Honest Work

Fair wages should extend to personal caregivers


In September, Americans celebrate the workers who make our country strong. We are proud of the traditions that brought us the eight-hour work day, paid vacation and sick days, and minimum wage and overtime protections.

Unfortunately, 129 years after the first Labor Day celebrations, more and more American workers find themselves without some of these basic labor protections. Amazingly, the fastest-growing occupations in the country—personal care and home health aides—are explicitly excluded from the Fair Labor Standards Act minimum wage and overtime protections. As a result, the 1.7 million workers who provide care and assistance to our frail and disabled family members are among the most poorly paid workers in our nation.

In 1974, the Fair Labor Standards Act was updated to include most domestic workers, such as cooks, maids and yard workers. However, companions for the elderly were exempted. At the time, long-term services for elders and people with disabilities were primarily provided in skilled nursing facilities. Home-care workers were considered the equivalent to babysitters, providing company to elders who were lonely or needed “someone in the house.”

Today, home-care aides provide the same skilled services to their clients as certified nursing assistants provide to nursing-home residents. These services include not only personal care such as bathing, dressing and toileting, but assistance with mobility, oral and injected medications, nutrition and monitoring of vital signs such as blood pressure. Clearly, these are not “companionship” services.

The biggest challenge facing the industry is attracting and retaining workers. Providing basic labor protections and fair wages would show that, as a society, we value the essential services that home-care workers provide. We cannot ask the caregivers—usually poor, often immigrant women—to sacrifice their meager wages to make care affordable. We must recognize that our nation’s labor laws apply to all workers.

Steven C. Edelstein is the national policy director at PHI, a nonprofit dedicated to improving the quality of jobs for direct-care workers and the quality of care for elders and people with disabilities.