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VOA健康报道2024--Despite Demand, No Takers for Care-worker Jobs

时间:2024-06-13 08:16:08

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Despite Demand, No Takers for Care-worker Jobs

From VOA Learning English, this is the Health & Lifestyle report.

The hardest part of Culix Wibonele’s first job in long-term care was not getting hurt.

Wibonele is from Kenya. In 2014, she worked as a certified1 nursing assistant (or, CNA) in Atlanta, Georgia. She went to the homes of mostly older clients and helped them with everything from bathing to cooking. Wibonele worked alone. Sometimes she had to lift clients who were much bigger than she was. It was hard work. She earned only $9 an hour and received no benefits.

If not for her second job as a babysitter and her husband’s wages, her family would not have made enough money to support their four children.

“My paycheck was almost nothing. I was shocked by the amount of work we did and the pay we got,” Wibonele said.

Wibonele’s experience shows a bigger problem in the long-term care workforce2. Those who care for older adults in private homes and assisted living places face low wages and the risk of injury. The industry also has trouble finding enough staff. Those findings are part of an investigative report by The Associated Press and CNHI News.

The need for these workers is rising as more people get older. By 2030, about 20 percent of the U.S. population will be 65 or older, the U.S. Census3 Bureau says.

“It’s a national problem, and it’s everywhere,” said Dr. Stephen Crystal. He is director of the Rutgers Center for Health Services Research.

Shortages and turnovers5

The industry has dealt with worker shortages and high turnover4 for years. These problems got worse during the COVID-19 pandemic.

Nursing care places lost many workers during the pandemic. The workforce has still not fully6 recovered. in March A study of nursing home providers by the American Health Care Association found almost all have open jobs and difficulty recruiting.

Turnover is so bad at nursing homes that some lose all their employees within a year, said Alice Bonner. She is director at the Center for Innovative7 Care in Aging at Brown University in Rhode Island.

“The people who are left are working much harder, double shifts, overtime8 and with temporary workers,” Bonner said.

Noelle Kovaleski is an administrator9 of the Carbondale Nursing and Rehabilitation10 Center in Pennsylvania. She said the biggest difficulty is the lack of candidates. One nurse supervisor11 job at her place went unfilled for two years.

“There is no workforce coming in,” Kovaleski said. “They’re just not out there.”

Workers pass on these jobs for many reasons, including low pay and a competitive labor12 market. Nurses, for example, can earn more money working at hospitals than nursing homes, Bonner noted13.

Experts expect more worker shortages as the industry grows. The need for full-time14 workers in long-term care is expected to increase by 42 percent between 2021 and 2036, says the federal Health Resources and Services Administration. The need for direct care workers, who make up most of the workforce, is expected to grow 41 percent.

Direct care workers are important in the lives of their patients. They help with bathing, medication and meals. These workers are mostly women and people of color. Many are immigrants.

Victoria Gardner is unable to use her arms and legs. She considers her at-home caregiver to be a lifeline. Her caregiver helps her 16 hours each day. Without this care, Gardner could not bathe, prepare meals, do laundry or clean her home.

“My situation is fragile because I have one caregiver,” Gardner said. “I’m not alone in that.”

The industry added about 1.5 million new direct care workers between 2012 and 2022. It is expected to add close to 800,000 new direct care jobs through 2032, which experts say will be hard to fill.

Low pay is a big reason for the worker shortages. The average yearly wage for home health and personal care aides was $33,380 in May 2023. These earnings15 were similar to cafeteria attendants and retail16 sales workers.

Experts say funding is a reason wages are low. Medicaid is the main payer of long-term care services. But many experts say Medicaid reimbursement17 rates are too low to properly pay workers.

Some states have tried to improve the workforce by requiring a percentage of providers’ Medicaid reimbursements18 to go to direct care worker wages. Others have used money from the 2021 American Rescue Plan Act to increase wages and recruiting efforts. Meanwhile, the Biden administration made a rule in April requiring 80 percent of Medicaid payments for homecare services go to pay workers.

Another reason long-term care workers are leaving the field, researchers say, is a lack of respect inside and outside the industry.

