Advocating for Professional Caregivers
Lou-Ellen Barkan
Founding Director
Just before dawn, Rosa Gonzales arrives at her job as a home health aide caring for an 85-year-old widow with Alzheimer’s disease. She will spend the next twelve hours keeping her client safe, occupied, clean and fed until a family member takes over. Sometime during the day, her client’s daughter will call to see how things are going.
“Fine.” Rosa says. “She ate well and had a nice sponge bath.” Rosa always reports that things are going well. Even on the days when Mrs. Rogers is yelling at her or accusing her of theft or crying because she wants her husband to come home from work.
Notwithstanding the challenging work, the absence of supervision, an annual salary ranging between $15,000 and $23,500, no medical benefits, minimal or no training and no job security, home health aides are among the five fastest growing job categories. This is primarily driven by a rapidly growing population of aging baby boomers, many of whom will eventually need assistance to perform the simplest activities of daily living; eating, bathing, toileting and dressing. Today, this assistance is provided primarily by home health aides, like Rosa, who are recent immigrants. As the aging population grows, Americans will be increasingly dependent on this immigrant population to meet our needs for home care. This should be an important concern as we consider immigration policy.
In 2016, the Bureau of Labor Statistics reported that there were 911,000 home health aides in the country. By 2026, we will need 1,337,000 aides to meet the demand; an increase of 46.7 percent. In the future, as in the past, most are likely to be immigrants attempting to break into the workforce by doing a job with low pay but few educational requirements.
Advocates for the aging community make the case that a deficit of home care workers will have the unintended consequence of reducing the tax revenue needed to pay for entitlement and health care programs. They project that thirty million baby boomers will live to eighty-five or older, at which time many will require full-time care for the rest of their lives. Without home health aides able to provide that care, family members will be forced to quit their jobs to provide care. This will dramatically reduce the tax base at the same time more tax dollars are needed to support greater use of government funded programs.
Many families prefer to keep their relatives at home until the end of life cared for by a family member with the assistance of a home health aide. But to achieve this, we will need a healthy flow of immigrants. Otherwise, it will be impossible to deliver the number of aides we need in 2019 and beyond.
As baby boomers age and government debates the economy, employment, immigration and health care policies, the need for an adequate supply of home health aides should be a critical issue for consideration. It is up to us, the voters, to ensure that we consider this issue when casting our votes.
Rosa Gonzales is a pseudonym.