I was honored to join my dear friend Rosalynn Carter last week in Georgia at the Rosalynn Carter Institute for Caregiving Summit.
Rosalynn has been an inspiration to me for my entire adult life. She showed an entire generation of women that we can have it all. We can nurture a family, a career and even a country. We don’t have to choose.
It’s a big reason I’m where I am today. During my time as an intern with the Carter administration, the passion, talent and dedication I saw there led to my future career in public service.
Rosalynn always had a unique ability to look around the corner. She did it with mental health treatment back in the 1970s, and she saw the current caregiver crisis coming before it was on anyone else’s radar.
Our system for caring for our aging population is buckling. Six million seniors need daily assistance to live outside of a nursing home, and that number will double by the year 2030. According to the Bureau of Labor Statistics, we have less than a million home health care aides in our workforce. They make about $21,000 a year, and these caregivers often have no health care themselves. That’s wrong. This shortage of qualified, well-paid professionals is one reason why four in five seniors who need daily care get it from loving members of their family.
I’m not just thinking about these issues right now, as a public official. I’m living them, as a daughter. Last week, my Dad went to the emergency room. He has had a number of medical challenges, including knee replacement surgery, and our family has been with him every step of the way.
Family caregivers do some of the hardest work out there, and it does matter. It matters to the elderly father who needs help opening a medicine bottle, taking a bath, changing his clothes or something simple like getting off the sofa. For me, seeing my family come together to care for Dad has reaffirmed one of my strongest beliefs as the United States Secretary of Labor. All work has dignity—even the stuff you don’t get paid for … especially the stuff you don’t get paid for.
As Labor Secretary, I believe we must honor the professionals who support our family caregivers. My department is currently looking at whether we should consider changes to the “companionship” exemption to the Fair Labor Standards Act that has prevented some home health care aids from earning minimum wage and overtime pay.
We know the duties these professionals perform have grown more demanding over time, requiring greater autonomy, responsibility and skill. Often, they’re serving people with physical and developmental challenges, as well as chronic and terminal conditions. It’s demanding work.
We also have clarified that the Family Medical Leave Act applies to caregivers who were raised by people other than their parents. This means if an aunt or a grandparent raised you, for example, you get 12 weeks of legally protected leave from your job to take care of them. We are enforcing this law to give more caregivers the support they need.
We also have a grantee in California that is working on a pilot program to train up an emerging class of professional that can be an asset and an advocate for our caregivers. They’re called community health care advocates.
When my Dad was having trouble with his knee, the physician said the pain was the product of his age. There were language barriers, sure. But there were generational issues that are too common in geriatric care. My Dad is a product of the Great Depression era. He can fight through pain. He doesn’t want medicine. He doesn’t like the way it makes him feels. He’s a strong male. But as it turns out, his doctors didn’t really hear what he was his saying. And we later learned his knee replacement was actually failing. At one point, they told him to consider an amputation. The physician actually thought that would be preferable to ongoing treatment. It was a cost-savings approach instead of a humanitarian approach. We pushed back as a family. But I thought about what would happen to other families who didn’t have an advocate.
Our grantee in California is creating a curriculum to train a new generation of community health advocates. They will provide a range of support—from helping families apply for Medicare to arranging transportation to doctors appointments to providing advice on nutrition and home-based care.
We believe the Affordable Care Act’s focus on preventive care will create new economic incentives for hospitals, clinics and employers to create more of these positions.
It’s time for this country to create a caring system to complement our curing system. Working together, I know we can improve the quality of life for our elders and their caregivers who give so much.