Barbara Bowers19 is founding director of the Center for Aging Research and Education at the University of Wisconsin-Madison. She said of long-term care workers, “I don’t think they get anywhere near the respect they deserve for the very hard work they do.”

Zulma Torres is a long-time home health aide in New York City. She said she used to cry after work because of how people treated her.

For years, she earned $6.25 an hour. Sometimes, clients treated her like a maid, expecting her to cook for the entire family. In some cases, when she took her client to the hospital, she felt judged by the nurses and doctors.

“Many times, Torres said, “you feel like just walking out.”

Culix Wibonele, the certified nursing assistant in Atlanta, now earns $18 per hour at an assisted living facility. But she has had to put up with years of low wages, layoffs21, and severe headaches from being injured by a client. She still feels she is not paid enough. “I can go to Walmart and make more money than being a CNA,” Wibonele said.

Still, even with the low pay, she plans to stay in the industry. In addition to working as a CNA, Wibonele is studying at Georgia State University to become a registered nurse in long-term care.

She said, “I love the older generation, their wisdom, their stories. I love knowing that I am doing something while they are still here on the earth.”

Words in This Story

certified – adj. having met special qualifications within a field

nursing – n. the profession of caring for the sick or infirm

client – n. a person who engages the professional advice or services of another

benefit – n. something that produces good or helpful results or effects or that promotes well-being22

