By Francis Adams
I’m a home care worker in the rural community of Washington, Pa., and I love my job. After working in the steel mills, I started my career in home care when my grandfather fell ill from black lung. I liked the work, and I began taking on other clients — seniors and people with disabilities — who needed help to live independently at home.
My work is important, and I know how many people depend on it. Home care workers not only assist with basic daily tasks like cooking meals and cleaning, but we also help with deeply personal needs like toileting and bathing. We develop strong, trusting bonds with our clients. They’re like family, so I want to care for them like family.
However, our country’s current long term care system is failing home care workers and our clients. Every day, more than 10,000 people turn 65 in America, and the demand for home care services is skyrocketing.
From 2018–2028, the industry will grow by 46 percent and will see more than 4.7 million total job openings nationally.
In Pennsylvania alone, 70 percent of people turning 65 need some type of long term care. However, there’s only one home care worker for every eight Pennsylvanians who want to stay in their homes. We can’t meet the demand. So what is contributing to this workforce shortage?
The national median wage for home care workers is $11.52 an hour, so every paycheck counts. Many of us don’t get paid time off, so if we are sick or need to take personal time, we forfeit that day’s pay and risk not being able to pay our bills or put food on the table.
Even if we could take a sick day, many home care workers don’t have affordable healthcare and go years without seeing a doctor. Long, unpredictable hours lead to burnout quickly.
For us to provide quality care for those in need, we need to be able to care for ourselves and our families, too. But with the current system, we’re unable to meet our basic needs.
I’m an on-call home care worker, meaning I step in when a client’s regular caregiver is unavailable. I never know what time of day the call will come, but whether it comes at 3 p.m. or 3 a.m., I answer. If I don’t, I don’t know who will.
But transportation isn’t always reliable in rural Pennsylvania. Since I don’t have my own car, I’m usually able to borrow one.
If I don’t have access to a car, I take the bus. But buses don’t run as often as they do in cities, so sometimes I have to walk. In a community where neighbors are separated by several miles rather than several blocks, it’s not always easy to get around town. For home- and community-based services, the infrastructure just isn’t there.
Seniors and people with disabilities in low-density areas are less likely to have access to the critical services they need to live with dignity and independence at home.
A home care worker is often the only person a client talks to all day, or maybe even all week. I never want to leave a client alone — loneliness can kill you just as fast as lung cancer.
Once, I arrived at a client’s house to find him lying on the floor. He had been there for hours waiting for his caregiver to arrive because he couldn’t afford an ambulance bill.
Many clients struggle financially, and I often pay out of my own pocket for things like transportation or supplies. But I only make $10.70 an hour, and work anywhere from 10–40 hours a week, depending on how many calls I get.
I’m also a full-time caregiver for my brother, but I’m not paid for that work. I do my best to support myself and my family, but at 70 years old, I have to work a second job to make ends meet.
Up to 60 percent of home care workers leave the profession less than a year after starting the job, and 80–90 percent leave after two years.
Low wages, lack of benefits and basic worker protections, and inadequate training push people away from a job that is so desperately needed. Until we make home care a respected, viable career, we simply can’t meet the growing need for long term care services — not by a long shot.
That’s why I’m joining home care workers in Pennsylvania and across the country to fight for the good, union home care jobs needed right now and in the future.
Through our unions, home care workers have the strength in numbers to advocate for ourselves and our clients. My union, United Home Care Workers of Pennsylvania, has worked together with the commonwealth’s government to strengthen our Medicaid program so that all Pennsylvanians, no matter who they are or what they do, can thrive. My union is my lifeline, and all home care workers must have the same same right to join a union.
At some point or another, everyone will need care. We must ensure the millions of qualified, compassionate workers who do this job can join a union, provide the highest quality care and support themselves and their families. The demand for long term care is never going away, and funding for home care services must increase if we’re going to make sure every person in this country — home care workers and those who need the services — has hope for a good life.
Francis Adams is a home care worker from Washington, Pa.