As Boomers Gray, Elder Care Jobs Enter Golden Age

W.C. Stingley knows what good home health care is, and what it is not.

Seven years ago, he hired a succession of home aides to help care for his wife, who had terminal cancer. Top-notch care was important, he said, because he wanted his wife of nearly 50 years to be as comfortable and as lovingly cared for as possible in her final months.

The first caregiver, the 81-year-old San Clemente resident recalled, was “like a cub bear with boxing gloves on” in the kitchen and was not fluent in English. The next stole a credit card.

But then came Linda Davis.

“Linda and her group did a wonderful job,” Stingley said. “They made my wife’s life as comfortable as it could possibly be.”

Good home caregivers are at a premium now and will be even more so in the future, gerontology and home health care officials say.

Home health aid is among the top 10 fastest-growing occupations in the country, with the number of jobs in that field expected to jump 76% from 1996 to 2006, according to the U.S. Bureau of Labor Statistics. And employment opportunities in home care are bound to improve even more after that.

With the aging of baby boomers and advancements in medicine allowing people to live longer--although not always in the best of health--the number of elderly people needing assistance is expected to mushroom.

Nationwide, those 65 and older currently number 34.3 million, according to the U.S. Census Bureau. In 12 years, that number is expected to grow by 15%. In 22 years, it will be 55% larger than today. And in just 32 years, there are expected to be twice as many elderly as there are today.

In Orange County, there are more than 386,000 people who are 60 years or older; by 2010, that figure is expected to grow to nearly 550,000, a 42% increase, according to the state Department of Finance.

Such growth means the public will need well-trained aides who know the proper ways to care for the frail, who understand the physical and emotional changes that senior citizens go through and who treat the elderly with the proper respect, said Sandy Marzilli, a project coordinator in Saddleback College’s gerontology department.

Saddleback is the only community college in Orange County that offers a home caregiver training program. Qualifying graduates receive a state certificate--CHHA, or certified home health aide--that one day may become required, Marzilli said.

Teachers give lessons on using proper balance and posture when moving someone, to prevent injury. They teach how to bathe a bed-bound person and perform other personal chores while respecting privacy and modesty. There are lessons in ethics, nutrition, sanitation and infection control. They discuss communication skills and psychological issues.

They also teach compassion.

Students enter class the first night and promptly have their wrists, elbows, shoulders and knees bound with tape. They are given vision-blurring glasses to wear--thick prescription lenses, smudged with petroleum jelly. They stuff cotton in their ears.

Then they are told to walk downstairs and get themselves a snack.

“They become very dependent upon one another,” Marzilli said. They hold the railing tightly as they labor with stiff legs up and down the stairs. They fumble for money for the vending machine. They hold hands to navigate better.

“When they come back, they ask, ‘Can we take this stuff off now?’ They had no idea that a simple movement would become a chore,” Marzilli said.

“They get a better understanding of the plight of seniors,” she said. “They can understand why seniors get angry, because their bodies aren’t working the way they’re supposed to.”

Marzilli said most private home care agencies and services now require their workers to have a CHHA certificate. Board-and-care and convalescent facilities require different certification, called a CNA, or certified nursing assistant, which places more emphasis on health and nursing-related skills.

Several regional occupational programs and a few private businesses in Orange County offer training for the certificates, a state Department of Health Services spokesman said. Saddleback’s CHHA training program, now in its second year, is funded by a $30,000 grant from the Irvine Health Foundation. Part of the grant will be used to disseminate the program to other California community colleges.

The Alzheimer’s Assn. of Orange County provides an eight-hour training course, specifically geared to caring for dementia patients, that is offered to home health care employers.

About 70% of Alzheimer’s patients live in their own homes; about half of the patients in nursing homes suffer from the disease characterized by memory loss and failing mental function, said Linda Scheck, executive director of the county group. Trainees learn tricks of the trade for dealing with patients who perhaps cannot remember when they last ate or who are suddenly fearful of the bathtub.

Marzilli said the students in Saddleback’s caregiver training program come from varied backgrounds. Some have enrolled to learn how to properly take care of their own relatives; others are young people who see caregiving as a future source of steady employment. Many, she said, are already working in the field but want to be certified in case it ever becomes a state requirement.

Davis, who took care of Stingley’s ailing wife, is one such graduate.

“Anyone can walk in and say they can take care of someone, but I went to school to get certified,” said Davis, who has been a caregiver for nine years.

“Some people just don’t care. To them, it’s just a job,” Davis said. “But with this field, you have to regard it as more than that.” Elderly patients and their families depend upon caregivers, yet some less-dedicated aides simply do not show up for work sometimes, she said.

“The seniors are so vulnerable,” agreed Bobbie Alitt, president of Bobbie Alitt’s Home Care Services Inc. The senior citizens’ dependency upon their caregivers also means that they can easily be intimidated or duped by unethical workers, she said.

Frank Bonetti, owner of SoCal Home Care Inc., said it is crucial for caregivers to be well-trained and dedicated, even though “this industry we’re in has no rules.” He likes his employees to have CNA or other training credentials, and he sends his caregivers to the Alzheimer Assn.’s program as well.

Bonetti has helped the Alzheimer’s group develop a brochure, to be available in July, aimed at assisting families hiring home caregivers. The brochure suggests questions to ask applicants about their training, provides definitions and offers other information about home care. It will be available through the Alzheimer’s Assn. at (714) 283-1111.

“Not everyone can be a caregiver,” Alitt said. “You have to have a wealth of compassion and the patience of a saint, besides the ability to do the job.”

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An Aging Population

The number of Orange County residents 60 and older will increase 42% in the next 12 years. The 85-and-older group will grow about the same amount, 45%. Nationwide, the number of people 65 and older will continue to grow in absolute numbers but will peak as a percentage of the entire population by the middle of the next century.

U.S. Projections

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65 and older (in thousands) % of Total 1998 34,286 12.7% 2000 34,709 12.6% 2010 39,408 13.2% 2020 53,220 16.5% 2030 69,379 20.0% 2040 75,233 20.3% 2050 78,859 20.0%

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Orange County Projections

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60 & older 85 & older 1990 306,630 22,871 1998 386,287 37,156 2000 404,988 39,695 2010 549,149 54,011

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Need for Help

The continued growth of America’s older population will help fuel a demand for home care and home health aides. Here are the occupations with the fastest projected employment growth for the 1996-2006 decade:

Computer scientists*: 118%

Computer engineers: 109%

Systems analysts: 103%

Personal/home care aides: 85%

Physical therapy aides: 79%

Home health aides: 76%

Medical assistants: 74%

Desktop publishing specialists: 74%

Physical therapists: 71%

Occupational therapy assistants: 69%

* Includes database administrators, support specialists and others

Sources: State Department of Finance, Census Bureau, Bureau of Labor Statistics; Researched by MARCIDA DODSON/Los Angeles Times