In 2017, Taiwan launched the National Ten-Year Long-Term Care Plan 2.0.
To attract more caregivers to community and home care services, the government has increased basic wages, adjusted payment methods for service categories and made work hours more flexible.
With such incentives, many institutional caregivers have started working as home caregivers, which are also the most desired jobs among elderly care majors.
As a result, long-term care institutions have within a short time lost many employees and are facing a serious labor shortage.
I have operated a long-term care facility and have offered caregiver training classes, while also teaching in the senior citizens service department at a junior college. I have witnessed the worker outflow from local institutions since an early stage.
There are a few relevant issues:
First, the government has advertised and promoted home care services, ignoring institutional care services, which has given home caregivers a sense of honor and mission, and successfully attracted institutional caregivers and graduate students to throw themselves into community and home care services. As a consequence, a lot of caregivers are leaving institutions.
Second, home caregivers are paid by the government, while institutional ones are paid by care service facilities. About 70 percent of my students say that they would prefer to establish their own home care service agency after graduation.
Apart from the low investment cost, the clients only need to pay for part of such services, as the fees are mostly covered by the government. This means that the number of clients and income are stable.
There is also a low willingness among elderly care majors to perform basic care services after graduation. The government’s plan has led to a constant growth of community and home care services.
As many as 90 percent of my students plan to work as home caregivers after graduation, and they hope that by obtaining a college degree, they will have a better chance to serve as agents, supervisors or managers, and avoid performing tasks involving intensive physical labor — such as bathing people, turning them over, patting their backs and transferring them from a bed to a wheelchair.
There are also no incentives for institutional caregivers to stay with their employers. Institutional care services offer “one-to-many- style” services, as each caregiver is on average responsible for eight to 12 people, while home care services are one-on-one.
Institutional caregivers regularly work night shifts, but home caregivers mostly work during the day, not to mention that their wages are higher.
Finally, many care service institutions rely heavily on foreign caregivers, marginalizing the abilities and roles of local ones. Due to the difficulty recruiting local caregivers, foreign professionals have gradually become the main force at care service institutions.
Besides, local caregivers’ expertise and training might be insufficient due to the low retention rate, with the result that foreign caregivers are more proficient in care techniques.
Theses problems have existed for a long time.
When promoting home care services, the government will hopefully also pay close attention to the constant labor outflow from care service institutions.
It could start with elderly care education, cultivating students’ care techniques to increase their willingness to provide bedside care services, while boosting retention and institutional caregivers’ sense of duty.
Li Li is a managing supervisor of the Taiwan Long-Term Care Professional Association.
Translated by Eddy Chang
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