turnover – n. the number of persons hired to replace those leaving

recruit – v. to fill up the number of with new members

shift – n. a scheduled period of work or duty

fragile – adj. easily broken or destroyed

deserve – v. to be worthy23, fit, or suitable for some reward

layoff20 – n. losing employment often temporarily


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1 certified fw5zkU     
a.经证明合格的;具有证明文件的
参考例句:
  • Doctors certified him as insane. 医生证明他精神失常。
  • The planes were certified airworthy. 飞机被证明适于航行。
2 workforce workforce     
n.劳动大军,劳动力
参考例句:
  • A large part of the workforce is employed in agriculture.劳动人口中一大部分受雇于农业。
  • A quarter of the local workforce is unemployed.本地劳动力中有四分之一失业。
3 census arnz5     
n.(官方的)人口调查,人口普查
参考例句:
  • A census of population is taken every ten years.人口普查每10年进行一次。
  • The census is taken one time every four years in our country.我国每四年一次人口普查。
4 turnover nfkzmg     
n.人员流动率,人事变动率;营业额,成交量
参考例句:
  • The store greatly reduced the prices to make a quick turnover.这家商店实行大减价以迅速周转资金。
  • Our turnover actually increased last year.去年我们的营业额竟然增加了。
5 turnovers 16e3b9fe7fa121f52cd4bd05633ed75b     
n.营业额( turnover的名词复数 );失误(篮球术语);职工流动率;(商店的)货物周转率
参考例句:
  • However, one other thing we continue to have issues with are turnovers. 然而,另外一件我们仍然存在的问题就是失误。 来自互联网
  • The Shanghai team took advantage of a slew of Jiangxi turnovers. 上海队利用江西队的频繁失球占了上风。 来自互联网
6 fully Gfuzd     
adv.完全地,全部地,彻底地;充分地
参考例句:
  • The doctor asked me to breathe in,then to breathe out fully.医生让我先吸气,然后全部呼出。
  • They soon became fully integrated into the local community.他们很快就完全融入了当地人的圈子。
7 innovative D6Vxq     
adj.革新的,新颖的,富有革新精神的
参考例句:
  • Discover an innovative way of marketing.发现一个创新的营销方式。
  • He was one of the most creative and innovative engineers of his generation.他是他那代人当中最富创造性与革新精神的工程师之一。
8 overtime aKqxn     
adj.超时的,加班的;adv.加班地
参考例句:
  • They are working overtime to finish the work.为了完成任务他们正在加班加点地工作。
  • He was paid for the overtime he worked.他领到了加班费。
9 administrator SJeyZ     
n.经营管理者,行政官员
参考例句:
  • The role of administrator absorbed much of Ben's energy.行政职务耗掉本很多精力。
  • He has proved himself capable as administrator.他表现出管理才能。
10 rehabilitation 8Vcxv     
n.康复,悔过自新,修复,复兴,复职,复位
参考例句:
  • He's booked himself into a rehabilitation clinic.他自己联系了一家康复诊所。
  • No one can really make me rehabilitation of injuries.已经没有人可以真正令我的伤康复了。
11 supervisor RrZwv     
n.监督人,管理人,检查员,督学,主管,导师
参考例句:
  • Between you and me I think that new supervisor is a twit.我们私下说,我认为新来的主管人是一个傻瓜。
  • He said I was too flighty to be a good supervisor.他说我太轻浮不能成为一名好的管理员。
12 labor P9Tzs     
n.劳动,努力,工作,劳工;分娩;vi.劳动,努力,苦干;vt.详细分析;麻烦
参考例句:
  • We are never late in satisfying him for his labor.我们从不延误付给他劳动报酬。
  • He was completely spent after two weeks of hard labor.艰苦劳动两周后,他已经疲惫不堪了。
13 noted 5n4zXc     
adj.著名的,知名的
参考例句:
  • The local hotel is noted for its good table.当地的那家酒店以餐食精美而著称。
  • Jim is noted for arriving late for work.吉姆上班迟到出了名。
14 full-time SsBz42     
adj.满工作日的或工作周的,全时间的
参考例句:
  • A full-time job may be too much for her.全天工作她恐怕吃不消。
  • I don't know how she copes with looking after her family and doing a full-time job.既要照顾家庭又要全天工作,我不知道她是如何对付的。
15 earnings rrWxJ     
n.工资收人;利润,利益,所得
参考例句:
  • That old man lives on the earnings of his daughter.那个老人靠他女儿的收入维持生活。
  • Last year there was a 20% decrease in his earnings.去年他的收入减少了20%。
16 retail VWoxC     
v./n.零售;adv.以零售价格
参考例句:
  • In this shop they retail tobacco and sweets.这家铺子零售香烟和糖果。
  • These shoes retail at 10 yuan a pair.这些鞋子零卖10元一双。
17 reimbursement lkpzR4     
n.偿还,退还
参考例句:
  • He received reimbursement for his travel expenses.由于出差的花费他可以得到公司的补偿。
  • Which forms do I need to complete for my travel reimbursement?我需要填什么表来报我的旅费?
18 reimbursements 7bea0397703fe448f3962669d3140bfb     
n.偿还( reimbursement的名词复数 );退款;补偿;赔偿
参考例句:
  • We had to put in for the food reimbursements again. 我们不得不再次申请食物赔偿。 来自互联网
  • Have you figured up the total of the reimbursements I gave you? 你有没有把我给你的报销账目全部加总了呢? 来自互联网
19 bowers e5eed26a407da376085f423a33e9a85e     
n.(女子的)卧室( bower的名词复数 );船首锚;阴凉处;鞠躬的人
参考例句:
  • If Mr Bowers is right, low government-bond yields could lose their appeal and equities could rebound. 如果鲍尔斯先生的预计是对的,那么低收益的国债将会失去吸引力同时股价将会反弹。 来自互联网
20 layoff QpZzCx     
n.临时解雇,操作停止,活动停止期间,失业期
参考例句:
  • Finally, prepare an explanation about what led to your layoff.最后,要准备好一套说辞来解释你被解雇的原因。
  • Workers were re-employed after the layoff.在暂时解雇不久后工人们又被再度雇用了。
21 layoffs ce61a640e39c61e757a47e52d4154974     
临时解雇( layoff的名词复数 ); 停工,停止活动
参考例句:
  • Textile companies announced 2000 fresh layoffs last week. 各纺织公司上周宣布再次裁员两千人。
  • Stock prices broke when the firm suddenly announced layoffs. 当公司突然宣布裁员时,股票价格便大跌
22 well-being Fe3zbn     
n.安康,安乐,幸福
参考例句:
  • He always has the well-being of the masses at heart.他总是把群众的疾苦挂在心上。
  • My concern for their well-being was misunderstood as interference.我关心他们的幸福,却被误解为多管闲事。
23 worthy vftwB     
adj.(of)值得的,配得上的;有价值的
参考例句:
  • I did not esteem him to be worthy of trust.我认为他不值得信赖。
  • There occurred nothing that was worthy to be mentioned.没有值得一提的事发生。

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