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EPISODE: #52

Paurvi Bhatt, MPH, Healthcare Executive and Care Economy Leader: Retaining Employees By Supporting Their Role in Caring for Others

WorkforceRx with Futuro Health
Paurvi Bhatt, MPH, Healthcare Executive and Care Economy Leader: Retaining Employees By Supporting Their Role in Caring for Others
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PODCAST OVERVIEW

“It's hard to bring what happens in the living room and the dining room into the boardroom,” says Paurvi Bhatt, board director of the Rosalynn Carter Institute for Caregivers and corporate executive. "I don't think we can do that anymore." Put another way, most of us are providing care to a loved one, and being open about that with colleagues, she thinks, can create a culture of understanding that will increase employee wellbeing. In fact, she believes that trend has already begun. “Leaders at all levels are starting to be much more vocal and vulnerable in sharing what's happening with them. There isn't a feeling that the only way to succeed is by hiding that these parts of your life exist,” she tells Futuro Health CEO Van Ton-Quinlivan. In addition, companies have access to new employee benefit options designed to relieve some of the administrative burden of caregiving. “A beautiful set of things are coming up for employers to take a look at. It's a reimagining of what benefits can look like.” Despite this progress, daunting challenges remain to make caring for loved ones at home viable, which Bhatt analyzes with the keen eye of someone who built a career as a global health leader despite heavy family caregiving responsibilities of her own. Tune in for a wisdom drop on how to rebrand the role of caregivers, reinvigorate the home care workforce, provide ethnically adapted care and get the home truly ready for home care.

Transcript

Van Ton-Quinlivan: Welcome to WorkforceRx with Futuro Health, where future-focused leaders in education, workforce development and healthcare explore new innovations and approaches. I’m your host, Van Ton-Quinlivan, CEO of Futuro Health.

 

Former First Lady Rosalynn Carter is noted for saying that there are only four kinds of people in the world: those who have been caregivers; those who are currently caregivers; those who will be caregivers; and those who will need caregivers. Our guest today, Paurvi Bhatt, can attest to that having been a caregiver herself since she was twenty-eight, supporting a father who had dementia and a mother who had complex lung disease and multiple cancers.

 

Despite her family responsibilities, she built an impressive career as a global health leader, holding high-level positions at Levi Strauss, Medtronic and the U.S. Agency for International Development, among many other organizations. She’s currently a member of the 2022 National Fellowship for Caring Across Generations which focuses on cultivating the advocacy and communication skills of family caregivers. By the way, I chose that Rosalynn Carter quote intentionally because Paurvi is the secretary of the board of directors of the Rosalynn Carter Institute for Caregivers. Thanks so much for joining us today, Paurvi.

 

Paurvi Bhatt: Thank you, Van.

 

Van: Paurvi, you have become a national voice advocating for policies to support caregivers based on your own experience. Let’s start by learning more about that. You said that being an only child, daughter and caregiver of immigrant parents gave you a unique front row seat to appreciating what really happens when care comes home. Tell us more about that.

 

Paurvi: Sure. To start the story, it’s important to understand my immigration history. I’m a second-generation immigrant of Indian parents. My parents came to the United States in the early 1960s, so pre-civil rights. They are also partition generation Indians who went through independence in India as well. I was raised within this family that was coming and breaking barriers at home and choosing to come to the United States mainly to make sure that there was a better opportunity, not only for me as their daughter, but also for generations of the family back at home in India. My father came by boat. It took him quite a bit of time to get here. My mother followed him two years later. I came one year after that, and so the story began.

 

As you rightly said, quite a bit of caretaking responsibilities came my way over the years. My mom actually had her first cancer when I was quite young, which is why I’m an only child. I’m the only girl child, so all of those things are ingredients that are important in recognizing what happened in our family and how we end up adjusting and adapting to care.

 

I grew up culturally understanding and believing it was my responsibility and my privilege to take care of my parents, and as such, I was adjusting throughout my education and my career opportunities to make sure that I could do that. My father’s dementia surprised us all. It came at such an early age for him, at fifty-eight. I’m fifty-six today, so I feel that now very acutely, and I can only imagine what he was thinking at that time.

