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'A little help here and there': Worker shortage leaves seniors without in-home care

Evelyn Davis' house with white siding in Wallace, Duplin County. An accessibility ramp leads to the front door. A beige van is parked in front.
Jason deBruyn
Seventy-five-year-old Evelyn Davis has lived in her house in Wallace, N.C. for 20 years. She likes being independent but could use a little help here and there. Like many others across the state, Davis is on a waitlist for in-home care.

Seventy-five-year-old Evelyn Davis lives by herself in the town of Wallace in southeastern North Carolina. She likes to keep her home warm, especially on cold and rainy days.

At her age, Davis has a few ongoing health problems. She survived breast cancer but needs her hips replaced and has shoulder problems. She's lived in her house since 2003 and likes being independent, but could use a little help here and there.

"I would like to have my ramp widened out to come around to the front. I need banisters for my back stoop," she says.

Inside the house, she faces other mobility challenges. For one, she's been sleeping in her recliner for weeks.

"The hospital bed that I have, I can't get up on it. Because it's semi-automatic," she says, accentuating the "semi." "There's a crank in the back of it, and I can't turn that thing."

These are tasks that might have been easy for her when she was younger. But she says it's hard to find help now. Even when she bought tools, one man who said he would help her never showed up. And she says getting help from her community or church is not like it was in her mother's generation.

"And whenever one of the members got sick, all of them pitched in, went to this person's house, cleaned it, washed the clothes, swept the yard, cooked, even painted sometimes. And they don't do that anymore," she says.

Growing waitlist

Davis qualifies for help from the county. But she's on a waitlist because — like many parts of the economy — Duplin County Services for the Aged has a worker shortage. Director Melisa Brown says they offer many of the kinds of services that Davis would like to have, including home-cooked meals, and other in-home help.

"We're making beds, vacuuming, mopping floors, all those type [of] things that physically maybe that senior's not able to do," she says.

Brown's department serves about 82 people, but there are another 40 people on the waitlist, and she says that number continues to grow. Her department has nine positions for workers that help directly in people's homes, but two are currently vacant. The positions in Duplin County will see a pay increase this year from just over $9 per hour — $1.75 above minimum wage — to almost $12 per hour, but Brown says even that has not increased the number of applicants. The county has also turned away some applicants because of failed drug tests. Brown says they have to be strict because they're sending workers into seniors' homes.

"I want to lay down at night knowing that I've done to the best of my ability, to make sure whomever we're allowing to go in there and serve seniors, that would be the same person I'd want to send in my mom's home," Brown says. "That's the way I look at it."

Funding the need

It's not just Duplin County struggling to find workers. Shortages across the state are expected to get only worse. State commerce department projections show the number of home health and personal care aide jobs will increase by 23% by 2030. That's one of the biggest increases of any job classification. And this for a job that's demanding, says state Medicaid Director Dave Richard.

"Depending on what you're doing, it requires going into somebody's home, doing the kind of work with somebody, really caring for somebody's life versus — I'm not going to downgrade the work that other folks do — but it's not quite as difficult," he says.

Difficult and low paid. The average median annual wage for a home health worker was less than $24,000 last year. That's below laundry workers, hotel desk clerks, and bartenders. Medicaid funds many of these services and Richard says there was COVID-19 pandemic funding that helped. But that's going away, and without the North Carolina General Assembly allocating more money, pay rates could go back down.

"And honestly, what we put in during COVID probably isn't enough," Richard says. "We probably need to do more. But we've got to at least stay where we are so we don't wind up having more people lose their workers during this process. So it's going to be a really important time during the General Assembly this year."

Richard says getting pay to at least $18 per hour would be a good start, but it's not likely to go that high this year. And that means more seniors like Evelyn Davis will continue to sit on a waiting list.

Jason deBruyn is WUNC's Supervising Editor for Digital News, a position he took in 2024. He has been in the WUNC newsroom since 2016 as a reporter.
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