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janbb's avatar

Encourage immigrants to come there and train them. My experience in the past few weeks with care givers, all immigrants, has been wonderful.

mazingerz88's avatar

@janbb Great idea. Legal immigrants and maybe even illegal ones who if they qualify and prove themselves good caregivers could be transitioned into working visa holders. Even better, a path to permanent residency.

MrGrimm888's avatar

I’m liking the immigrants idea. I have had great experiences, with immigrant nurses, and doctors. I never asked them about their citizenship, but they definitely weren’t born in the US…

JLeslie's avatar

I’m surprised they aren’t already trying to attract immigrants. That was the first thing that popped into my head too. We’ve done that for nurses for years, because of the nursing shortage. To get new visas for immigrants they need to work hand in hand with the federal government.

The state can give away housing and land as a way to attract people to move to the state. Maybe make the deal available for people who work only in the geriatric care industry. Just one person in the household needs to work in that profession.

Create a safe city like in The Netherlands so more people who have dementia can live safely, and maybe not need one on one help as much. Here is a link to a longish video about it that covers the history of how it developed and how it functions. Basically, you can think of it like a walled city. It has a grocery store and restaurant, but no money changed hands, open courtyard to be outside The patients can do normal daily things but can’t wander off outside of the safety of the property. They decorate so it feels like 40–50 years ago because Alzheimer’s patients typically have stronger memories from the past. Here is a shorter clip if you don’t want to see the entirety of the other video. I recommend the long one though if you can get through it. Gupta talks to patients and several caregivers.

Where I live we have facilities that have varying stages of care. Most of you know I live in a retirement city full of activities you can do. Most people live in their own single family house, but we do have apartment style housing both rental and ownership, where the monthly fee is fairly expensive, and different levels of care. There is independent living, where the person doesn’t need help at home, but they get one or two meals made for them every day, and they can use the transportation shuttle that takes them to the stores and to the activities in The Villages, the same ones I attend. Plus, there are activities inside the facility. As they age and need more help they graduate to a different level of service in the facility. Since these are built in a city that people want to live in that helps with staffing, but my bet is we still have some trouble staffing these places. Better pay will help attract people. People who live in The Villages work there and also you get people who live outside of the town.

My city is a test pilot for home monitoring. They put sensors throughout the home and an alert is sent if someone is in bed all day, or doesn’t move around enough, doesn’t go to the bathroom, etc. The alert might just go to a family member or can be more of an emergency.

Robots. If robots can help reduce some of the workload.

One or more of the European countries has a program for college students to live for free with older citizens. They get free housing, can help the older person and the older person helps by imparting wisdom and they both have some companionship. It isn’t older citizens who need significant care though. Maybe they pair them with like interests? That would be good. Engineering students with engineers, etc.

I think the federal government will have to get involved eventually. Whether it be work visas for immigrants or funding facilities and towns or subsidizing pay for caregivers.

The pay is a big deal I think. In home caregivers who work for a company generally get paid very poorly and so it attracts a lot of people who don’t care much about their job nor doing a good job.

The thing about the caregivers is you want the people giving care to like the job, or at least not hate it.

seawulf575's avatar

Healthcare is one of the largest growing fields in this country. I don’t think there is a shortage of healthcare givers in this country, nor a dwindling supply of young folks entering this field. I think that some of the problem is location. Young folks oftentimes want to live in a place that will support their lifestyle. If that lifestyle includes night life or specialized activities like surfing, Maine probably wouldn’t offer as much as California or Florida or even the Carolinas. Add to that the concept of tax rate being relatively high in Maine and it creates even more of a problem. If I can go work in Maine and pay 7% income tax or go work in Texas and pay 0%, Texas looks more appealing. I think the solution for Maine is to increase the pay scale for healthcare workers, possibly tax breaks for those in areas of greatest need. Offer incentives for education at state universities in the healthcare field with the agreement that upon graduation they agree to X number of years service in that field in that state. There are many ways to entice good talent.

JLeslie's avatar

@seawulf575 I agree with you about wages and location, but your idea that there are plenty of people willing or able to do the jobs is incorrect. There is a shortage of labor and it will get worse.