 

Today, we hear the story of so many young people who are feeling the pressure of having to consider caring for their own parents while they’re in their twenties, and we see many more of them today. I’m of the Gen X generation, so there aren’t as many of us, but I was doing it very similarly at that time, and that carried forward all the way through until this year when my mother recently passed away.

 

With nearly thirty years of caregiving on top of growing my career, what’s important for me is recognizing that I was trained in healthcare. I led and continued to lead a lot of work in the healthcare space, and lo and behold, I ended up being not only a consumer of healthcare like all of us are, but in the most fragile time of life — in the most unique and precious situation at home — I saw firsthand where things are breaking down. It is when we try and bring care home. It’s also in the times that are the most culturally sensitive. We know that culture in our family and our community really comes to life at birth, at marriage and at death. These end-of-life stages are so culturally diverse and rich, and so much of our health system hasn’t yet caught up with what we need to do to make sure that we all get what we hope to get when it is time for us to meet our end-of-life moments, and to ensure that our families have what we need.

 

Now, I’m doing what I can to bring a voice to this and to see what we can do as a community, specifically in healthcare. We’re setting up what we can in the best possible way for a diverse solution for families looking to take care of the end-of-life stages at home.

 

Van: Paurvi, I was wondering if you could give us some insights for any of our audience members thrown into this situation where you may not have too much lead time. Is there a cycle of emotions that you experience and set of steps that people go through?

 

Paurvi: Yeah.  In my experience and what I’m learning from others going through this — not only in caregiving but also in grief and loss — it’s a continuum. It is two sides of the same coin, frankly. It happens without planning. I remember when it happened for me, like I said, in my late twenties. It was at a stage of life when everyone else was planning a different part of their life. They’re thinking about family, but in a different way…how to grow their family, considering partnership and children while also growing their careers. Never once would I have expected that my time to take care of my parents would come as soon as it did during that same phase when other questions were in front of me. It did back then, and it certainly has sharpened that question now.

 

But at that point, I remember feeling the shock…never questioning that I needed to do something, but also realizing I was ill-prepared. I keep peppering in the immigrant experience because I felt that I was ill-prepared in a couple of directions. First, I didn’t see my grandparents grow older in front of me. My grandparents were in India. I experienced them in routine visits and spending time, but not every day. For my parents as well, they experienced supporting their family mainly through letters and phone calls, not as much in a day-to-day experience.

 

When aging and crisis in healthcare showed up here in the United States, we as first and second-generation immigrants haven’t had the opportunity to even experience that phase of life. It can be very challenging. We can certainly feel a bit of a crisis like, “What do I even do?” That was a challenge and remained a challenge all the way through because that was just the beginning of the journey for us.

 

The other piece of it was just planning. I remember thinking at that time in my twenties and talking about it with my friends like, “Wow!” Think of all of the time we spent thinking ahead and planning from the time we were early teenagers, sometimes even before that, all the way through to college really figuring out and having this illusion of control. This belief of, “You will have a hand in determining when you will define your family and define what you want to do with your family. You will determine your future.”

 

Never once in that preparation process for young people do we ever begin to explore that there may be someone older that will need your help and you won’t dictate the terms of that. That will just happen, and you will need to be just as ready. I’m a big proponent of that kind of planning and bringing more proactive questions into the process.

 

I noticed the other day, even in my financial planning and doing it for or with my parents, that it was clear that there’s a whole algorithm of questions asked. It’s all about “When do you want to retire? Do you feel you have what you need? Do you have what you need for your children’s education?” But never once does anyone explicitly ask, “Do you believe you’ll have someone in your care that isn’t a child today? Do you believe that they have enough resources for it? Do you believe you’ll need to have resources for it?” All of the things that we use to plan for our future, from 401Ks, retirement, Medicare, Medicare Advantage, and Medicaid in some cases. Never once do we really come into a conversation about the other ring of care that goes beyond children, but into the elders that we are here to support.

 

If you’re an immigrant family, it’s even more valuable because if it’s not prompted, especially in the system that we live in today, you won’t realize what you may need. No one’s bringing that to you as elders get older and have experienced it for themselves yet.

