{"id":1561,"date":"2015-03-16T09:00:19","date_gmt":"2015-03-16T15:00:19","guid":{"rendered":"http:\/\/admin.patheos.com\/blogs\/janetheactuary\/?p=1561"},"modified":"2015-03-22T22:17:41","modified_gmt":"2015-03-23T04:17:41","slug":"from-the-library-the-age-of-dignity-preparing-for-the-elder-boom-in-a-changing-america-by-ai-jen-poo","status":"publish","type":"post","link":"https:\/\/www.patheos.com\/blogs\/janetheactuary\/2015\/03\/from-the-library-the-age-of-dignity-preparing-for-the-elder-boom-in-a-changing-america-by-ai-jen-poo.html","title":{"rendered":"From the library: The Age of Dignity; Preparing for the Elder Boom in a Changing America, by Ai-Jen Poo"},"content":{"rendered":"\n<\/head>

The author (whose foreign name is due to Taiwanese ancestry, but this doesn\u2019t particularly factor into her story) is billed as \u201cCo-Director of Caring Across Generations and MacArthur \u201cGenius\u201d Fellow, and her background is not one of working with the elderly, but advocating for the home care workers (healthcare and, more typically personal care aides), alongside other \u201cdomestic employees,\u201d and this book is not about the elderly per se, but those who work for them (with large portions of the text spent telling stories of individual workers), and her crusade for improved pay, working conditions, and respect.<\/p>\n

She begins with her own personal story, and some general words about the increase in the number of elderly and the difficulties that it brings. \u00a0For example: \u00a0the lack of geriatricians, who aren\u2019t just \u201cnice to have\u201d but important to healthcare for the elderly; someone without specialized training and experience will mistake a treatable condition for a normal consequence of aging. \u00a0One difficultly: \u00a0Medicare reimbursements presume a 15-minute appointment, but in reality, office visits for the elderly require much more time. \u00a0Within families, daughters (because it\u2019s generally daughters, not sons) caring for aging and severely impaired parents struggle mightily as the \u201csandwich generation,\u201d feeling guilt for wishing the parent would die.<\/p>\n

What about paid caregivers? \u00a0Sometimes they\u2019re hired via Craig\u2019s List or other informal sources; other times from an agency. \u00a02\/3rds of domestic workers (that is, including nannies and housecleaners as well) are foreign-born; half are here illegally. \u00a0They work far in excess of a 40-hour week, are paid less than minimum wage, are sometimes flat-out mistreated (even to the point of being subject to sexual demands) and, for those here illegally or otherwise working under the table, accept this for fear of being exposed or because they simply don\u2019t want to lose the job and risk being unable to find a new employer.<\/p>\n

She also cites a more general \u201cunfairness\u201d that all manner of \u201cdomestic work\u201d is low paid, and attributes this to the fact that it\u2019s viewed as \u201cwomen\u2019s work\u201d and of little value accordingly. \u00a0(Not for her questions of supply and demand.) \u00a0And she describes the advocacy that produced the New York Domestic Workers Bill of Rights<\/a>, and an update to Department of Labor regulations <\/a>(effective 1\/1\/2015) that substantially narrowed the type of elder care that\u2019s exempt from minimum wage and overtime; now, only work that is almost exclusively that of \u201cfellowship\u201d\/\u201dcompanionship\u201d and \u201cprotection\u201d (that is, making sure they don\u2019t fall, etc.) is exempt, where previously, elder care was more generally exempt form minimum wage and overtime law. \u00a0(Live-in workers are still exempt from overtime requirements, but are still covered by minimum wage law for all on-duty hours.)<\/p>\n

What\u2019s her agenda, ultimately?<\/p>\n

First, a $15 an hour wage.<\/p>\n

Training opportunities for elder care workers.<\/p>\n

Legalization for all illegal home-care workers, and a new guest-worker program.<\/p>\n

How to fund this? \u00a0She\u2019s not particularly interested in these details, but offers (1) tax hikes, (2) abandoning immigration enforcement and (3) Medicare and Medicaid \u201cnegotiation\u201d of drug costs, and she cites long-term care benefits\u00a0in Japan and Germany that are part of their social insurance programs, as well as proposals in various states. \u00a0 She doesn\u2019t particularly make an effort to calculate the cost or outline the extent to which the government should pay. \u00a0Does her preferred program include government coverage of 100% of care costs, and relieve family members who are currently caring for the elderly without pay?<\/p>\n

What\u2019s my take-away from this book?<\/p>\n

She insists that institutional care is unaffordable because of its astronomical cost: \u00a0she cites a cost of $84,000 per year for a nursing home stay, and says that home care is more economical, but if we take her proposed $15 an hour, and multiply by 24 hours a day, 7 days a week, 52 weeks a year, even excluding the additional costs for taxes, benefits, another other expenses, we\u2019re at $131,000 per year, just for the care manpower.<\/p>\n

She also focuses a great deal on the desire of the elderly to preserve their independence, even when, in reality, they are dependent on their caregivers.<\/p>\n

But consider this: \u00a0the only ones who hire workers to care for their children, directly in their own home, are the wealthy and upper middle class. \u00a0Most families in need of child care services elect more cost-efficient daycare centers or home daycare providers. \u00a0Surely in the same way, elder care is more efficiently provided, perhaps not in large nursing homes, but in small groups, either as a group home, similar to the disabled, or via adult daycare, when the elder spends nights at \u201chome\u201d (which may be a child\u2019s home) \u2014 especially for those for whom the care needed is meal prep, toileting help, and general supervision. \u00a0Or is the problem that the elderly want companionship, but don\u2019t really want to be around, well, other old people?<\/p>\n

Bottom line: \u00a0she highlights a real problem, but is woefully short on real solutions.<\/p>\n<\/body><\/html>\n","protected":false},"excerpt":{"rendered":"

The author (whose foreign name is due to Taiwanese ancestry, but this doesn\u2019t particularly factor into her story) is billed as \u201cCo-Director of Caring Across Generations and MacArthur \u201cGenius\u201d Fellow, and her background is not one of working with the elderly, but advocating for the home care workers (healthcare and, more typically personal care aides), […]<\/p>\n","protected":false},"author":2209,"featured_media":0,"comment_status":"closed","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[1],"tags":[237],"class_list":["post-1561","post","type-post","status-publish","format-standard","hentry","category-uncategorized","tag-eldercare"],"yoast_head":"\nFrom the library: The Age of Dignity; Preparing for the Elder Boom in a Changing America, by Ai-Jen Poo<\/title>\n<meta name=\"description\" content=\"The author (whose foreign name is due to Taiwanese ancestry, but this doesn't particularly factor into her story) is billed as "Co-Director of Caring\" \/>\n<meta name=\"robots\" content=\"index, follow, max-snippet:-1, max-image-preview:large, max-video-preview:-1\" \/>\n<link rel=\"canonical\" href=\"https:\/\/www.patheos.com\/blogs\/janetheactuary\/2015\/03\/from-the-library-the-age-of-dignity-preparing-for-the-elder-boom-in-a-changing-america-by-ai-jen-poo.html\" \/>\n<meta property=\"og:locale\" content=\"en_US\" \/>\n<meta property=\"og:type\" content=\"article\" \/>\n<meta property=\"og:title\" content=\"From the library: The Age of Dignity; 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