When I was laid off I could have gone to school for free to become a nurse, because Florida needed more nurses. I don’t know if they are still doing that program. Probably, other states have done it, or at doing it.

The US already gives visas for healthcare workers. That’s why there are so many nurses and other parts of healthcare who are from the Philippines, Jamaica, West Asia, Eastern Europe, you name it. We import people for healthcare.

I found an article on foreign born health care workers. Some parts of healthcare almost ¼ of the workers are immigrants.

jca2's avatar

In thinking about this, and thinking about the city that I work in and have delivered social services in, I am thinking the issue in Maine is not a one dimensional problem.

I have relatives in Maine and while it’s a beautiful state, and has charming little villages, it’s the small town charm that is what keeps immigrants out. Maine is cold from October thru May. You need a car because those charming little villages don’t have much in the way of services, including social services. You’d probably have to go to the County seat, which, in a rural county, might be a long way away, without a car, and in cold weather, not an easy thing to do. Many people live out in the boonies. Beautiful but for someone delivering home health care, it means you have to have a car and be prepared to travel a lot. The charming little villages don’t have much in the way of public transportation.

I have no idea what the income tax situation is in Maine or how they are when it comes to delivering social services (food stamps, help with rent, etc.). If they are not very giving, they should look into being more welcoming in that way.

Add to this the attitude of many Mainers which is one of being rugged and able to handle the weather and the circumstances. In our family are teachers and lobster fishermen. It sounds stereotypical but they are very much like an LL Bean catalog in the way they dress. When I was little, they were the poor relatives in Maine, and toys I outgrew or clothes I outgrew were shipped up to them.

If there are 47 other states that an immigrant could work in, and maybe find more hospitable, why would one want to work in Maine?

seawulf575's avatar

@JLeslie I have no problem with bringing in healthcare worker immigrants and using them. But just because someone comes to this country doesn’t mean they want to move to Maine. It’s interesting you bring up Florida. Like Maine, it has a high number of elderly people and a high demand for nurses. I think that areas needing more nurses need to really focus on that. As I said, I think there are options for enticing more nurses.

JLeslie's avatar

@seawulf575 I was addressing your statement: I don’t think there is a shortage of healthcare givers in this country. Yes there is. That’s why we keep granting visas for healthcare workers. If we had plenty of healthcare workers in the US we wouldn’t be handing out that work visa in such big numbers anymore.

@jca2 You summed up part of the reason my grandmother moved to Manhattan in her 70’s. Public transportation, delivery of almost anything, convenience.

ragingloli's avatar

Turn all the cripples and geezers into soylent green.
Lower the number of people needing “care”.

johnpowell's avatar

Oregon is very white. 87%. I have seen a lot of doctors in the last year. I will try to remember them.

Oncologist – Korean
Infectious Disease – Mexican
Ear Nose Throat – Mexican
Ear Nose Throat #2 – Maybe Vietnamese
Oral Surgeon – Mexican
Radiologist – White
Oncologist – Egyptian
Nutritionist – White
Speech/Swallowing guy – British
Oncologist #3 – White
Dentist – I think Korean

The nurses have been 90% white. African-Americans actually seem to be well represented in nursing considering they make up around 2.5% of the population.

janbb's avatar

All of the doctors, nurses and health care workers I have seen in the past three weeks have been Asian.

JLeslie's avatar

@johnpowell and @janbb Did they all seem to be new immigrants? The west coast has been full of West Asians and Mexicans for many generations so I just wondered if maybe you could tell by the accent if they most likely were born here, or if they came here as adults.

My area has a ton of doctors from South Asia. None of them born in America from what I can tell. My GYN is from Venezuela.

janbb's avatar

@JLeslie The skilled workers seemed to have been nere a while; for some of the aides, it was only a few years.

jca2's avatar

Maine can start by raising its minimum wage.

Cut and pasted from the article: Care workers in Maine were paid about $11.37 an hour in 2017, according to an AARP report, with a 2019 minimum wage of $11 an hour. As Kristi Penny, who has cared for Honey for four years, noted over the phone: “Even Dunkin’ Donuts pays you more.”

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