 

Van: This element of planning and emotional processing leads me to think about the process of growing a family from adding children, whether through adoption — where there’s a one or two-year process that you go through — or otherwise. There are so many books on what to expect when you’re having a child, but I’m not sure how much is out there when it comes to taking care of your parents or someone older.

 

Paurvi: Yeah. There’s a lot of conversation now around, “Do we even realize that we’re taking care of people? Do we identify as being a caregiver of some sort?” I love Mrs. Carter’s quote, and look at how long ago she even coined that phrase, right? We’re now on the brink of realizing that we’re in this tsunami that’s been growing for quite some time. All of us are taking care of someone, and if we’re not, we certainly will be on the other end of it, receiving care from someone. How you think that through proactively is tough.

 

I know for my own side, it’s hard to think about things that might be sad. The loss of a parent or anything that makes them less than how you know them today can be difficult to think ahead for. I imagine people shy away from it. I think we have a culture that does shy away from the difficulties of loss and grief and the strain of care. We have a great opportunity now to almost rebrand it as a way of how cultures come together to support each other and to find joy in the coming together versus the fear of stepping on something you shouldn’t have because of the emotions.

 

It is isolating. There’s no way around the process of care, the feeling of, “Oh my gosh, I need to do something.” It is stressful because, of course, we all want to do the very best we can for those that we love. When that hits, it’s an illogical emotion, right? It comes at you fast and it’s hard to process. At times, we’re like, “How can I provide the best, here?” when you also know that you’re at an age when you need to deliver the best you can for yourself and for other members of your family. That can be difficult to navigate, especially if you don’t have counseling, coaching or anyone to lean on to help you see a way through.

 

Van: Let’s talk about your supposition to rebrand this whole role of caring. The responsibilities for care had been largely off the radar for most employers, or at least kept to a minimum, until the pandemic and then millions of women had to exit the workforce. How shall we be supporting working daughters so that they can grow their careers while giving care?

 

Paurvi: I think opening the conversation, first. One of the tactics I started to use — since my father’s dementia happened so early — is I’d come to job interviews with my cell phone on the desk. I used that as an opportunity to openly convey that I was a working daughter, as much as we are more comfortable with working moms and working dads. I openly would say that you may have your phone out because of a soccer injury or something that might happen at school. I have mine now because my father might wander. Either way, we may need to drop everything and take care of what we need to take care of.

 

I purposely did that because I knew that my situation was unique or that there weren’t as many people talking about it. I didn’t see it, at least. I felt a little bit of an edge. I was feeling like, “Well, there seems to be something here for working moms, but not as much for working daughters. Don’t we all have someone to take care of?”

 

The rebranding really does feel like it’s around how we really show up as our full selves at work. That’s a throwaway quote nowadays — how to show up as our full selves. To sum it up, it’s just to be our full selves, to start talking about what’s happening and finding vulnerability and comfort in each other in how we build community at work and at home.

 

To me, the first step of rebranding is to be clear about what’s happening. You can’t rebrand something without being clear about what exists today, starting to pull in what we’re all trying to see both at work and in our communities, which is a sense of belonging and a sense of inclusion. Both of those sensibilities require vulnerability and acceptance, and the notion of a partial self doesn’t allow us to really appreciate each other.

 

What I’ve learned over the years in having what I felt was no choice in having to be open, is that it opened the conversation for others. As soon as that happened, my stress got better and I would have never guessed it. I remember when I was at one of my past employers, a whole hallway of us were at a certain age. We were representing a certain demographic and a certain level in the company as well. But there was one week where you could see each of us running to get out of the office to go take care of something that needed to be taken care of at home. It was palpable that there is a lot going on. This was pre-pandemic.

 

We are now a generation of people taking care of our extended families needing to find not just flexibility — although flexibility is often now called the new inclusion, and the best way to include is to offer that flexibility — but grace and a sense of comfort. It became clear that my work colleagues were the ones I could lean on the most because it was a bit separate from family. They could listen and hear things differently and offer me different ideas, but that can only happen in inclusive environments.

 

Van: Are there best practices that employers should adopt — not specific to any one supervisor — in terms of being able to set up an inclusive environment? How should a company think more holistically about care?

