On a Treadmill Going Backward, my Direct Care Alliance blog post about how hard it is to get by on a home care worker’s wages, is developing a life of its own.
Right after it was published, Steve Farnham of the Aroostock Area Agency on Aging asked permission to give copies to legislators and legislative candidates “to support an effort to increase wages and promote benefits for direct care workers in Maine.” The Maine Peoples Alliance asked me to read the essay on their Town Hall telecommunication system last month—to about 10,000 people! On Labor Day I gave a copy to Mike Michaud, who is running for governor of Maine. And I will be reading the story at the Kennebec Valley Organization’s Candidate night on September 18.
Most Americans can go to work each day with confidence because their workplace is regulated for safety, but this is not the case for those who work in a private home. There are currently no provisions to address workplace safety for home care workers, and that makes it difficult to create a stable and predictable work environment. No wonder home health care and personal care always rank among the occupations with the highest rates of job-related injuries on Bureau of Labor Statistics reports.
An unsafe workplace not only endangers the aides who work there but undermines their ability to support the client. For example, home care workers often face scenarios like this: Continue reading »
DCA Maine has a long history of empowering direct care workers to speak up and voice their concerns on issues regarding their work. Members have testified before legislative committees, spoken with our elected representatives in Congress and taken part in work groups and coalitions to improve the conditions of direct care work.
Notable successes include two grants from the U.S. Department of Health and Human Services’ Health Resources and Services Administration (HRSA); one for helping direct care workers to obtain health insurance through their employers and another for training direct care workers on core competencies so they can easily transfer from one population to another. We are also proud of being part of the campaign to remove the companionship exemption for home care workers from the Fair Labor Standards Act.
But a lot still needs to be done to create a world where direct care workers receive adequate pay, support and training to do the work we love. So when Direct Care Alliance let us know it had run out of out of funding, we looked for another group that could support our work. Continue reading »
With your support, Direct Care Alliance has been the national advocacy voice of direct care workers for almost ten years. We can all be proud of what we have accomplished together.
Inspired by the vision of former Executive Director Leonila Vega, we built a nationwide advocacy network of direct care workers through the Voices Institute and other means. These worker leaders are eloquent about the value of their work and have a passion for improving our system of long-term services and supports.
We influenced legislation and regulation, taking important steps at the state and federal level to improve the health and economic security of direct care workers, invest in the workforce and enhance training and advancement opportunities. A key recent victory was the final home care rule extending basic labor protections–including federal minimum wage and overtime pay–to home care workers nationwide.
We developed a national credentialing program that is an important step toward building recognition of personal care work. We assisted many direct care workers in finding health insurance under the Affordable Care Act. We also provided technical and financial assistance to direct care worker state associations.
Unfortunately, the world has changed, and our income has decreased every year. The board has grappled with this over the years, trying to trim costs while maintaining services and supports for workers, but we don’t have enough funding to continue operating. We regretfully inform you that DCA staff operations will cease and our offices in Washington, DC and New York will close by June 30. Continue reading »
Our offices closed and our staff stopped working on June 30, 2014. The board is operating a “virtual office” to respond to members through October 20. Our communications consultant is also staying on part-time to maintain our website, blog and social media.
Finding grant funding has became more and more challenging in recent years, and our income has been steadily decreasing. The board has been trimming costs where it could, but we arrived at a point at which things were no longer sustainable.
What will DCA do between now and October 20?
The board is exploring possible partnerships with other organizations in hopes of finding a new home for our members and allies. If you know of a group that might be interested in partnering with us, please let us know. Continue reading »
If you talk to direct care workers about what they do for a living, you will discover within the first five minutes of your conversation that they are proud of the care they provide. Talk to them a little longer and you will probably also hear how conflicted they are about their work, largely because of how underappreciated and disrespected it is by the rest of us.
Growing up I can vividly recall my mother, a 30-year career CNA (now retired), exemplifying that dichotomy when she spoke to me and my brothers about her work. While she certainly enjoyed the care side of direct care work, I could hear the disappointment in her voice when she talked about how the work she and fellow direct care workers provided was rarely appreciated or talked about with respect by others within the nursing home and VA hospital she worked at. Continue reading »
I’ve been covering the world of long-term care for almost 20 years now, focusing for more than half that time on direct care workers, so I’ve thought a lot about the many traits—including competence, compassion, reliability, attentiveness and patience—that make good direct care workers so good at their work. But not until my own mom became a “total care” nursing home resident did I learn to appreciate what I now think is the most important trait of all.
