Those who care for our elders continue to be stuck at the bottom as far as wages and respect [PDF], despite rapidly growing need for their services. No matter the setting in which they work—nursing homes, assisted living, individual homes—direct care workers are low-paid, often without health insurance and confronted with back-breaking labor and challenging clients with complex medical needs. And, no surprise, nearly 9 out of 10 direct-care workers are women, 28 percent are African-American and 23 percent are immigrants [PDF].
These caregivers provide the most intimate care imaginable to frail and vulnerable people. We depend on them to give competent, compassionate attention to our grandparents—and to us as we age. Their clients’ lives are literally in their hands. “What we do is important,” says Tracy Dudzinski, a direct-care worker in Wisconsin since 1996. “One of the most rewarding experiences you can have is to go in and help make a difference in a person’s day.”
According to the Bureau of Labor Statistics Occupational Outlook Handbook, the elder care field is among the fastest-growing in the nation, with 50 percent growth from 2008 to 2018 predicted for home-care workers. But we’re doing little to attract people to these critical jobs. We reward women like Tracy with wages of less than $10 an hour. And Tracy, whose husband is on disability, is the sole breadwinner for her family of four children. Like another heavily-female occupation–child care–our nation expects caregivers to subsidize these services with their low wages.
Now, direct care workers are taking matters into their own hands and speaking out. “People misunderstand us,” says Tracy. “We’re smart people and hard workers.” Tracy has a leadership role in an emerging movement to transform the lives of direct care workers: She is a staffer at Cooperative Care, a worker-owned co-op of home-care workers based in Wautoma, Wisconsin. She also serves on the boards of both the Wisconsin Direct Care Alliance and the national Direct Care Alliance (DCA), headquartered in New York City. She has traveled to Capitol Hill and the Institute of Medicine of the National Academies to testify about the working conditions of her peers. “I used to be the mouse in the corner,” she says. “Now I’m a changed person.”
Among DCA’s most successful projects is the Voices Institute, a week-long retreat and intensive training session for direct-care workers to become advocates for their profession.
When I asked Tracy what the public can do to support these efforts, she offered, “Show direct-care workers some respect. Get involved with the DCA. Learn about the issues and contact legislators. The more noise we make, the sooner things will be fixed.”
Photo courtesy of http://www.flickr.com/photos/gregor_y/ / CC BY-SA 2.0
Thanks for covering this important issue. Direct-care workers, by 2018, will our nation’s second largest occupation. It is shameful that these workers earn so little–and it is bad for economic growth. To learn more about the importance of the direct-care workforce and what we can do to improve jobs, check out http://www.phinational.org/policy.
Bravo to Beth Baker for highlighting once again an issue of paramount importance in our society. Why is it that caregivers are so under-valued in our society? The whole situation is shameful. We’ve got to do better.
I knew direct care workers were poorly paid, but the situation is worse than I thought. Yet I know, from our experience with my in-laws, that nursing homes are very expensive. Where does the money go to? I’d be very interested in seeing a break down. Perhaps this could be the basis of another article or a congressional investigation.
I never really thought about how invaluable direct care workers are until my parents needed help. They can make all the difference for the elder and their family. Thanks for shedding light on salary issues for these critical workers.
My father died in an assisted living home, where he was cared for by angels who flattered him, talked with him, wheeled him out so he could smoke, and changed his diapers. He was humiliated by the indignity of it all, but they made it bearable. My Mom has advanced Alzheimers and is living in the same place. I pay a huge sum of her money each month for her to be there, but I put all of the proceeds from the sale of their house into accounts used just for her. As long as I can afford to pay, I will keep her there. She gets compassion, hugs, activities, and a safe environment. I, also, wonder where all of the money I pay is going, since the loving care-givers and nurses are not getting rich. I joke with them that I’m not sure who they take better care of, me or Mom. Because every time she presents me with new symptoms, I sit and cry and beg them to tell me how to deal with her. For that they deserve to be getting at least a living wage!
