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Caregiver shortage emerges as a crisis for Massachusetts elders

The state is grappling with a shortage of paid caregivers for frail older and disabled residents, with thousands of jobs going unfilled at nursing homes and home care agencies across the state.

Roberta Rhodes ate lunch with friends and fellow residents at Christopher Heights, an assisted living residence in Marlborough last winter.Jessica Rinaldi/Globe Staff

Massachusetts is facing a growing shortage of paid caregivers for frail older and disabled residents, with thousands of jobs going unfilled and rampant turnover reported at skilled nursing homes and home care agencies across the state.

At a State House hearing Tuesday, front-line care workers and senior living officials attributed the worsening shortage to low wages, lack of opportunities for advancement, and a surfeit of better-paying jobs in the hot Massachusetts economy. They also blamed tightening federal restrictions on immigrants, who make up a large share of caregivers in the state’s homes and skilled nursing facilities.

“These workers are the eyes and ears of the health care system,” said Lisa Gurgone, executive director of Mass Home Care, which represents a statewide network of agencies that coordinate care for more than 60,000 recipients. “And we need to get the system to invest in these workers.”


The average hourly wage earned in Massachusetts was $13.98 for personal care aides, $14.82 for home health aides, and $16.12 for certified nursing assistants, according to the most recent data from the Bureau of Labor Statistics.

Some lawmakers have been pushing to increase wages to at least $17 an hour, especially for caregivers paid through reimbursements from MassHealth, the state Medicaid program.

“From every corner of the Commonwealth . . . we have heard there’s a lack of people who will do the work,” said state Senator Pat Jehlen, Democrat of Somerville and cochair of the Joint Committee on Elder Affairs, which hosted Tuesday’s hearing. “And it’s such important work. This is a crisis.”

There are currently about 5,600 vacancies at nursing homes across Massachusetts, said Rebecca Gutman, vice president of home care at Local 1199 of the Service Employees International Union, which represents caregivers. Among certified nursing assistants, a key front-line job category, the vacancy rate has climbed to 17 percent from 6 percent over the past decade, Gutman told the lawmakers.


Joanne Edmond, a Haitian-born nursing home worker, said the $15 an hour earned by many of her colleagues “leaves us very little money for anything” but room and board. “I love my job,” she said. “I’m attuned to my residents, and they’re attuned to me. But not enough workers on the floor means the residents don’t feel well cared for.”

Recruiting, training, and retaining nursing home and home care workers are priorities for the Baker administration, said Elizabeth Chen, the state secretary of elder affairs. “The work of caring for another individual is a life-giving profession,” she said. “We can do more to honor these workers.”

Len Fishman, director of the Gerontology Institute at the University of Massachusetts Boston, agreed respect is important. But without higher wages, he said “the situation will continue to worsen.”

And, he added, “If we adopt more stringent immigration policies, that would further increase the gap between demand and supply.”

The dilemma was laid out by Nancy Munson, chief executive of Bristol Elder Services, who said there are about 100 frail seniors waiting for home care aides on any given day in the Fall River area. “We set up interviews, people don’t come,” she said. “We hire people, and they leave in a very short time.”

Her comments were echoed by Richard Bane, president of BaneCare Management, based in Braintree, which runs a dozen Massachusetts nursing homes. Its three homes in the Berkshires currently have 10 openings for full-time certified nursing assistants and 16 openings for part timers, he said.


Bane said his nursing homes must compete for workers with coffee shops and a Wayfair call center that can offer higher pay and lower stress.

“We have weekly job fairs, sometimes attended by no one,” he said.

Robert Weisman can be reached at robert.weisman@globe.com.