The Boston Globe highlights a real problem facing senior citizens who need support in order to age in place. But the proposed fix—expanding state licensing for home care agencies—risks treating every senior as if they required high levels of medical care. Many do not. Many simply need help with daily tasks and, just as importantly, steady companionship. No amount of regulation can create meaningful human connection.
In other words, a broad new licensing system overlooks a basic reality. This is not a one-size-fits-all population. Under the bill’s definition, “home care services” covers everything from light housekeeping and meal help to dementia-related support, yet the state would apply one uniform regulatory framework to all of it. Older adults who are aging in place often do not need intensive medical care, but they do need support that is affordable and reliable. Adding more state requirements may create the appearance of safety, but will ultimately make in-home support, for many, even more expensive and harder to find.
There is a better path. An Au Pair-style model, similar to the long-standing State Department program in which sponsor organizations provide extensive screening and security safeguards for both hosts and au pairs, would offer flexibility, affordability, and protection. And unlike a rigid licensing system, it would strengthen the relationships older adults rely on.
Massachusetts should address problems in the system, but should not regulate this space into fewer options. Real leadership means expanding support that reflects how people actually age and restoring the companionship that allows them to remain at home with comfort and dignity, which is what most seniors want more than anything.