JUDE BARBACK looks at what is preventing younger people from working in aged care.

The health and disability workforce, and the carer workforce in particular, is ageing. At the inaugural Careerforce workforce conference earlier this year, economist Dr Ganesh Nana described how half of the carer workforce is over 50 years old – substantially older than the total New Zealand workforce. What’s more, this workforce is continuing to age. The number of carers aged 65 years and older has dramatically increased in the past eight years, again surpassing trends for the total New Zealand workforce.

These statistics would be nothing more than idly interesting if it were not for the trends occurring in the ageing population, for which these carers are caring. Thanks to advances in healthcare and technology and the encroaching wave of baby boomers, the number of

New Zealanders aged 75 and over is expected to more than double from 250,000 to 516,000 over the next 20 years. This, coupled with the boomer factor – older people are going to become more demanding – and the dementia factor – the number of older people with dementia is going to nearly double every twenty years – means it seems clear the workforce in its current form will be unable to adequately care for this demographic.

Who will supplement an ageing workforce?

What to do? This was one of the key questions asked at the Careerforce conference.

Although caregivers are working until later in life, who is waiting for their jobs when they retire?

Part of the answer lies abroad. Migrant workers form a significant chunk of the carer workforce. Thirty-two per cent of carers were born overseas, and a quarter of these arrived in New Zealand within the past five years. To this end, Immigration New Zealand’s introduction of new guides for employers and migrants in the aged care sector was welcomed by conference attendees.

Another part of the answer lies in the younger generation. One of Minister of Business, Innovation and Employment Steven Joyce’s pet projects has been getting vocational pathways up and running as a means of directing younger people from school into vocations. Approximately 70 per cent of school leavers do not enter degree level study, so there are many students looking at alternative options and careers via a different pathway. It is now acknowledged that NCEA Level 2 or an equivalent is the minimum qualification that young people now need to succeed in New Zealand’s economy, and the Government has set a target for 85 per cent of 18-year-olds to have Level 2 in 2017.

To this end, there are six vocational pathways covering the road to employment in primary industries, services industries, creative industries, social and community services, manufacturing and technology, and construction and infrastructure. Each pathway is colour-coded, and the colour for the social and community services – the pathway under which aged care falls – is purple.

The purple pathway is designed to help young people obtain the skills and competencies, including literacy and numeracy, to enter and progress in this sector.

The objectives of the newly launched Kaiāwhina Workforce Action Plan are aligned with the pathways. One of the key actions is to develop the NZQA registered health and disability New Zealand qualifications, which provide pathways for school leavers, informal carers, and employees for levels 2 to 6 and into the regulated workforce.

While it would appear the pathways are being paved, it is going to take a huge cultural shift to get more younger people in the aged care workforce.

Are younger people suited to aged care?

Then there is the question of whether younger people are suited to the sort of work demanded of them in aged care.

Summerset human resources and business support officer Kay Morgon claims that caregiving is a job in which maturity is valued but that maturity doesn’t necessarily translate to age.

“Some of our older caregivers might have had experience with their own parents or have had children, which brings particular skills, but younger caregivers could have also had experience with the elderly – say, their own grandparents.”

Bupa Care Services’ managing director Grainne Moss agrees that a person’s age doesn’t come into it.

“It is suited to all ages – it’s about being kind, caring, and valuing the older person.”

However, community support worker, Jenny Goodman, believes younger people are generally not suited to working in aged care.

“It’s not just a job that needs NZQA. You need life skills. People wonder why young people aren’t keen to work in the industry, and it’s because you need to be able to communicate with older people.”

Leanne Pickering, general manager people and performance for the Selwyn Foundation, agrees, to an extent.

“Older people have life experience that enhances their levels of compassion and empathy with the elderly, and sometimes the resident is more comfortable with an older caregiver who may better understand the changes that occur with age.”

However, Pickering is quick to add that younger people bring another dimension to the workplace.

“Residents equally enjoy the company of a younger person, if that individual has the right personality for the demands of the role, and younger staff can bring another dimension to the industry, which adds value in different ways. We find this particularly with those who are young mothers and are able to communicate and share stories about their children.”

Morgon agrees.

“Our residents enjoy having younger people around them, for the energy and youthfulness they bring … that said, the people we are looking for need to have certain qualities, like empathy and maturity, regardless of their age.”

Pickering acknowledges that the work involved can be physically and emotionally challenging. She points out that older staff may find the physical demands of the role a greater challenge than their younger colleagues, while younger adults may need additional support with things like palliative care and the terminal nature of many of the conditions affecting some residents.