 

Paurvi: I think a lot of them are starting, or well past starting that now because of a couple of things that we’re seeing which are best practices. Leaders at all levels are starting to be much more vocal and vulnerable in sharing what’s happening with them. There isn’t a feeling that the only way to succeed is by hiding that these parts of your life exist. I’ve seen in every one of the instances I’ve been in that in leaders from the c-suite all the way through, you would see those pockets of vulnerability come through. That brings a bit of relief, right? You see that people are starting to get more comfortable being their full selves, and that kind of modeling becomes very important.

 

We’re also seeing more boutique Employee Assistance Programs that are coming forward that allow for a new suite of benefits. I happen to be an advisor for a couple of them. One is called Wealthy. There are many groups like Wealthy, but to give you a sense of what they all provide, they take the administrative friction out of what it takes to take care of someone. We all have been there. We’ve been on a conference call, a Zoom call, or even a meeting and the doctor calls because of what may be happening with a child or an elder. You know for a fact that if you don’t pick up the phone when that doctor calls or that nurse calls, the details that you need won’t be in the voicemail and you won’t be able to return that call quickly because of what happens in trying to find people. You’ll be two days behind because you missed that one call. The stakes are too high to be two days behind.

 

Groups like Wealthy and others are able to take that call and to be your arms and legs when you’re busy doing other things. It saved me. It allowed me to stay at work a few extra years. There comes a time, I think, for everyone when things are getting more progressive and you need to spend 100% of your time taking care of someone, and I was blessed to be able to do that with my mom. That time may have come sooner if I didn’t have a benefits suite that allowed some flexibility for me to stay focused at work while also knowing that some of the administrative things that I’m not necessary for were being handled.

 

I actually believe it allowed me a bit more comfort, but also a better quality of life for my mom and I because the stress at home was not as intense as it could have been. As an aside, I lived with my mom and my mom lived with me for thirteen years. She was my longest roommate, so a lot of what we were going through was happening right at home. She saw the stress I was under, and that wasn’t helping her either. No mom wants to see that for her kids. These kinds of new and different benefits are important.

 

Another one is called Empathy. Empathy picks up where Wealthy leaves off, basically, with bereavement and loss care and the administrative burden and friction of what happens when someone you love passes away. It’s a part of life we don’t talk about much. If anyone’s gone through it you know that silently, you and maybe three family members are stuck trying to figure out some really dense administrative steps in wrapping up someone’s life right when you’re feeling the intensity of grief. It’s the worst possible collision of factors that comes together.

 

Groups like Empathy and others now offer a benefit that employers can tap into to help smooth that out and they take on some of that hassle and work while also providing virtual counseling if you need it as you go. A beautiful set of things are coming up for employers to take a look at. I’ve named two that are specific companies, and I advise for both, but there are many others and they’re all here to help us. It’s a reimagining of what benefits can look like, and to reimagine planning.

 

I’ll end in saying I think in the next round, what would be very helpful is on the financial planning side. About this time of year — when everyone’s thinking about open enrollment for their health plan, is their 401K set up the way they want it to be, or if you’re sitting with your financial planners, taxes are starting to come together — it’s about the right time to think about all of these issues too. It might take the sting out of feeling like you’re being hit with a lot of problems in an unpredicted way if we would have some tools and opportunities to talk about planning now.

 

Van: Well, these are great tips that you’ve provided to our listeners. Paurvi, you come from a healthcare background professionally, in addition to the personal work that you have to do. What do we need to do in healthcare to support greater care in the home that is ethnically diverse and inclusive? I harken back to your immigrant experience.

 

Paurvi: Thanks for the question. There are so many people looking at this question now. You hear so much about “hospital at home,” bringing technology into the household. I’m a big believer in that, too, but I will say the home isn’t ready. That’s the part that I think we’ve got a grapple with. We sure can’t bring a hospital home until the home is ready.

 

What does that mean? We need more in the bricks and mortar of what’s necessary at home so that we can take care of people at home. Not everyone has main-level living in their household, for example. Not everybody has all the things that you need to really be able to take care of people at home, and so you’re seeing some new and interesting ideas come up with how to ensure the technology can enter the household. And, there are new technologies that that can make it easier for health providers to be able to more efficiently influence the level of care that’s happening at home.

