Greedy CEOs are pitting elderly Americans against the workers who care for them
(Brian Wolfe / Flickr)
By Marjorie E. Wood / Other Words
Who will take care of grandma?
It’s a question we need to answer. As baby boomers grow older, the elderly population — seniors who are 80 and older — will increase almost 200 percent by 2050.
Our long-term care system isn’t ready. Studies show that older Americans prefer home care over institutionalization. But because of low wages and poor working conditions, recruiting and retaining home health aides and personal care assistants is very difficult.
In the end, that means a lower quality of care and fewer home care workers for grandma.
Maybe the home care industry just can’t afford to pay workers more?
Hardly. The industry has boomed over the past decade. According to the National Employment Law Project, its revenue increased 48 percent, while CEO compensation ballooned by a whopping 150 percent.
In fact, home care today is a multi-billion dollar industry. Because of rising demand and skyrocketing revenues, Forbes called home health care one of the hottest franchises in the market.
During the same period that [industry] revenue soared, average hourly wages for workers declined by 6 percent.
Sadly, home care workers haven’t shared in the industry’s prosperity. During the same period that revenue soared, average hourly wages for workers declined by 6 percent.
And that’s not the worst of it. Because of a “companionship exemption” to federal labor laws, more than 2 million home care workers today are excluded from minimum wage and overtime pay protections.
Ninety percent of them are women. More than half rely on public assistance to make ends meet.
The Department of Labor has tried to stop the industry from misusing the companionship exemption to pay home care workers less. It passed a new rule that was supposed to make these workers eligible for minimum wage and overtime pay this January.
But before the rule went into effect, several for-profit home care associations — including the International Franchise Association — successfully sued the Department of Labor to prevent the change.
The industry is claiming that higher wages mean grandma won’t be able to get the care she needs.
The truth?
Studies show that higher wages mean grandma will be able to find and keep the best caregiver. And the 15 states that already provide minimum wage and overtime pay for home care workers prove that it’s feasible.
All told, Grandma will be more likely to get the care she needs when her caregivers can earn a living wage.
Marjorie Wood is a senior staff member of the Global Economy Project at the Institute for Policy Studies and the editor of inequality.org. Distributed by OtherWords.org.
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Sadly not everyone can afford $25 an hour which is the going rate. this should be covered by Medicare; expand Medicare!
Yes, they need to do that as a beginning of keeping families together.
Only for non profit companies. For profit nursing homes, hospitals, insurance companies, home health agencies should not exist.
Two points on this matter: I talked to a young student today at my college who has missed class for the first time in months. She is doing overnight caregiving work under the table, filling in for other caregivers who are on vacation this summer. (She is here legally as a student but has not received a work visa or her Social Security number yet, so cannot legally work.)
She has a university degree from her home country, speaks four languages in addition to studying English, and is frustrated with her inability to earn money for her family. So she works a 12 hour shift and earns $50.
I was shocked when she discussed this arrangement with me, especially because I know her to be one of the brightest and hardest working students in my classes.
Such low wages to care for our most senior community members…
Point 2- Unfortunately, it is estimated that 70% of people will require long-term care at some point in their life. This could be due to an accident, serious illness, surgery, or some other factor that incapacitates them for a long period of time. So while simply aging may increase the odds of needing long-term care, younger people as well as older adults need to prepare for it.
However most young people refuse to purchase long-term care insurance, or wait until they’re older and it’s more expensive, incorrectly believing their healthcare will cover it, or Medicare will provide assistance.
They do not.
This means most people rely on friends and/or family members to provide assistance during this time. But if the caregiving need continues for very long, are specialized care is required, or a person lacks these resources, it could lead to loss of care, loss of savings and other serious outcomes.
For all these reasons I encourage my friends to plan and purchase insurance to cover this need. You are much more likely to need it vs. other types of insurance that are commonly purchased. Or start saving your money now for care giving- you have a 70% chance of needing it, at some point in your life.
