by Ava Dimichele
The direct care workforce, and care as a whole, is feminized— they are roles that are taken on by women. Of the almost 3 million direct care workers in the United States, 87% of them are women based on numbers from a KFF report. More than that, 65% of them are considered low-wage, making less than $35,000 per year according to a KFF report— which is significantly lower than what is considered a livable wage in the United States. PHI reports that the median hourly pay for direct care workers lags others in similar jobs in different fields, and these wages don’t even meet livable wage standards in some states. Care-oriented jobs, like direct care work are undervalued (and underpaid). Gendering care work is further entrenching the gender pay gap in society; women are directed towards these kinds of jobs because of their gender, and their pay isn’t measuring up to that of jobs that are more male-oriented. Jobs like construction work (with an average pay of $25/hour) or factory work (with an average pay of $17/hour) show that men have more earning potential based solely on their gender.
According to a report in JAMA, anywhere from 53 to 68% of unpaid family caregivers are women, and even when compared to male family caregivers, they typically spend more time providing care— up to 2.2 times their male counterparts daily. These caregivers are also disproportionately low-income, 44% come from households living below twice the federal poverty level. Caregivers are estimated to provide up to 80% of direct care and community-based services to family members— up to $600 billion performed in yearly services across the country. Yet, family caregivers are not recognized for these important contributions in our care infrastructure: 60% of these caregivers have had to limit their hours working in paid positions, take leaves of absence, or leave the paid economy altogether to care for their loved ones. They also face increases in mental health struggles like depression and anxiety and even increased mortality due to their high-stress lives. The women caring for their families often can’t advocate for themselves or their loved ones in a meaningful way from within a system that doesn’t prioritize them.
Women in both the direct care workforce and those who act as unpaid family caregivers are underrepresented in the national conversation about labor, healthcare, and living wages— despite the growing need for care workers in the United States. One care worker shared her story with PHI, and expressed that in her 20-year, tireless 24/7 care for her clients through every holiday and every personal issue, she never received thanks from her employer, in words or in bonus payment. All she wants is to make just $7, and even though she doesn’t, she continues to take care of each and every need of her 88 year-old Veteran patient and his family. A family caregiver shared her story through the Family Caregiver Alliance as well, and talked about the immense difficulty she had with taking care of her husband with multiple health conditions while struggling with her own depression and a lack of support from other family members. These women deserve to be recognized for their life-changing work and dedication, but they’re left to struggle instead.
Caregiving is difficult, sometimes grueling work. It requires skills and training. We should be professionalizing this workforce by increasing pay and creating career ladders and lattices. In addition, we must recognize the unique and critical role that unpaid caregivers play in the care infrastructure by providing additional support.
Here are a few important national projects and programs that are lifting up these important roles in care:
RAISE Family Caregiver Advisory Council was established to provide recommendations to the Secretary of Health and Human Services on effective models of family caregiving and support to family caregivers, as well as improving coordination across federal government programs. The National Strategy to Support Family Caregivers included a number of recommendations around professionalizing the direct care workforce. DCW remedies will also help family caregivers.
The Administration for Community Living funds the Direct Care Workforce Strategy Center to provide technical assistance and facilitate collaboration across service systems to improve recruitment, retention, and training of the professionals whose services make it possible for people with disabilities and older adults to live in their own homes and communities.
As the need for care continues to rise, the roles of direct care workers and family caregivers are absolutely vital. Together, these caregivers form the common thread that weaves through the fabric of our long-term care system. Together in Care, is a multi-year collaboration between PHI and the National Alliance for Caregiving, serves as a bold step toward strengthening the relationship between these essential caregivers.