Pay, progress and perceptions

Morgon believes more could be done to communicate the possible career pathways within aged care to younger people. She says young people entering the workforce are looking for a job in which there is a clear pathway in their career, or a way to get skills and experience.

“Some see caregiving as a way into nursing; they can see that there are skills and experience to be gained doing this kind of work, and a clear career path ahead of them, but perhaps there could be more work in this area.”

Pickering agrees.

“We could also do better in highlighting the professional leadership roles that are available with the larger providers – the opportunity to work within modern, state-of-the-art facilities, the benefits of ongoing education and professional development, and the prospects for career progression.”

She believes the lack of younger people in the industry can be attributed to three things: a lack of reasonable remuneration, a lack of a formal career pathway, and the way the aged care industry is presented and perceived.

“The problem really extends to all ages and all jobs – to registered nurses and caregivers alike. Many of the physical tasks are the same as those undertaken in other care settings, such as childcare and hospital HCA roles, yet these attract younger people. Therefore, it’s fundamentally a problem with how the sector is perceived generally, so more positive promotion is called for that focuses on and values our elders.”

Josie Bidois who works as a District Health Board healthcare assistant in the Specialised Health Services for Older People, confirms there are many young people in her department, with many viewing the healthcare assistant role as a stepping stone to nursing. Conversely, registered nurse Christiane Telfer says at 46 years old, she is one of the youngest at the rest home where she works.

Grainne Moss believes employers have a responsibility to promote aged care work as a career option for younger people. She also believes the media could do more to present aged care and the ageing process in a more positive light.

Ryman Healthcare, one of the larger aged care providers in New Zealand, is taking up the challenge.

“We need to increase awareness of the potential for career progression, job security, and the opportunity to build a great career at all levels in the industry. There is also the potential for staff with plenty of aptitude, energy, and ambition to work through the ranks into management within a reasonably short time frame,” says Ryman group human resources manager Nicole Forster.

Ryman has increased pay rates for caregivers by five per cent a year over the past two years, but Forster says this is just one piece of the jigsaw.

“We offer extra training, scholarships, and clear career paths. We encourage, for example, caregivers who are interested in becoming registered nurses by offering training scholarships.

“[Ryman has] been selected to take part in a Government pilot scheme, called the Industry Training Fund. This gives us direct access to funding and has meant we can extend the training we offer caregivers and housekeepers,” explains Forster.

The issue of pay does not appear to be a strong deterrent for younger people. New to the workforce – indeed to any workforce – generally they do not carry high expectations for their starting pay rate.

The issue is a lack of pay progression, linked to a lack of career progression opportunities. Training actually appears to be well-executed at many facilities, however the attainment of qualifications or new skills is linked to pay in an ad hoc manner across different facilities. As an unregulated workforce, there is no formulaic system for recognising that the better you become at your job, the better your pay and the better your chance of promotion. A young person considering the industry will recognise a lack of pay and promotion opportunities and for the same money may opt for a job at a supermarket or a fast-food restaurant, where the pay is comparable, yet the avenues for progression are better defined and publicised.

There are notable exceptions, however – true success stories that serve to demolish these arguments.

Tracey Sprott, manager of Ryman Healthcare’s Shona McFarlane Retirement Village, provides a shining example of someone who has managed to progress her career in aged care. She joined Ryman in 1998 as a caregiver and took up any opportunity for training and progression within the company. In the space of 11 years, she moved from caregiver to senior caregiver, to quality assistant manager, to service department coordinator, to administration, to village manager.

“I tell my care staff that opportunities can open up for everybody, but you’ve got to be willing to put the hard yards in and push yourself forward. There are lots of opportunities in this company,” says Sprott.

Bupa’s Shaun Brown, who won the EEO ‘Walk the Talk’ Award in 2012, is another prime example that it can be done. Brown started out as a caregiver, trained as a registered nurse, then moved on to become a clinical leader before becoming operations manager for Bupa Care Services. In this role, he helped others progress their careers in similar fashion.

Connecting the pieces

Of course, bigger players like Bupa and Ryman are more likely to offer more career opportunities. Sprott acknowledges the role that Ryman has played in her climb up the ladder and concedes that such opportunities may be harder to come by in smaller facilities.

The good news is that the wheels are in motion to change this. The NZQA qualifications review is expected to tie in well with Careerforce’s objectives and the Kaiāwhina Workforce Action Plan.

But this is just one part of the puzzle. Career progression, achieved through training, qualifications, and clear pathways within organisations, needs to be linked to employees’ pay. By now, we all know that this is not easily achieved without a lift in Government funding.

The jigsaw is certainly coming together, but there are a vital few pieces missing. Only when it all comes together can we truly expect to see young people taking the purple pathway, and into aged care work in particular.

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