The Caregiving Crisis: Major Changes Required to Fill Caregivers’ Roles in North Carolina Nursing Homes

Long-term caregivers in North Carolina provide the most delicate of daily personal and health care needs to people recuperating from chronic acute illness, as well as the fragile and elderly who can no longer effectively care for themselves. COVID-19 has shed light on the long-term care sector’s issues, notably a critical shortage of caregivers. North Carolina must consider long-term care professionals as equals in health care and devote greater resources in workforce development to meet the oncoming tidal wave of North Carolinians in need of long-term care.

A combination of low wages and difficult work has resulted in a crisis in North Carolina. Data from the North Carolina Nurse Aide Registry reveal that the number of people working as nurse aides has decreased by about 20,000, or 16%, since 2015. According to the Protected Health Information (PHI), at least 4,000 of these people have stopped caring for others totally, while others appear to have moved to assisted living, where a frontline caregiver is not required to be a nursing aide. Because of this, it is not surprising that a 2020 survey conducted by the North Carolina Area Health Education Centers (NC AHEC) discovered that nurse aides are the most in demand in the state’s health care system.

According to a 2020 study performed by Appalachian State University, most nurse aides were either highly unsatisfied (24%) or unsatisfied (31%) with their pay. He previously referenced NC AHEC study also noted low pay as a contributing cause to the scarcity of nurse aides.

Even before the COVID-19 epidemic, the low wages offered to these long-term caretakers made the role unappealing within health care and in comparison, to other industries.

State-run health care facilities and independent hospital and health care systems, such as Duke Health and Novant Health, pay at least $15 per hour and typically provide more benefits. Aside from health care, many retail and other industries pay $15 per hour or more for entry-level jobs that require no training. This is much more than the median hourly wage of $11.44 for frontline long-term caregivers.

We need to start treating these individuals like the health-care professionals that they are. This entails significant progress in at least four areas.

First, wages must be raised significantly, and improved benefits, like as sick leave and paid time off, should be made more readily available.

Second, legal immigration. Long-term caretakers should be prioritized for professional visas by policymakers. Today, 98% of North Carolina’s long-term caregivers are US citizens, with 95% being citizens by birth, compared to 17% of Florida’s caregivers; Georgia and Virginia also have higher percentages of noncitizen long-term caregivers, at 6% and 9%, respectively.

Thirdly, educational reform. We need to improve the paths into long-term caregiving by connecting individuals interested in the field with potential employers and providing more employer-sponsored training. The current education requirements for nurse aides make it difficult to recruit new caregivers. They frequently entail waiting for a planned course at a community college, commuting some distance, going unemployed for a period, and acquiring a generalized health care education.   

Lastly, respect for ling-term caregivers. Society should acknowledge these professionals as essential members of the frontline health care workforce that they are. At the beginning of the pandemic, many health care professionals and other frontline vital workers were lauded as heroes on newscasts and billboards. Long-term caretakers, on the other hand, were frequently disregarded or blamed.

Addressing present and future long-term care difficulties will necessitate the recruitment of thousands of new long-term caretakers. North Carolina must create a better-paid, more stable workforce of nurses by raising funds, creating new career pathways, reforming educational requirements, and instilling a renewed sense of respect and admiration for the hard and significant work these professionals do for the state’s most vulnerable citizens. 



Information from North Carolina Medial Journal (NCMJ) – Article “The Caregiving Crisis: Significant Changes Needed to Fill the Void of Caregivers in North Carolina Nursing Homes”

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The Caregiving Crisis: Major Changes Required to Fill Caregivers’ Roles in North Carolina Nursing Homes
Ashlyn Pieri 15 December, 2021
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