 

But I will say — and it’s not something that’s spoken of as openly as I wish it would be — at the end of the day, you still need people at home. There’s such a chase right now in the care economy after billions of dollars that’s been sized. People are chasing it with interesting new companies like the couple that I’ve mentioned before and others. But at the end of the day, it’s the talent that’s needed at home that provides a certain level of compassionate and quality care.

 

That hands-on care is necessary. It’s what we want, and we often do it as family members, and we want to, but we know that we need support. It’s the shadow part of healthcare that we really haven’t invested in to the extent we need. We speak of it as the problem, right? We all know that we have a healthcare worker shortage right now, that people are burning out from the tops of qualified healthcare all the way through to the front line that is all the way to our household. Folks are burnt out, so are family caregivers. The reason why is because we haven’t set the system up so that we can all succeed. The brokenness of the of the referral chain that brings people home, the suite of things you need once you get home, which is beyond medical care…do we have the right kind of social care around us? Do we have food that’s necessary to ensure someone is able to stay healthy? Do we have transportation that’s needed?

 

People in the healthcare industry are big on jargon, right? You’ll hear all about social determinants of health pretty much everywhere, and it’s fantastic. We need that conversation. I’m a public health person, so I’m the first to say, “Thank goodness, we’re talking about it.” But at the end of the day, those social determinants require action, and they’re not just social determinants for the poor. We all have social determinants. If I can’t get into a car and get to my doctor’s appointment, I’m out of luck, as was my mom and as was my dad. The system around us at home hasn’t been strong. That’s why I say home isn’t ready, and home hasn’t been invested in to be ready. We’ve got great companies out there, from Best Buy to some spin-offs from Home Depot, Lowe’s, and other bricks and mortar type of companies trying to look at the question of how do we get home ready because the infrastructure we have today for health and aging is creaking under the pressure of what’s coming.

 

The piece that I’ll add that’s around ethnicity is very, very real. In our case, for example, I’m of Indian descent, as I mentioned before. My parents, especially mom, is vegetarian. We’re a Hindu family. We participated in every part of Medicare that I could figure out and leverage. Here I was working in healthcare, so I was trying to leverage everything I knew, and it still left me with gaping holes as to my understanding. Here we are as healthcare leaders, and yet as healthcare consumers, we are just as confused as everyone else. As an aside, there’s a responsibility that those of us in healthcare have, which is to take that confusion back into our work and fix it.

 

My step in trying to fix it involves one of the benefits that my mom had under a Medicare Advantage plan that provided ten meals upon discharge from hospitalization. This is a common benefit that tends to be bundled into a Medicare Advantage plan.  The first year that we used it was in that moment of chaos. Mom was immediately hospitalized. I was trying to figure things out, while still working. I came home and was like, “Great, ten meals. Let me see what we can get.” As I explored what my mom can have, it seemed that all that was on the menu that would work for her was oatmeal. In the panic of trying to make sure I could get the best that I could get, I ended up with ten days — two meals each — of oatmeal. Of course, we couldn’t eat that much oatmeal, but I wasn’t willing to leave it on the table, right? I needed to make sure I got that benefit.

 

The second year when I was met with this, there were a few other vegetarian options. Now, I had a little more savvy maybe because I was getting my advocacy under control. I did speak to the vendor, as well as the insurance provider, to say, “You realize that if I were to fly United, Delta or pick any global airline, I can get a Hindu meal. That means someone’s producing this at scale, freezing it and delivering it which means someone paid attention to do that. So, there is no reason why a vendor that’s providing meals for us couldn’t do that for a Jewish family that may want kosher, a Hindu family that may need something specific, a Muslim family that may need something specific. It’s just that we haven’t had the willingness to figure that out yet. The first one that does is going to win market share, so put the business hat back on for healthcare. If you wanted to think that through, you could probably market that and you’d have a pretty easy time in getting a different segment of the population to sign up for your plan. You just haven’t thought it through yet.” This is where one very simple example of ethnicity comes to life.

 

Another comes to life on the hospice side, and even in the care and comfort services that happen inside of a hospital. Oftentimes, a chaplain may come visit someone at the hospital bedside, or as part of hospice services if you’re at that stage of end of life. While they are trained in multiple faiths, many times they are not as well versed in what happens in those faiths, nor do they bring people from that faith with them.

