It is difficult to appreciate the toll of caring for an ailing, elderly relative until you’ve lived through it.
Watching a loved one suffer is heartrending. Your bond with that person can fray as the daily frustrations of tending to their needs mount. That brings its own kind of anguish. And with so much of your attention focused on caring for an elder, your work life or parenting can suffer.
For the older person, leaning on a spouse or a child for help with a meal or a trip to the bathroom can feel humiliating. The guilt of pulling that spouse or child away from other responsibilities can be hard to live with.
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Any kind of break can feel vital for both parties.
That’s what makes home health care and other kinds of at-home support — help bathing and doing laundry and preparing meals — such important work. It’s a respite for families in some of the most difficult periods of their lives.
And the service has taken on even greater importance during the pandemic years, allowing older people to stay out of congregate settings where the coronavirus can spread to deadly effect.
As demand has spiked, the agencies that provide these services have struggled to find workers to meet it.
In Massachusetts, government-set reimbursement rates translate into pay of about $15 to $19 per hour for home health aides, who help clients get around their living rooms and bedrooms and provide them with medication reminders, and workers known as homemakers, who wash and fold clothes or make sandwiches at lunchtime.
Jobs at Walmart and Dunkin’ pay at similar rates, without the same physical and emotional demands. And it can be hard to compete.
Federal and state governments, to their credit, have supported the fragile industry these past few years by providing “add-ons,” or temporary funding boosts — with much of the money targeted to increased pay for home health aides and homemakers.
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But as the country moves into a different phase of the pandemic, and as an aging society comes to terms with the growing need for at-home supports, those temporary bumps won’t do. Something more sustainable is required.
State lawmakers could, and should, take a couple of important steps.
The first is to approve a Senate measure, tucked into a stalled economic development bill, that would create a $250 million reserve to enhance pay for some of these vital workers and other human service workers. The money would have to be spent over the next two years, but it could mark the start of a longer-term commitment.
The second is a measure that would create standards for a rate-setting process that’s pretty opaque at the moment.
State officials would be required, for instance, to analyze the cost of similar services provided in other health care settings — like hospitals and nursing homes. And they would have to provide reports to state lawmakers about how they arrived at the rates.
The hope is that the standards and transparency will tilt the system toward better pay for front-line workers over time.
Given the importance of what they do, better pay should be an urgent priority for the state.
Editorials represent the views of the Boston Globe Editorial Board. Follow us @GlobeOpinion.