Thank you, Beth, for giving this phenomenon some attention. I know, from friends who have done this work for (low) pay and from doing it myself, that “back-breaking” is a literal term. Now that I am a widow with no relatives within several hundred miles, I pay a lot of money for long-term care insurance, in the hope that I can hire someone to do for me what I did for my late husband when my time comes. These angels of mercy deserve a living wage. I cannot get past the conviction that, if this were not largely women’s work, it would be valued more highly.
Thank you, Beth, for highlighting a critical problem, indeed. I’ll never understand why our society chooses to pay its most important workers not even a living wage; it’s not only unconscionable, it’s unwise. It seems to me prudent, as well as fair, to compensate such sensitive, difficult, sometimes extremely demanding work adequately, if not generously. I, for one, would not want an overly stressed, possibly resentful, individual being responsible for the happiness and well being of a loved one and low wages along with no compensatory benefits could be cause for both possibilities.
Teachers have fought long and hard and are still fighting to receive just compensation for the crucial work that they do…I hope the DCA and projects like the Voices Institute are successful in spotlighting a cause equally worth fighting for.
Home health aid who bathes 90+ old woman at my house bills $22 per hour w/2 hr min. This is through an agency which means she probably gets about half that. Another interesting fact is that our contract with agency requires us to pay a finder’s fee of $2k if we directly hire the worker. This seems like a good business decision, but bad for underpaid workers.
Elders and disabled, as well. (I’m now a “two-fer”, aging disabled feminist.) It is an issue that I can delay as long as my spouse can be my caregiver. There is a good reason for an alliance between elders/disabled and care workers, also called aides, attendants and whatever the euphemism of the day is. I am an artist = low income. Nursing homes/assisted living (and other euphemisms, and note that LTC long term care facilities use the same word, “facility” as prisons’ euphemism – “correctional facility” for prison.) have priority in funding. See http://www.adapt.org whose motto is “Free Out People” – that is, giving choice to those of us who would automatically be put into nursing homes of whether we wish to live at home with “direct care” as the article notes or in a nursing home. It is many times cheaper to live at home with “direct care”, long term, than in a nursing home.
As noted in another comment, agencies who send out care givers/direct care persons, make a profit and the hourly rate is high for those who are not affluent, but the care worker is not getting much of the hourly fee. Please see http://www.adapt.org and know that many of the activists in the group are women.
So glad this was brought up.
My mother went back to school when I was 9 or 10, and she became a home health aid. She soon after got pregnant, and my little brother came along.
In a profession that is largely female-occupied, it is an utter shame that maternity leave wasn’t even offered or discussed. she spent so much money, worked so hard, put in so many hours, helped so many people… Her reward?
She couldn’t go back to the job, she was away from it for 2 years raising my little brother (11 years younger than me) and she would have had to pay to go back to school and do it all over again. My Dad had an unpredictable job, currently has another unpredictable one, and my mother needed a steadier paycheck to pay the bills and support three kids.
The lack of help these womyn get is a crying shame.
I am SO glad to know that there is movement afoot to get these valuable workers more respect and awareness. We need to honor these workers as the noble and valuable people that they are. After a long and very toubled experience with my very aged father, I can attest that good direct caregiving makes or breaks the last years we spend on this earth.
I own a Home Care agency and am striving to change the culture and the service that boomers are going to expect and I’m starting today. In order to hire motivated, qualified individuals I can almost guarantee I am paying more than most agencies, but understand, that when I clients will only pay between 17-19/hr, which is quite a sum of money, there is little left over for the company after payroll taxes, training, insurance, and incidentals. Perhaps the CLASS ACT coupled with more people purchasing Long Term care policies will change this eventually, but the reality today is that margins are tight with what people can afford. I would love to pay my workers 13-15 hour, but for now that is impossible and still run a business. I do agree that our employees are the face of our business and our most important asset. Hopefully, the intangibles I can offer along with a higher than average salary will keep them on board. I do think offering them other types of work within the agency also helps with retention. I often go visit senior communities for movies, donuts, health fairs, etc. I think it is advantageous to everyone to include the caregivers in some of these functions. Pay above avg., keep the work interesting, and treat them right and everyone wins.
