A new campaign calling itself Caring Across Generations has in mind nothing less than a 180-degree turn in the way that Americans think about themselves, one another, the economy and workers. This group aims to create 2 million quality jobs in the process and put us all on track for a happy, healthy old age too. But first we need to talk, out loud, about care.
A meeting in New York in February kicked off with stories. “Share a personal care story,” coaxed Ai-jen Poo, co-director of Caring Across Generations (CAG) and director of the National Domestic Workers Alliance.
From around the table, the stories came. The story of the grandpa whose homecare worker came to his hospital to brush his hair after he suffered a stroke. The nanny who took the kids to school so Mom could practice law. The lover with disabilities who needs full-time care: “It takes a village, but right now I’m the village,” says the partner, Alejandra, who also uses a wheelchair. Domestic worker Barbara, born overseas, was nervous: “I’ve been a caregiver all my life, and now I’m turning 65. Who’s going to be there to take care of me?”
Funny how storytelling works. Within minutes I’m thinking of the live-in assistants who helped my father, Michael Flanders, perform on Broadway. A star, but also a polio survivor, Dad rolled onto the stage in his wheelchair every evening thanks in part to the help of an assistant in the morning. My grandmother Hope was said to be “independent” because she lived past 100 in her own apartment teaching writing to the end, but her students’ classes and her sense of self got a whole lot of help from Geen Crooks, her live-in aide.
Ask anyone. We all have our “care stories.” What we don’t tend to have is a plan for what we’ll do when someone we love needs care, or when we ourselves turn out not to be invincible. We don’t have a plan, and neither does our government, and yet a crisis looms. The immigrant population grows as the baby boomers age. As of 2010, every eight seconds another American turned 65. The “age wave” is upon us—except it’s not a wave; it’s a tsunami. Just as more families are economically stretched, the number of Americans in long-term care is projected to mushroom, from 13 million in 2000 to 27 million in 2050. More of us want to stay in our homes, where care also happens to be cheaper. (The National Association for Home Care & Hospice reports that one day in a nursing home is four times as expensive as twelve hours of homecare.) But the current homecare workforce—at approximately 2 million workers—is nowhere near large enough to meet the need.
High-quality long-term caregivers are already in short supply, and it’s no big mystery why. Homecare is a female-dominated world, open to young and first-time workers and immigrants. It’s also unprotected, uncovered by basic wage and overtime laws that apply in nursing homes. At the time the Fair Labor Standards Act (FLSA) was passed in 1938, caregivers were thought of as relatives or friends—or as a way to get the unemployed off welfare. Which leads us to now: in 2010 the national median wage for homecare workers stood at $9.40 per hour. According to a 2011 survey by the Paraprofessional Healthcare Institute (PHI), the mean annual income for these workers in 2009 was $15,611. More than half of all personal care aides live in households that depend on one or more public benefits. Although homecare has become an $84 billion, largely for-profit industry, the typical care provider can still be hired and fired at will.