In the debate over modernizing the health-care system, the realm of home-based health-care services seems mired in the last century. Long dismissed as unskilled “senior sitters,” home care aides have only recently been officially included under minimum wage and overtime protections. Yet even as they’re just catching up to last century’s labor laws, home care is quickly adapting to 21st-century medical standards—creating the double challenge of shaping dignified careers out of a traditionally thankless job.
Since home-based health-care services is one of the fastest growing sectors, home care jobs are being redefined largely by market trends. But a program developed through the SEIU home care union in Washington sees the sector’s expansion as a platform to systematically transform one of the lowest-paid jobs into a career of the future.
The SEIU Healthcare Northwest Training Partnership’s apprenticeship program, an initiative administered through a nonprofit founded by the union in partnership with employers and the state, takes a two-pronged approach: first, equipping aides to “keep people healthy and out of emergency rooms and hospital beds” by delivering preventive senior and disability care; second, to help union members “reap a fair share of the financial benefits that accrue to the system,” primarily by avoiding more expensive emergency and hospital care. The broader goal is boosting job quality for the workforce, comprised of mostly working-poor women, by reducing extremely high turnover rates (currently exceeding 60 percent annually) and building equitable career pathways for future workers.
The apprenticeship program, which just graduated its third class, with plans to expand to 3,000 trainees eventually, focuses on core medical skills along with social aspects of the job, like dealing with trauma and mental-health issues, as well as self-care to help workers manage the extreme stresses of the work.
Clara Aiken, a recent apprenticeship graduate, says the program has helped her develop a way to “speak” with a client who has been nonverbal since suffering a stroke. To understand her needs, she says, “it was very important for me to watch her body language, her hand signals, as well as her facial expressions…. For instance, when I come in, I always talk to her, although she cannot talk to me…. It made her feel like although she couldn’t speak, she was able to communicate with me with body language, and let me know some of the things that she wanted.”