Will Staff Shortages in Long-Term Care Settings Lead to the Use of Robotics?
by Don Drake, Connelly Law Offices, Ltd.
There is no sector in healthcare services that is feeling the effect of the staffing shortage more than the Long-Term Care industry. Although many point fingers at the pandemic as the cause, those working in the field know this is a problem that existed long before anyone uttered the words COVID-19.
"The pandemic exacerbated these workforce shortages and drew attention to the challenges that providers face in staffing their facilities," said certified elder law Attorney RJ Connelly III. "Going back at least five years, I was having conversations with administrators and other senior care providers, and they all cited this as a growing concern for them. These concerns also included the excessive cost of overtime and an increased worry about staff burnout."
"The pandemic exacerbated these workforce shortages and drew attention to the challenges that providers face in staffing their facilities." ---Attorney RJ Connelly III
According to the United States Bureau of Labor Statistics, the nursing home industry has lost some 235,000 jobs since March of 2020, equating to 15% of the workforce. This number far exceeds those lost in all other areas of healthcare. In a poll conducted by the American Health Care Association and the National Center for Assisted Living (AHCA/NCAL), 99% of nursing homes and 96% of assisted living communities said they are facing some degree of staffing shortages. Fifty-nine percent of nursing homes and 30% of assisted living communities characterized their staffing situation as “severe.”
To date, as we are beginning to return to some sense of normalcy, long-term care providers continue to say that the issue is not improving. Since June of this year, 86% of nursing homes and 77% of assisted living programs say the staff shortage has not improved with most saying it has gotten worse. There is also another problem that will have an impact on the growing number of seniors in care, a declining birth rate.
Fewer Born, Fewer Providers
Demographers anticipate that by 2060 almost one in four will be in the age group that may need long-term care, meaning there will be some forty-eight million more elderly individuals in our country just four decades from now.
The National Center for Health Statistics released a report that stated American births have fallen to record lows in recent years, extending a deep decline that began in 2008. This is problematic since birth rates are an important measure of a society’s demographic balance. If rates are too high, resources like education and housing are strained, and yet if they are too low, a country will face challenges replacing its workforce and supporting its seniors.
Technology and Home Healthcare
Most of us who work with seniors are aware of the new innovations in the home that have allowed seniors to continue living on their own. Devices hooked to phone lines that monitor pacemakers, defibrillators, and other medical hardware help to keep them from moving into long-term care facilities. But it’s not just medical assistance that seniors living independently need, they also need help with everyday chores like cooking, light housework, and managing finances.
Relatives are often not close enough to help with this work and evidence is beginning to show that when relatives do this work, it is neither healthy nor sustainable for either party. This has led to the explosive growth of professional home health care services. These businesses, however, struggle to keep their positions full and their employees professionally trained as well. The need for dedicated and experienced staff far outstrips the supply and as we stated earlier, the workforce shortage is only projected to get worse.
Turning to Robots
Without people to staff these positions in long-term care facilities and home care services, and costs of care skyrocketing, healthcare providers are considering robotics to help supply these services. It makes good business sense, they say -- a one-time investment with some upkeep, robots don’t call out sick or quit, and they provide consistent care without the emotional baggage of a human provider.
In the past, many providers and consumers had strong negative feelings about robotics being involved in the care of humans, but the attitudes are changing. Recent surveys of professionals and families in need of health aids for aging parents indicate an acceptance of robot help in providing care.
And as we alluded to earlier, European providers are using a prototype with several elderly people across the continent – the GiraffPlus robot.
This machine is designed to help elderly people who want to stay at home remain independent past the point they’d usually be unable to live alone due to physical or cognitive difficulties. Motion sensors track if someone is in a certain room while pressure sensors under beds and sofas can tell if someone is sitting down. There are also sensors that are activated when certain appliances are plugged in and sensors that monitor when doors and windows are open or closed. The sensors can measure room temperature and humidity, turning on heat or cooling systems.
This robot has other uses as well, it can be fitted to measure weight, blood pressure, and sugar levels and monitor the night movements of the senior. The machine also allows “virtual visits” from friends, family, and healthcare professionals by using a screen fitted to it. Despite some minor difficulties with robotics, its inventors see these problems as being corrected simply and quickly. In short, the elder care industry there sees the use of robots as something that will happen sooner rather than later.
Warm Hands Versus Cold Hands
Although we mentioned that surveys show some acceptance of using robot technology, many others in healthcare have a major concern, best summed up in this phrase – “warm hands versus cold hands”. These concerns are not to be taken lightly.
In many cases, daily caregiver visits are the only human contact some elders have with other human beings. Lacking the human touch, they say, will not only further isolate seniors but lead to a rapid decline in health. This concern became readily evident during the pandemic.
The practice of social distancing and canceling visits in long-term care facilities contributed to an epidemic of physical and emotional problems as seniors faced social isolation and loneliness. Isolation is best described as an objective lack of social contact while loneliness is a subjective feeling of being by yourself, and both have some profound consequences.
In a study by Julianne Holt-Lunstad, Ph.D., of Brigham Young University, she found that both isolation and loneliness are associated with increases in heart disease, dementia, and other health problems. Social isolation by itself increases mortality risk on a par with such risk factors as smoking, obesity, and lack of physical activity.