Tuesday, September 28, 2021

Two Articles on Caregiving

We all know the importance of caregiving and some of the issues facing the U.S. vis a vis caregivers.  First, an article a few days ago published in the Huffington Post, Why A Transformation Of Caregiving Could Be Biden’s B.F.D. Here's one excerpt from the article

It’s got three main components. One is an initiative to provide up to three months of paid leave to take care of family members, including newborns. Another is a proposal to make child care and prekindergarten available to any family that wants it, and to improve the quality of that care for everyone. The third piece is a proposal to fund what are known as “home- and community-based services,” a clunky piece of policy-speak that refers to programs that allow disabled and elderly Americans to live on their own rather than in nursing homes and other institutions.

After discussing the politics of the plan, the article provides a history of caregiving. "Responsibility for caregiving has historically fallen disproportionately on women ― who, in turn, were expected to provide it for little or no pay. That was possible, in part, because until relatively recently in history most women didn’t have alternatives in the paid workforce. That was especially true for women of color, who were subject to discrimination (and, at one time, enslavement)."  Discussing the pay scale for caregivers, and the approach in other countries, the article discusses the "policy opportunity" at hand in Congress.

Then consider this recent article from the New York Times, Long Hours, Low Pay, Loneliness and a Booming Industry,  about the home health industry.

The industry is in the midst of enormous growth. By 2030, 21 percent of the American population will be at the retirement age, up from 15 percent in 2014, and older adults have long been moving away from institutionalized care. In a 2018 AARP survey, 76 percent of those ages 50 and older said they preferred to remain in their current residence as they age. In 2019, national spending on home health care reached a high of $113.5 billion, a 40 percent increase from 2013, according to the most recent data from the Centers for Medicare and Medicaid Services.

The ranks of home care aides are expected to grow by more than those of any other job in the next decade, according to the Bureau of Labor Statistics. It’s also among the lowest paying occupations on the list.

The article examines the wages of aides and the activities they perform. The article also covers the impact of the pandemic on them, including those who died of COVID.  The article looks at the regulations of home health agencies in NY. This particular part of the article gave me pause. "Working overnight makes an already isolating and demanding job even more so. Aides assigned to “live-in shifts” spend 24 hours a day at a patient’s home, sometimes for several days in a row. The aides are paid for only 13 hours of that time because they are expected to get eight hours of sleep and three hours of meal breaks, according to New York State guidelines and federal regulations."  And it is only recently that aide  have been protected by the Fair Labor Standards Act "Home health aides are classified as “domestic service” workers, many of whom were exempt from a set of labor protections known as the Fair Labor Standards Act until 2015, when the Department of Labor expanded its regulations."


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