Higher costs for these basic needs hit low-paid personal care providers hard. These workers bathe, feed and get clients in and out of bed for $10 to $13 an hour, and often aren't offering health benefits, paid time off or reimbursements for travel costs, Totaro said.Cheryll Tice has been employed in home health for about seven years, and currently works with with Bayada. Tice routinely begins her workdays at 10 a.m. and doesn't return to her home in Magnolia, Delaware, near Dover, until nearly midnight, she said.
"I'm considered part time, but I usually work full-time hours. There are always hours available because of the shortage of aides. You can work 24/7 if you want to. That's how much the need is," Tice said.
Four days a week, Tice puts roughly 100 miles on her car and spends about one-third of her day in transit. On the fifth day, she takes care of her mother, who has dementia.
"It's been really hard. You work for little pay, and you're putting a lot of your paycheck into gas," Tice said. "Plus, you have the wear and tear on your vehicle."
Tice recently got a $1.25 raise to $15.25 per hour but knows she could make more in food service, where she spent most of her working life. Her husband is retired and on a fixed income, and she hasn't been able to afford health insurance for the past seven years.
Still, Tice finds the work rewarding. "Some people don't have family members, and they lie in urine and feces all day until their aide shows up," she said. "Those are the kinds of things you run into. It's heartbreaking. These people look forward to us coming."
If gas prices remain high, Tice may have to switch to facility-based care, she said. She's trained as a certified nursing assistant but let her certification lapse. In the meantime, Tice, who is in her 60s, may pick up more home health shifts, even though it's tiring. Or she can cut back expenses by packing lunches instead of buying meals on the go, she said.
Sarah Anderson, senior vice president of caregiving recruiting at Help at Home, said the company has been trying to find ways to alleviate the impact of rising gas prices on its employees. Help at Home is trying to match workers to closer clients and to recruit more aides in rural areas to limit commuting time, she said.
"We don't ever want to turn away a client," Anderson said.
Inflation is a burden for the already financially stressed members of Home Healthcare Workers of America, which represents more than 32,000 workers in New York, said Joe Pecora, the union's vice president. "We were having a hard time making ends meet beforehand," he said.
Most members of the union, the majority of whom are women of color, make $15 per hour and live in New York City, Pecora said. While many rely on public transit, the rising cost of other consumer goods such food has been a challenge, he said.
Once the pandemic was declared an emergency, workers were able to use pandemic relief cards to buy food, Pecora said. But such benefits are at risk when the public health emergency ends, likely later this year.
That will make it even more difficult to recruit for the understaffed home health industry, he said. "Patients, who are most vulnerable population, are not being cared for," Pecora said. "If there is no home health worker, then there is no one there."