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Caring For The Elderly

It's one of the toughest yet most vital jobs of all — caring for the millions of elderly Americans who, though infirm, remain in their homes. There are an estimated 1.7 million of the Home Health Care workers across the US to assist the elderly, but that's far from enough workers.

There's already a shortage of Home Health Care workers, and the need for more will continue to grow as the elderly population continues to grow at a rapid pace. Hiring Home Health Care workers, however, is becoming harder, mainly because of the poor pay and working conditions offered them. They are not even covered by the federal Fair Labor Standards Act that sets a minimum wage and requires overtime pay.

The wages of Home Health Care workers are at a nationwide average of $9.34 an hour, with one in five living below the poverty line. In more than two-dozen states, their pay is low enough to qualify them for public assistance. That “has created harmful working conditions and undermined the quality of care,” according to a new study by the National Employment Law Project.

The law project's authors note that aside from paying workers poorly, the work is both emotionally and physically demanding and that the morale among Home Health Care workers is generally low and workplace injuries common.

President Obama appears to be ready to try to ease the problem through a Labor Department overhaul of the workplace rules that govern Home Health Care, one of the country's fastest growing industries. Meanwhile, the Labor Department has been seeking comments from the general public on the proposed changes.

The National Employment Law Project recommends putting Home Health Care workers under the Fair Labor Standards Act, as well as making clear that those who assist the elderly in their daily activities are not acting simply as companions, which would exempt them from the law.

The changes, as the project's executive director Christine Owens says, are the least we can do for those who care for the nation's elderly and disabled. It also is the least that can be done for the Home Health Care industry, whose very future appears to be at stake.

It's simple: If the poor working conditions that limit the number of people willing to take Home Health Care jobs aren't improved, the industry will have far fewer workers than required to help care for the growing number of Americans who need home care.

By 2050, an estimated 27 million Americans will need home care. And though the Home Health Care industry is expected to grow, it may very well fall far short of meeting the need – and the demand – for home health care workers, even in these times of high unemployment.

The Home Health Care industry is indeed an industry. And like all other industries in this capitalist society, it's controlled by large corporate interests. Providing badly needed help to the elderly is a great thing to do – but only, of course, if there's a profit to be made from it. As taxpayers, we provide most of the money the Home Health Care corporations collect, since they're paid mostly from Medicaid and Medicare funds.

The good news is that some home care employers are already starting to improve working conditions by paying their workers overtime, despite their federal exemption from having to do so.

All Home Health Care employers should treat their workers the same, of course, and otherwise treat them decently with pay and benefits reflecting the difficulty and importance of the work they do, and the profits they help bring to their employers.

There's a way to make sure of that: Unionize the industry, and the sooner the better. Some people are surely thinking of that, and some have already taken action, notably through the Service Employees union. Wish them luck.

Dick Meister is a San Francisco-based columnist who has covered labor and politics for a half-century as a reporter, editor, author and commentator. Contact him through his website,


  1. Harvey Reading August 8, 2011

    My, my, aren’t we a compassionate bunch? And to think that we have the utter gall to consider ourselves “exceptional”. Exceptionally mean and bloodthirsty is more like it.

  2. Harvey Reading August 12, 2011

    Laughing out loud over a load of wishful thinking propaganda.

  3. Rich February 24, 2012

    The reality is that the demand for home healthcare workers is exploding. You would think with growing demand that wages would see an uptick.

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