Medicare requires a “Cost Report” be done annually for each facility. The question about “where the money goes” is answered in this cost report. This report can be purchased from Medicare.
The majority of revenue in a facility, is spent on labor.
I agree that good, caring, compassionate, “CNA’s” are underpaid. If facilities could afford to pay better wages to the CNA’s we could attract a better group to this carreer choice. So, many are high school dropouts, no work ethics, have criminal records, have little or no respect for our elders etc. Many of these people could not work in a fast food restaurant, because they dont have “people skills”, but we have them caring for our most frail elderly.
Maybe the job does deserve greater pay, but it also should demand greater education. I feel sorry for anyone who has to trust their care or the care of their loved ones to someone with the same education as a short order cook.
How hard is it to get an RN (only 2 years of schooling) or an LPN (even less!)? If someone couldn't manage to pass these courses/exams, do you really want "your life in their hands"? When I was a teenager I was a "Home health aide" , I didn't know my ass from my elbow. I was compassionate and tried my best, but the fact that someone with zero education or experience could be in that position is the real tragedy, NOT that their pay is in line with their education (or lack thereof) .
I’m a CareGiver…..
With Integrity, Honesy, Compassion & Love I attend to the Health, Hygiene and Saftey of Someone’s Parents,Grandparents, even GreatGrandparents.
I Wake Them, Dress Them, Feed Them, Wash, Fold & Put Away Their Clothes, Walk with Them, Push Them in Their wheelchairs, Guide Them with their walkers, Talk with Them (even if it’s repetitive), I Laugh with Them, I Listen to Them, I take HITS from Them, I Comfort Them, I Lift Them (Physically & Emotionally), I Serve Them, I Read to & for Them, I Assist Them, Change Them, Check On Them, and I Leave Them WITH THEIR DIGNITY.
That’s ALOT, isn’t it?
Then, WHY am I being paid LESS THAN $9 an hour???!!!!????….YES, not even $9!!!!….And NO INSURANCE.
Familes are charged THOUSANDS of DOLLARS a month with ONLY 2 PSAs (at my ALC) serving 25-35 residents, many with Alzheimer’s, Dementia and other disabilities.
We DESERVE SO MUCH BETTER!!!
This article is right-on. I worked in corporate America most of my career. When I was suddenly paralyzed I needed assistance from health care aides. I could not believe the wages they receive for the amount of work they do, no vacation or sick time pay, no medical or dental plan. It’s dispicable that we in America allow these positions to be so devalued. These are the people with whom we entrust our loved ones. Maybe someday even ourselves. Do we want overworked and underpaid aides to help us? Valuing their service is important, but it doesn’t pay the bills!
In order to get decent pay and respect, direct care workers will have to collectively demand better treatment and pay. Nurses were paid diddlysquat until they started picketing and refusing to work for subpar wages.
I worked at an assisted living facility making $7.25 a few years ago! No, I didn’t have a CNA license. I was just thrown in. I only lasted two months, but I experienced frustration and exhaustion from it all. I loved the clients, but it was just the way I was expected to do a million things during my 12-hour night shift and was made to feel like a failure if I didn’t get to my cleaning tasks after taking care of 12 residents by myself for 12 hours. A lot of them were bed-ridden or extremely fragile. I was in charge of making all the food for the next day too, but I never even had time to take a lunch break myself! It was non-stop running around making sure residents didn’t fall. I put I couldn’t provide those poor old people the care that I wanted to because there was no way…. Nobody died on my watch though. Phew.
I am a teacher now and facing the same frustrations of low wage. Although teachers at least make pretty decent comparatively. Don’t you love being a female?