 

I know my mom was much stronger with her advocacy because she had to be with my dad, so when it was her turn, she would sit with the chaplain in the hospital. She had no problem with that. She was an open believer for all different faiths and was very spiritual that way. But she schooled him pretty quickly to say, “You realize you have that with me, but there might be an Indian woman two doors down that wouldn’t even listen to what you have to say. You know that there were X number of Hindu temples in this town. Why not partner with them and bring them with you so that you’re able to bring that service?”

 

That’s the same with hospice. When I was shopping around looking for which providers should be the one to serve my mother, I said, “It won’t be like we’re at an Indian restaurant and I’m helping you with the menu at that time. It’s actually the other way around. I will be under strain, so I’m going to need you to know more than I do to help me through. Are you ready for that?” Most of them were not. That’s another example.

 

We all know you can only go to scale if you hook into a system that’s already reaching scale. Our system in this country, which is lovely, is set up for a majority, which is important. Some adaptations to that system would help the rest of us be a part of it. For the lack of that, the rest of us are setting up parallel systems which does not work. And we know that we’re not going to get there if we keep going this way. It’s not meeting the moment that we’re in, which takes us back to inclusion and belongingness again, and that needs a systemic response.

 

Van: Paurvi, you inspire me with your stories of advocacy and examples of where it’s not working. You do a lot of advocacy around broader access to paid family leave as a partial solution to this problem. Tell us more about what’s going on there.

 

Paurvi: Yeah. We’ve had some amazing headway on paid leave and paid family leave so that it’s not just bifurcated for children — and for maternity and paternity leave — but total family leave. We’ve been lucky with some strides in at least normalizing the conversation. Certainly, the politics on it has moved a bit. But I think what’s happening is while we make some strides, oftentimes — when the sausage-making of public policy hits — this larger conversation on paid family leave falls to the wayside, and frankly, comes back to employers and what they are willing to do.

 

I think everyone is realizing now, with so much analysis behind this, that no one sector alone can handle it. We’re going to need all of us to be inside of this solution because there’s only an increased need of care, not a decrease need of care, and therefore an increased need for time to care. How can we all reach this conclusion together as private and public sector employers? How do we approach this?

 

You’re seeing some creative use of benefits that are happening…some creative ways of considering paid leave time so that it’s not just about maternity and paternity leave, but it is inclusive of all family leave, inclusive of a broader and more flexible use of time even for bereavement. As you know, every cultural tradition has a different pathway of how to honor a bereavement, and many bereavement plans are a couple of days. That doesn’t really meet the need, whether it’s a cultural path or your own grieving path, and what you may need to just re-enter life.

 

Having broader definitions around family leave has been taken up by some employers, which is fantastic, but there is a need now for a larger national conversation and public policy that actually moves to protected leave. We have a lot with the FMLA, but as everyone knows, FMLA is not paid leave. It’s protection, but it isn’t paid. The sooner we’re able to ensure that more and more people have that protection and are able to have employment and be paid during that time off that they need, the better we’ll be. Many countries around the world offer that, and you’re seeing better qualities of life for a lot of those citizens. There’s a lot of interest now to move in that direction.

 

Van: Thank you for your work on that front. You’ve shared a lot of thoughts on how we should approach care, loss and grief, and the responsibilities of care for the family beyond children. I’m wondering if you could just comment on the workforce that is needed. If you’re thinking about a systems approach, what needs to be done on the workforce side?

 

Paurvi: I’m so glad you asked that question. Again, with the hunger to bring care home, the workforce that is closest to home hasn’t been invested in to the extent that it needs to be. It hasn’t been elevated to be professionalized and grown in the way that it needs to be. Beyond the banging of pans and the things that we did in the early phases of the pandemic, that energy to really elevate the segment that truly takes care of us at the bedside in a facility and at home, really hasn’t grown, and there’s so many reasons why.

 

Hourly pay for many of the people that come into our homes and do basically the most vulnerable work with a level of compassion that is just remarkable is often less than minimum wage.  You have to really come with full heart to take on roles that many of these folks do, and  yet you can make more at a Starbucks than doing this. They often have to make hard decisions for their own livelihood. Many folks that are working at home to help take care of us have their own families that they’re trying to take care of, and they don’t have a system that allows for that.