Well said and very informative. Thanks.
In the case of a married couple one of whom needs nursing home care, the ill partner can go on Medi-Cal while still leaving family assets intact. Elderlaw attornies can arrange this. It’s not commonly known that the family does not have to spend down all its assets in order to go on Medi-Cal and have nursing home care paid for by Medi-Cal.
True John. But for single people, this would not be an option. We are on our own, and insurance is essential.
Not sure about unmarried couples. If they live together, could the other’s income disqualify the disabled partner from receiving public assistance? Or perhaps they could use IHSS (in home support services) to help pay for the caregiving they provide
As one with personal experience in this situation, unmarried couples are not legally married. Therefore, anything that’s true for married couples is not true for them. If the ill partner of the unmarried couple has income less than about $1000. a month (say from social security) and no assets, that person is eligible for Medi-Cal. If he or she has traditional Medicare, he or she can get on Medi-Cal. That combination of Medicare and Medi-Cal is the best insurance you could possibly have. It will pay for absolutely everything in terms of medical bills and drugs. It doesn’t matter how much income or how many assets the well partner has. Legally, the ill partner is single and poor.
Being on Medi-Cal also qualifies one for In Home Supportive Services (IHSS). Depending on the person’s needs as determined by a social worker, a number of free hours per month is provided. Although the person provided by IHSS is technically not a caregiver (i.e. they are not supposed to administer drugs or do things a CNA or nurse would do), their help goes a long way to keeping the ill partner at home and out of a nursing home.
thanks for clarifying.
With my family my mother (in her 60s/70s) cared for her mother (80s/90s) for nearly 20 years. Only in the final few years did she apply for and receive IHSS support, initially for care she provided, which helped tho was far from sufficient. (E.g, they allocated 2 hours of care/day, when in fact my grandmother needed much more than that.)
I became a caregiver for both of them for a time, when they were hospitalized with unexpected surgeries. Fortunately we found Southern Caregiver Resource Center (www.caregivercenter.org) which provided volunteers to come to our home and provide interim/respite care to give us breaks.
This was essential- I was doing a research fellowship at UCSD at the time, and had no family leave thru that appointment. The volunteers made it possible for my mother and me to have some “time off” from caregiving.
My grandmother lived to be 97, and had Medicare, MediCal etc. As you note; these cover most medical costs, but not all. After one of her final hospitalizations I opened the bill- it was for over $220,000!
Thankfully, we owed nothing, but it was a stark lesson to me about why medical bills often lead to bankruptcies, and the costs of aging and needing long term care- in home or elsewhere.
Lori, IHSS is a notoriously poorly run program, but it provided much needed help since Judy’s caregiver was a friend and neighbor who really loved her and went way beyond the guidelines insofar as taking care of her and gave me much needed respite. Initially they provided 60 hours a month. After a recent hospitalization with help from her caseworker at the hospital who called IHSS and said she needed many more than 60 hours, the social worker came out and reevaluated her with the result that her hours were increased to 120 a month. IHSS is a bureaucratic nightmare, but it also was indispensable for us. Judy could have gone into a nursing home at no cost since she had Medi-Cal, but she wanted to stay at home which she was able to do until the end.
I have been caring for an ill spouse for over 20 years. Medicare doesn’t cover any type of help and paying someone for the almost constant care needed is out of the question. So is dumping my spouse in a nursing home! My family were of no help; they just did not understand or truly care. They were more worried about their inheritance and own agenda than our wellbeing and happiness. One even stole from us when they didn’t get their own way. This is why I combined households with another person who also has an ill spouse. They understood. Together we support each other, giving each other much needed breaks, helping with personal care, running errands, they list goes on and on. Besides the financial advantages, It has turned out to be the most wonderful thing we could have done for ourselves and our ill spouses. We all get along great and we are a true family! Not everyone understands but we do what is best for us. You have to be creative as a spouse caregiver. They American health care system has failed.