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What is the Price of Dignity?

As Americans we profess to care deeply for our loved ones—particularly the elderly and those who are chronically ill or living with disabilities. But when we compare the wages paid to our caregivers to wages for other workers providing services, it seems we value other things much more.

For example, we seem to care greatly about our cars, given the fact that nationwide, we pay mechanics an average of $13.62 per hour. It also seems that we care more about our pets, based on the average wage of $11.09 that we pay dog trainers. And of course we care about maintaining a youthful appearance, so we pay aerobic instructors $10.84 per hour.i

What about the elderly and those with chronic illnesses or disabilities? Just how much do we value their care? We pay those who provide daily "hands on" care to our loved ones—the home health aide, nursing aide and personal care aide—on average just $7.97 per hour.ii

Since many of these jobs are part-time, more than 18 percent of nursing home and home care aides—nearly one out of five—live below the federal poverty level, and one in seven is forced to rely on food stamps to survive.iii

In contemporary America even many fast food jobs now offer health insurance, so one would assume that the vital work of caring for the elderly and disabled would offer similar benefits, right? Not so. Even though it is the front-line staff who make our health care system function each and every day, few are offered health benefits. Our direct-care staff in nursing homes and home care agencies are nearly twice as likely to be uninsured as other American workers.iv

Many of us might think this situation is unjust and that the responsible party should do something to improve the picture. But just who is responsible for paying these essential health care workers such low wages and few benefits? That would be you and me. We as taxpayers fund more than 60 cents of every dollar paid into our long-term care system, through the Medicare and Medicaid systems.v So we should all be involved in ensuring that these programs are used effectively to bolster the wages of the caregivers who are so necessary to our society.

Given such low wages and few benefits, it is little wonder that nursing homes and home care agencies across the country are experiencing the worst staffing shortages in the history of their industry. Many agencies are simply unable to attract a stable, caring workforce, so much so that some providers are reporting that they must turn away clients.

Because of its physically/emotionally stressful nature and the low wages it offers, caregiving has become an unattractive employment option for many individuals. The result is that even those who truly love to care for others have been forced to leave their profession.

Officially, staff shortages are now at a crisis level: The U.S. General Accounting Office, in its May, 2001 report, announced:


"Retention of nurse aides is currently a significant problem for many hospitals, nursing homes, and home health agencies, with some studies reporting annual turnover rates for aides working in nursing homes approaching 100%. Low wages, few benefits, and difficult working conditions contribute to recruitment and retention problems for nurse aides. High turnover can contribute to both increased costs to the facility and problems with quality of care." (GAO-01-750T, Page 8)