid discovered the challenges of the elderly and the vulnerability of this pandemic and the importance of the professionals in the front-line range of care that are paid for low wages," she said.

Michael Stair, CEO of Care and Comfort, an agency based in Waterville, Maine, said the scarcity of workers is the worst he saw in 20 years in the company.

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"The end result is all from dollars - dollars for the provision of home care, dollars to pay for competitive people," he said. Agencies such as sound are in a difficult position in competition for workers who can take other jobs that do not require a background check, special training or driving in the homes of people of bad weather.

"Maine workers can be paid more to make other less difficult and attractive jobs," he added.

Its company, which provides services to 1,500 customers - most of which are enrolled in Medicaids, the Federal Health Program for Low Income - accounts about 300 staff members, but could use 100 others. He said it is very difficult to find workers in urban areas such as Portland and Bangor, where there are more job opportunities. Most of his jobs pay between $ 13 and $ 15 an hour, on what McDonald restaurants in Maine advertise for the workers at the beginning.

The minimum wage of the state is $ 12.15 an hour.

The stairs stated that half of its workers leave the first year, a little better than the average turnover rate of 60% of the industry. To help retain employees, it allows them to define their own schedules, offering paid training and provides a holiday vacation.

"I worry, there are people who take place without care and people whose conditions are declining because they do not receive the care they need," said the stairs.

Medicare does not cover long-term home care.

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Medicaid requires States to cover home care nursing for those who qualify, but it has a limited right for home services and eligibility and benefits vary by state. Nevertheless, over the last decade, States, including the United States, increased the financing of groups providing home and community services Medicaid - something medical assistance using household - because People prefer these services and cost a lot less than a retirement home.

States also finance home care programs such as Maine for the same services to people who are not eligible for Medicaid in the hope of preventing older people from needing Medicaid coverage later.

But the care of the elderly care say that the request for home care far exceeds the offer.

The bills in the Legislature of Maine would increase the reimbursement rates of the thousands of home care workers to ensure that they are paid more than the minimum wage of the state.

The state does not set workers' remuneration, only reimbursement rates.

It is not only a low salary and a lack of benefits that hobbles the hiring of workers, according to experts who are studying the issue. In addition, home care providers have trouble recruiting and maintaining workers who do not want the stress of the care of people with physical disabilities and, often, mental health problems, such as dementia and the Depression, said Sawyer-Mantre de Seniorsplus.

"It's a puzzle job," said Kathleen McAuliffe, a home care worker in Biddeford, Maine, who was once worked as a medical navy and served in the body of peace. It provides householder services for a state-funded program by Catholic charities. She usually visits two clients a day to help them with housework such as cleaning and cleaning floors, wiping bathrooms, aspirate, preparing meals, doing food shopping, organizing medications and bring them to doctor.

Its customers are aged 45 to 85 years old. "When I commit myself, the laundry is stacked, the dishes are stacked, and everything must be put in order. It is hard work and very taxable, "said McAuliffe, 68.

She is about $ 14 an hour. Although the work of taking care of fragile seniors requires large skills - and training in things like a safe swim - it is generally classified as a "unskilled" workforce. Working part-time, it does not receive any holiday benefits. "Calling American housewives rings as if we can cook Brownies," she said.

The HomeMaker program serves 2,100 maine residents and has more than 1,100 on a waiting list, according to Maine Catholic charities. "We can not find the job," said Donald Harden, a spokesman for the organization.

The federal government gives more dollar states for home care - at least temporarily.

The American relief plan, approved by the Congress in March, provides a10 increase in the percentage point of Federal Funding Medicaid States, nearly $ 13 billion, for home and community services.

Money, which needs to be spent by Mars 2024, can be used to provide personal protective equipment to home care workers, train workers or to help states reduce waiting lists of persons to receive services.

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For Maine, the bump for the funding of the American rescue plan will provide a $ 75 million increase in funding. But Paul Saucier, director of aging and disability at the Ministry of Health and Social Services of Maine, said that money will not disappear people waiting because it will not solve the problem of too little workers.

Joanne Spez, Director of the University of California-San Francisco Health Care Research Center, said they had laid more money in home care will only work if money is intended for recruitment, training and retaining workers, as well as providing advantages and opportunities for career growth. She doubts that she has significant improvements will happen "if we just put money out there to hire more workers".

"The problem is that people who are in these jobs always receive the same amount of remuneration and the same level of respect little respect, no matter how many years they are stationed," said Spez.

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Kn (Kaiser Health News) is a national press room that produces in-depth journalism on health problems. As well as policy analysis and survey, KHH is one of the three major operating programs ofKff (Kaiser Family Foundation). KFF is a non-profit organization that provides information on health problems to the nation.