Three months ago, I was just like the majority of Generation Y. If one had asked me about the importance of social insurance programs, such as Medicare, Medicare, or Social Security, I would have given a generic answer about how the elderly, people with disabilities, and poor individuals rely on these programs, knowledgeable only on the superficial level. Ask me now about the importance of such programs, especially in regard to the Direct-Care Workforce, and keeping me from “sounding off” would be a problem. I have learned so much about the importance of such programs and now, as a young adult, I realize why my generation must be involved and aware of the benefits social insurance programs offer.

The Direct-Care Workforce (DCW) consists of individuals employed as home health aides, certified nurse aides, or personal care attendants. This workforce is one of the fastest growing, with projections to increase from 3 million to 4.3 million people by 2018, which exceeds the demand for workers in other occupational groupings, such as fast-food workers, public safety workers, and teachers from k-12.

With a majority of female workers (89%),
the average age of a worker is 42;
more than half (55%) are educated at the “High school or less” level;
the median annual earnings for all DCWs is $16,800;
and 46% of DCWs rely on public benefits, such as Medicaid or food stamps.

It should be no surprise that individuals prefer to stay in their homes as they age. As illness and frailty commonly inhibit individuals from independent living, direct-care workers provide an essential stepping-stone to making this desire of staying at home a reality. Not only do DCWs relieve family caretakers in order to avoid institutionalization of their loved one, but by allowing individuals to remain at home, it is much more economic.

Below are some shocking facts that I was exposed to during my National Academy of Social Insurance internship, with my placement at PHI National, formerly known as the Paraprofessional Healthcare Institute.

Every 8 seconds, an American turns 65, which means that 10,000 people turn 65 every day. By 2030, the number of adults aged 65+ will have exploded to over 86 million, up from 35 million in 2000 which is a 147% increase. Seven out of ten people turning 65 will need Long-Term Care at some point in their life. While families are the primary source of care for people with long-term services and supports needs, Direct-Care Workers often supplement that care. The federal training requirement is less than the requirement for dog groomers, and the federal regulations for minimal training hours for DCWs have not been updated for more than 15 years. The Direct-Care workforce is equated to babysitters, in that the profession is exempt from minimum wage standards. In fact, parking lot attendants do better than Direct Care Workers on the Forbes worst paying jobs list.

This leads me to ask, does our society value material goods such as cars more than it values the care given to their elderly and/or disabled loved ones? How can one fathom the idea that individuals “watching over the car” are more important and more financially stable than individuals “watching over the people you love most, such as one’s parents?” It truly is mind-boggling.

The Direct-Care workforce is an integral component of community-based living and home health services for the aging population. The efforts and care provided by DCWs is underappreciated when considering their average wage earnings per hour lag well behind other occupations. For instance, in Connecticut, a DCW makes on average $12.50 per hour while all other occupations’ earnings are $19.29 per hour; in Kentucky, a DCW makes on average $9.54 an hour while all other occupations’ average earning are $14.38 per hour. In addition to the measly annual earnings, a large percentage of workers rely on public benefits (Medicaid, food & nutrition programs, or other) and a disproportionate number of workers lack healthcare coverage (27%) in comparison to the average U.S. citizen (18%).

Medicine and healthcare improvements have led to individuals living longer, which is a triumph of chronic disease over acute illnesses. The 65+ age group will need assistance as they age. DCWs can be a resource and provide a link to successful aging. The demand for DCWs is increasing but quality care is generated through quality jobs.

The DCW is an important puzzle piece in solving the eminent problems in our society. These problems stem from the growing elderly population, the small workforce of DCWs, and the emphasis on nursing homes and institutionalization rather than living at home as individuals get older. As stated as a part of PHI National’s mission, “Quality Care [is achieved] through Quality Jobs.” Individuals want to stay in their home for as long as possible, avoiding nursing homes. Direct-Care workers are the stepping-stone to helping the elderly stay at home, but the workforce deserves to be treated with dignity and respect.

by Raven Weaver

Raven Weaver is a Senior at Berea College in Kentucky where she will graduate with a degree in Psychology and a minor in Women and Gender Studies. As a 2011 National Academy of Social Insurance Intern in Washington D.C., Raven worked with PHI (formerly Paraprofessional Healthcare Institute) under the supervision of Carol Regan. She worked on a variety of research projects including data collection on minimum training standard regulations for Home Health Aides, and researching Direct-Care Worker associations. Raven plans on pursuing graduate studies in gerontology via the public policy pathway.