A massive stroke at the end of 2012 left Mom with severe expressive aphasia. She can usually understand what is said to her and knows what she wants to say in response, but she can rarely get out the words she needs to make herself understood. She’s come a long way, after months of speech therapy, but for every time she can say the right word or short phrase there are many more when she can only get out a string of unconnected words.
Watching people react to Mom has taught me a lot about how our words define us. Continue reading »
Watch Respect: The Joy of Aides, a wonderful 20-minute documentary by Eva Sweeney, a woman with CP, about how to hire and manage aides and what it’s like when a direct care worker and a client work well together.
The following is an edited excerpt from a journal I kept in October 2004 about life as a home care worker in Augusta, Maine.
Two days ago, I pulled the ligament under my kneecap at a client’s home, catching my foot on a plastic rug. Then my car started to make “dentist drill” noises and my mechanics told me I needed to replace the pulleys on the alternator. I squeezed another 12 miles onto the odometer before I felt a change in the power steering, letting me know the alternator wasn’t doing its job. Welcome to the home care worker’s biggest nightmare: Lack of wheels!
I reflected on my need for transportation as I took a taxi to work yesterday. Basically, my car is used for business transportation. “Drive to work, work to drive,” as a friend used to say. To save money, I do all my errands on my way home from an elder’s house. Of the thousands of miles on my old car, I have probably logged about a thousand traveling for pleasure, usually to see family and friends. The rest were all spent driving to and from my clients’ homes. Continue reading »
Direct care work, in one sense, made me feel like a rock star. When a stranger asked me what I did for a living, and I said, “I work in a facility for emotionally troubled teenagers,” the response was often: “Wow, that’s so great.” No other job I’ve ever done—and I’ve sampled dozens—has ever netted me such a consistent response.
And the job was great, for all the reasons these strangers guessed. It was important work that pulled my heart and soul and body into the huge effort required each day. It was clear as I started a shift at the residential center that I would be challenged and that I would have the chance to help young people in crisis.
I think part of the awed response to these direct care positions comes from the urge that everyone has to do meaningful work. Many people have jobs that don’t feel meaningful to them, and those people fantasize about leaving a position to make a difference. Most people respect a job where, at the end of the day, you can clearly point to a crisis you helped solve or a person in pain who you helped comfort.
It’s mysterious and tragic that the respect we have on a one-to-one basis for meaningful jobs doesn’t translate to respect for an industry or a whole category of employees: the group of direct care workers.
The lack of respect results in things like low wages and stressful working conditions.
Have you ever done a happy dance? Well I don’t dance, but I did a happy dance when I completed the enrollment process for health insurance through the new health care marketplace. It was frustrating at times, but the frustration was worth it because I finally have health insurance again!
I have had to deal with a lot of stress in the past in keeping my family insured through Badger Care, Wisconsin’s Medicaid program, as the children got older or the rules changed. I’ve also had my own struggles with maintaining health care coverage. For many years as a home care worker I qualified for Badger Care. Then I got a raise and was making $50 a month too much to qualify, so I had to switch to my employer’s insurance plan. That lasted for years, but I lost that insurance in November 2011 when the home care agency I work for stopped offering insurance because it was too expensive.
I went without health insurance for two and a half years after that. There were several times during that period when I should have seen a doctor but did not because I couldn’t afford it. Continue reading »
“That was so compelling.” “How can I learn more?” “How powerful!”
That was some of the feedback I received from the people who approached me following a May 8 briefing on Capitol Hill. The Washington, D.C. briefing was hosted by OWL–The Voice of Midlife and Older Women, to observe the release of its annual Mother’s Day report. The focus of this year’s report is long-term care, services and supports (LTSS), including growing demand, challenges, and opportunities for improvement, and I had been asked to talk about how direct care workers fit into that picture. My co-panelists highlighted key considerations including how best to meet the needs of older adults and people with disabilities, the challenges facing family caregivers, financing, and the lack of a political will for change. I spoke about the critical role played by direct care workers and how best to strengthen and support the direct care workforce to meet the growing demand for high-quality care and support.
When I spoke, there were gasps from the audience at the size and anticipated growth of the workforce, the percentage of women in the profession, and the low wages and high rate of dependence on public assistance among direct care workers. We are so familiar with these facts and figures that we sometimes forget how shocking they are to people who are new to them, but reactions at the briefing proved that we were reaching new people, teaching them about the urgency and importance of direct care workforce issues, and inspiring them to take action. Continue reading »