 

What I think is happening in a lot of parts of the world is that there’s a stronger system of community-based care, community health workers, and a pathway that allows for the community to select people that they trust into the home, formalized training for them, employment of them, and even a talent pathway for them to grow in their own careers. While you might be able to come in as a community health worker or a home health aide, there’s a clean path that allows you to get into, for example, subsidized nursing school or medical school or any other parts of the formalized health system and its care if you wish.

 

We haven’t viewed all of care under one system that allows for a talent pathway to a dignified career that is celebrated so that you can, with honor, say that this is the kind of work that you do. Instead, sadly, we view it as labor. We view it as labor that is challenging to manage with high turnover. As such, we use the tools of that sometimes to solve for the problem. At the end of the day, if you talk to anyone that’s a family member at home, they will be the first to say that when someone that cares so deeply and someone who’s trained so well to take care of your family member needs to move on, it is the hardest thing to recover from. It’s not just the shock of all of a sudden knowing you have to take care of someone at home, it’s the constant shock of having to figure it out when someone who’s here to help you is now not there because of whatever the system has done and their need to move on.

 

For me, it’s a trained pipeline of care that’s necessary. It’s a reimagining of how to turn this into a true career path, even considering how to reach young people in high school to imagine what they could do here, and rebrand it. I keep using rebranding. Maybe it’s my Levi’s days that keeps bringing this up, but I think it’s an opportunity to show the next generation that this can be a really vibrant and important way to spend your life.

 

We know that majority of people who do provide care closer to home happen to be women of color, so we’ve got this larger dynamic that’s going on where we’re trying to ensure greater levels of equity of service, employment and of fair wage. None of those things can happen, I believe, unless we reinvigorate what we can do with care at home as a true career path.

 

Van: Well, Paurvi, we’ve learned so much from you. I know that our audience members will agree. As we wrap up, I wanted to give you the opportunity to share any thoughts, any insights, any call to action regarding the future of care.

 

Paurvi: Oh, that’s a great question. Thank you, Van, for everything you and your organization does. You’re hitting on the points where we’re starting to see so much progress, and you’re a part of that progress, so I just really want to thank you for what you provide and what your partners provide.

 

I think we just need accelerated growth, creative financing for that growth, and really looking at more than just what’s the problem definition to starting to see outcomes that matter. And people have them. There are brave leaders that are starting to step up and speak more and more about these issues.

 

I think the call to action is threefold. First, tell your own story proudly and bravely. Back to Mrs. Carter’s quote…each one of us has some part of the care story happening live, so no matter where you are in your organization or even at home and within your family — we’re getting ready for a season of gratitude as we close the year — take the time to talk about it and what it means. That’s the first call to action: lead bravely first with yourself and your own story.

 

The second is directed at the caregivers that happen to also work in healthcare. Try hard to bridge the gap of what’s happening personally to what’s happening professionally. We all are seeing the confusion as a patient, as a caregiver, in facility and out, of what it takes to get things done. Somehow, it’s hard to bring what happens in the living room and the dining room into the boardroom. I don’t think we can do that anymore. There’s a moral imperative, if you’re in healthcare yourself, to take that experience and start to problem-solve with that in mind. That would be the second one.

 

The third is creative financing. There’s a lot that makes it difficult because of the way healthcare is organized in our country to really innovate and get to scale. Creative financing — whether it’s venture capital, public social bonds, an impact investor together with philanthropic investment — what can it take so that we can accelerate growth? Otherwise, we will have a patchwork of a lot of really interesting small businesses that are starting, none of which will be ready for scale. That one employer can only do so many boutique Employee Assistance Plans. That alone will not take it to scale, so we’re going to need something that catalyzes growth.

 

Van: Thank you so much, Paurvi, for spending this hour with us.

 

Paurvi: Thank you, Van. Again, thank you for everything you and your team does. I think the future is going to be shaped by people that are involved with the work that you do, so thank you.

 

Van: Likewise. I’m Van Ton-Quinlivan with Futuro Health. Thanks for checking out this episode of WorkforceRx. I hope you will join us again as we continue to explore how to create a future-focused workforce in America.