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For those of us who live long enough, there will come a day when we need help: someone to lift us gently out of bed, to remind us to take our medications, to prepare a warm meal or simply to be present in our moments of fear.
Home health care workers who do this work are the backbone of our aging society, performing jobs that are physically demanding, emotionally complex and necessary. They do vital personal care work that many others can’t or won’t do.
With the massive baby boom generation reaching retirement, the number of Americans aged 65 and over will increase by almost 50% in the coming decades, from 58 million in 2022 to 82 million by 2050, and the demand for home health care workers will boom too.
There are 4.3 million home health and personal care aides in the U.S. today, according to the Bureau of Labor Statistics. Some industry analysts have projected that with the explosion in the retirement-age population, we may have 4.6 million unfilled openings for home care workers by 2032.
Home care is hard work. The vast majority of home health aides are women, who are more likely than in other jobs to be people of color or foreign-born. Many face racism, sexism and classism on the job, and lack benefits, predictable schedules or safe working conditions. The jobs are poorly paid, with low reimbursement rates from Medicare and Medicaid, which account for the majority of the sector’s annual revenue. Median pay is $34,900 a year, or $16.78 an hour; 1 in 4 home workers live below the poverty line.
Enter artificial intelligence. With the right investments, there is an opportunity to leverage technology to boost productivity and lift wages, improve working conditions and create a better path for career progression. AI tools that reduce paperwork, streamline scheduling and track patient outcomes can free up more Medicare and Medicaid reimbursement dollars from back-office functions to go directly to care workers instead.
AI is already lifting productivity and wages in industries such as manufacturing and professional services; in industries most affected by AI, wages are rising twice as quickly as in those that aren’t. On the other hand, AI is reshaping how people enter the workforce: a Stanford study published last month found that jobs for younger workers in AI-exposed industries fell by 16% since 2022. For home care, where the pipeline of new workers is already strained, AI designed to increase productivity alone can't solve the labor shortage.
Human presence can’t be mechanized. But AI could modernize direct care through scheduling software, task optimization tools and platforms that are promising to boost efficiencies.
On the one hand, there’s a risk that these technologies could deliver benefits to shareholders but harm workers. For example, AI scheduling software can reduce hours and pay for workers who are already vulnerable. AI-generated task lists could erode worker autonomy and introduce risks and liability when mistakes happen. Handled poorly, productivity gains from AI could be captured at the top, with profits shared with shareholders instead of giving raises for workers.
But if implemented wisely, AI could not only introduce efficiencies but could also improve the lives of those who provide home care. AI-powered incentive software, for example, enables the tracking of patterns across millions of shifts in real-time, allowing employers to customize acknowledgments and rewards for workers who pick up last-minute work, achieve individual learning and professional development goals, or receive positive feedback from patients.
AI could also open pathways for career progression for home care workers. Data from scheduling software or AI-powered note-taking could be used to recognize and certify on-the-job skills, such as dementia care or medication management, enabling them to advance to better-paying nursing or administrative roles. Caregivers shouldn’t have to seek out expensive certifications or courses to prove competency in tasks they do every day.
AI also offers a path to improved working conditions. For now, it’s hard to transform tasks like lifting an older person from their bed to a wheelchair. But there are AI tools that offer real-time technical assistance to workers on how to use mechanical aides such as wheelchair lifts, or that monitor and flag inappropriate or abusive interactions for the protection of both the worker and the patient.
Policymakers and technologists must not be the only ones who decide how AI is used and what values are embedded into it. AI tools aimed at improving home care should be developed in consultation with care workers, rather than imposed on them, to ensure that AI is used to improve their working conditions and wages.
The government’s responsibility to our retirees should extend to investment in AI technology to improve home care, such as home care chatbots and fall detection technology. We need rules for AI that ensure people have consented to their data being used, that limit continuous monitoring and that give users more control over how AI tools affect them.
Home care is a critical part of the economy of the future, and one for which many of us will be consumers. If we can leverage AI to improve conditions for home workers and for patients, it may help address the looming demand for home workers for an aging population – and improve the lives of those workers at the same time.
Vilas Dhar is a global AI policy expert and president of the Patrick J. McGovern Foundation, a philanthropy focused on exploration, enhancement and development of AI and data science for the common good.
Jade Lin is a Master of Public Policy candidate at Harvard’s Kennedy School of Government and a fellow at the McGovern Foundation, where she researches how AI can improve frontline work.
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