Home health aides care for the elderly. Who will care for them?

One of the fastest-growing jobs in America is also one of the hardest.
By Alexia Fernández Campbell@AlexiaCampbellalexia@vox.com Aug 21, 2019, 9:50am EDT

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According to the latest estimates from the Bureau of Labor Statistics, the US economy is expected to create about 1.2 million new positions for home caregivers like Angelica by 2026 — a 41 percent increase from the 2.9 million personal care and home health aides working in 2016.

Aging baby boomers and expanded Medicaid coverage have led to the surge in the need for workers to care for the sick and elderly in their own homes. But these positions, which require minimal training and no college degree, are among the lowest-paid in the country.

Beyond that, home care workers are an easily exploitable workforce. Because of the job’s roots in slave labor, these workers have long been excluded from US labor laws. Live-in caregivers are not entitled to overtime pay or a minimum wage under federal law, or any other labor protections. Neither are caregivers who spend less than 20 percent of their job helping clients do basic tasks. None are protected from racial discrimination or sexual harassment. They have no right to a safe workplace, and in some cases, they have no collective bargaining rights. One of the fastest-growing jobs in the US is a really lousy one.

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The stakes are high. The problems health aides face could compromise not only the future of American work but also the state of care for the aging population. If unemployment keeps dropping, and caregivers discover better job options, they won’t stick around for long. Yet few policymakers have attempted to address the problems in a system rooted in racism and sexism.

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