Respecting Direct-Care Workers.

It's a little old (April 2) but well worth the read: an article by Beth Baker from Ms. Magazine on the low pay and respect afforded our vital direct-care workers. As our nation ages and as more elders come into the health care system via new laws and new medical advancements in end of life care, and as we work to provide care to all members of society, direct-care workers form an increasingly important wing of our health care delivery system. I think Baker helps initiate the necessary discussion of why these workers are so poorly paid, who makes up their ranks, and how we can work to ensure that their vital work is properly rewarded.

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 Allianceand 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.”