After the Ministry of Health and Welfare amended the long-term care payment system, media reported that a monthly salary of NT$40,000 for long-term care workers would no longer be just a dream. This means that Taiwanese university graduates would not have to settle for a starting salary of NT$22,000 per month if they are willing to work hard and devote themselves to what they are doing.
Low pay is not the only reason for the nation’s shortage of long-term care workers, there is also the problem of how to retain talented people within the profession.
Traditionally, people show the greatest respect toward doctors. While they are indispensable to any medical team, cross-disciplinary cooperation is necessary to give patients the best care possible.
Due to the public’s lack of understanding of professional division of labor and because there is no proper system for promotion for medical workers, it is difficult for them to gain the recognition they deserve.
Under these circumstances, many qualified nurses, physiotherapists and pharmacists have no choice, but to change careers or look for employment abroad.
There are many schools offering courses on long-term care, but if there is no system for promotion, and if people are not recognized and respected for what they do, they would leave the profession.
To reduce the outflow of talented people from the nation’s long-term care sector, the government should raise their salaries.
However, the salary hikes should not be the same across the board; the satisfaction rates of patients and their family members should be taken into consideration.
A patient of mine has employed a Taiwanese caregiver and is paying a high salary, because the caregiver is willing to learn, is easy to communicate with, asks serious questions during treatment and helps the patient do physical therapy activities at home, enabling the patient to achieve double the results with half the effort.
To build an adequate promotion system, the nation could learn from Japan’s commercialization of the long-term care industry. Japanese care providers are formally called “care workers.” They can take a national certification exam and be promoted to “case managers” and be qualified to run a care-service institution if they pass.
Taiwanese care providers can enter a job after taking lessons and accumulating practical work experience, but there is no chance for promotion.
If the long-term care industry was commercialized, a promotion system could be introduced.
Care providers are not generally treated as experts and some patients’ family members treat care workers as servants, asking them to do chores. While it might be necessary for caregivers to help elderly people who live alone with housework, it would be much better for them to focus on care services.
They should help patients cough up sputum, feed them, turn them over, help them take a shower and exercise. Patients’ family members should also learn these techniques and use them appropriately to help provide the best care.
The work hours of caregivers are limited, while the family is responsible for taking care of the patient the rest of the time.
The retention of talented long-term care workers should not just be a matter of offering higher salaries. It is equally important to teach people about the medical role of care providers. If people can show long-term care professionals respect and provide the positive feedback that they deserve, more talented personnel would be willing to enter the long-term care industry.
Cho Chiung-yu is an associate professor at National Cheng Kung University’s Department of Physical Therapy.
Translated by Eddy Chang
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