The Changing Face of Caregivers in the U.S.

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January 6, 2013; WCPO (Cincinnati, Ohio)

Healthcare is one of the fastest growing segments of our economy, and direct care is a substantial part of that growth. Almost five million Americans earn a living as direct-care workers, slightly more than those working in retail sales (4.97 million), and significantly more than teachers (3.9 million) or law enforcement and public safety workers (3.7 million). In addition to being one of the largest, it’s also one of the greyest segments of our economy. Indeed, as WCPO Cincinnati writes, “The new face of America’s network of caregivers is increasingly wrinkled.”

According to the Paraprofessional Healthcare Institute, by 2018, 29 percent of direct-care workers are expected to be age 55 or older. In some areas of the direct-care industry, WCPO Cincinnati writes, seniors are the “largest single age demographic in the workforce.”

The greying of the direct-care workforce is somewhat logical. The jobs are typically part-time and do not require substantial training, making such work an easier fit for a senior looking to reenter or extend their time in the workforce.

Direct care employees include nursing assistants, home health aides, personal care aids, and independent providers. Caregivers work in a wide range of settings including nursing facilities, group homes, non-residential day programs, large facilities such as hospitals, in-home, and other community-based settings. Clients vary, but can include the elderly, those with intellectual and developmental disabilities, and those recovering from illness or injury.  

There are, of course, a number of concerns. Direct-care jobs are not well-paying positions. While the median hourly wage for all U.S. workers was $16.71, the median wage for direct-care workers was significantly less: $10.63. According to the Paraprofessional Healthcare Institute, inflation-adjusted hourly wages—also known as “real wages”—have declined over the last ten years. The direct care workforce is often employed part-time and, according to a recent study, many employees do not receive healthcare benefits for themselves or their families. While these benefits may be unnecessary for seniors and may change under the Affordable Care Act, it is still important to recognize the lack. In fact, it is estimated that as many as 48 percent of these workers live in households earning below 200 percent of the federal poverty line, and that 49 percent live in households that receive public benefits. Presumably, many also turn to nonprofit organizations for services.

We might also consider the greying of the direct-care workforce to be part of another trend. As the baby boomers age, they and their children are finding unique ways to support prolonged independence. Senior transportation cooperatives, for example, have also sprung up in cities across the United States.