Elder Care Workers in the United States Are Fighting for Justice

The aging of the largest generation in the United States, the Baby Boomers, is creating a desperate shortage for care workers for elders. By 2024, upstate New York will need 451,000 home health workers in 2024; currently the state employs 326,000. Already, the shortage is problematic for New York. For example, Rebecca Leahy of North Country Home Services reports that, every week, it is unable to provide a staggering 400 hours of homecare services which have been authorized by the state. Leahy explains, “My fear is that in the near future most patients in the three Adirondacks counties of Franklin, Essex, and Clinton could be without services because the sole provider for most of this region will not be able to cover payroll.” That would leave thousands of elders without the physical and emotional urgent care that they need.

The current trend, pushing us into a critical shortage of homecare workers, has been caused by the lack of well-paying jobs in the elder health-care industry. That lack creates a pool of continually underemployed workers. Upstate New York, and most of the country, consistently employs workers at wages and conditions that keep them in poverty, causing a high turnover rate of workers in a health industry that needs stability. Currently, the number of people in the United States over the age of 65 is expected to double. With the urgent and pervasive need for personal-care aids and home healthcare workers, employers and the state should provide jobs that give aids decent wages and benefits, including paid time off and health insurance.

Those benefits have not been procured by employees. Ai-jen Poo, Executive Director of the National Domestic Workers Alliance, has highlighted the extreme precariousness and vulnerability in elder care workers. With an industry where 90% of workers are women, the majority women of color and 30-40% immigrants, the conditions are impossible, ‘The average income for home care-workers is $17,000 a year. The median income for an elder care-worker…is $13,000.” Additionally, according to Poo, because they are characterized as domestic workers, elder care workers don’t qualify for work protections such as “limits on hours and overtime pay, days off, health benefits and paid leave.” Workers are completely dedicated to the patient who needs care, but are unable to receive the benefits and pay they deserve, many taking care of our families and loved ones.

Nearly 75% of nursing home care and home health care is paid for through Medicaid and Medicare, where the reimbursement rate has stagnated for several years. With the Trump administration’s attempts to roll back expansions granted under the Affordable Care Act, those reimbursements are unlikely to increase any time soon.

The National Domestic Workers Alliance is one of the leading organizations in the United States working for the inclusion of domestic workers, which include elder care employees, into the Fair Labor Standards Act which guarantees workers a federal minimum wage, overtime, sick, and vacation pay.

Caring Across Generations is a coalition of more than 100 local, state, and national organizations, working towards a policy agenda which includes, “access to quality care, affordable home care for families and individuals, and better care jobs.” The organization lists four major proposals to help address the underemployment of homecare workers and the growing need for elder care services:

  1. Increase the national minimum wage floor for domestic workers to $15.00 per hour.
  2. Improve workforce training and career mobility to ensure quality.
  3. Develop a path to citizenships for undocumented caregivers.
  4. Create a national initiative to incentivize and recruit family caregivers into the paid workforce, since nearly 85% of long term care is provided by family members.

According to Ai-jen Poo, domestic workers, including elder care workers, “need fair wages, decent working conditions and access to reproductive health care, including abortions”. It seems a simple request, considering these workers provide physical, mental and emotional care for our elderly family members while sacrificing their time with their own families. Given the emerging crisis, the time to help these workers is now!

 

(Photo Credit: Caring Across Generations)

Seven billion. Who cares?

According to the United Nations, the world population reached 7 billion today. Ok, maybe it’s really tomorrow or the next day, maybe it was yesterday. The exact date is somewhat beside the point. The point is 7 billion. Maybe the child is a girl-child named Danica May Camacho, born today in the Philippines. Maybe the child is a girl-child named Nargis Kumar, born in India. The exact child is also somewhat beside the point, although the choice of gender for symbols is telling.

Seven billion is a big number, difficult to visualize. Of course, two centuries ago, when the population was a `mere’ 1 billion, that also was a big number, difficult to visualize. In 1930, when the population reached 2 billion, in 1960 when it reached 3 billion, in 1975 when it reached 4 billion, in 1987 when it reached 5 billion, in 1999 when it reached 6 billion, each time the number was a big number, difficult to visualize. That means in less than 40 years, the world population had doubled. Clearly, `we’ are not very good at numbers.

Some will tell you this is largely a story of India and China. Others will note that, of the continents, Africa has the fastest population growth. Of course, the whole of Africa has fewer people than either China or India, but it’s growing. Others will talk about inequality and resources. Geographic inequalities between people born, raised, living in different parts of the world. Inequalities between and among generations, between and among genders as well.

These are important issues to discuss. So is this. Who cares and who will care for the billions? Already, we know that the world population is growing older … quickly. Every state in the United States, has prepared a program to “Ride the Age Wave,” mostly by coining groaningly clever phrases and quandaries, such as “The Age Wave:  Silver Tsunami or Golden Wave of Opportunity?

Who will care for the growing global population of elders, the growing scattered populations of children, the growing population? Care workers. Child care providers. Elder care providers. Nannies. Maids. Housekeepers. Family members, more often than not unpaid. Women. Women of color. Women from “somewhere else.” And girls. Women and girls. Women and girls who are too often described as silent. Women and girls who are too often described as invisible. They aren’t silent, and they aren’t invisible. We’re simply not listening or seeing.

Care work is systematically dropped out of development programs and public policy debates. Care workers are systematically excluded from any consideration or consultation concerning … care. The ILO Convention Concerning Decent Work for Domestic Workers is a step towards correcting that situation. So are campaigns like the Caring Across Generations Campaign, launched by the National Domestic Workers Alliance and their allies, in the United States.

Another step would be global conversation. Try it. The next time someone says or writes, “The world population is …”, answer with a question. “Who cares?” And then, together, answer the question.

 

(Infographic Credit: NPR / UN Population Division)