By Harry S. Margolis
Over my 30-plus years practicing elder law, the nature of elder care has changed dramatically, from one that was nursing home-based to one where care is largely provided at home or in assisted living facilities. (Of course, then and now, most care is provided by family members at no cost. Actually, "no cost" is wrong. No dollars may change hands, but the care is often provided at great cost to the caregiver.)
A great weakness of our "system" for providing elder care is that despite its great cost, most care providers are drastically underpaid. This has detrimental effects on them as well as on the people for whom they care due to the resulting stress and fatigue on caregivers and their turnover as they seek other ways to earn a living. One result has been the huge number of coronavirus deaths in nursing homes across the United States, but especially in Massachusetts. (See Deaths in Nursing Homes: How We Let Down Our Older Citizens.)
In an effort to ameliorate this situation, in 2015, the U.S. Department of Labor, for the first time, extended minimum wage and overtime protections to home care workers. Unfortunately, a new Government Accounting Office (GAO) study reports that this has done little improve the income of most home care workers, in part no doubt to the low federal minimum wage of just $7.25 an hour in 2020. Home care workers in 2019 earned a median income of just $400 a week—just $10 a week more than the average income for jobs with similar education and training requirements. Median means that half such workers earned less than $400 a week!