As the average age of the US population continues to rise, the nation will need to improve and transform what is currently an inadequately developed and funded system of care. In The Age of Dignity, Ai-jen Poo, director of the National Domestic Workers Alliance, provides a blueprint for building a culture that supports and values the care of our elders. Order the book from Truthout now by clicking here!
It's a bitterly cold early February afternoon and Ai-jen Poo - a 2014 MacArthur "genius" award winner, author of a just-released book called The Age of Dignity: Preparing for the Elder Boom in a Changing America, co-founder of the 15-year-old New York City-based Domestic Workers United, and the executive director of the National Domestic Workers Alliance - is sipping tea in a bustling café in downtown Brooklyn. I'm five minutes early for our prearranged meeting, but it's clear that Poo has been nestled in a corner table, writing and preparing a presentation, for a while. Waving hello, she motions for me to sit while she finishes a call. Her focus then shifts and she graciously prepares to be interviewed. She smiles widely, warmly. And while I suspect she's answered each of my questions many times before, she evinces neither boredom nor annoyance. Instead, she gives me her wholehearted attention and appears to think deeply about everything I ask.
Now 41, Poo is on a Caring Across America tour to promote The Age of Dignity. But this is far more than a simple book tour. Poo's agenda is enormous and will potentially transform US social arrangements. The goal? To make caregiving a national priority and improve the salaries and benefits of the nearly 2 million workers who currently provide in-home assistance to the elderly and disabled.
There's not a moment to waste, Poo notes, since every eight seconds another American turns 65 and more likely than not, would prefer to age in place, that is, remain at home, with help, for as long as possible. "We know that people can work and play longer if they have the right support," Poo says. "Home care can be cost saving and prevent hospitalizations and re-hospitalizations, but we have to empower home health aides and pay them well. It's not a question of whether we'll live or die. We'll all die. But we owe it to ourselves to support people's living."
Part of what's needed, she continues, is increased respect for intergenerational relationships, something her parents and grandparents hammered home throughout her childhood. They taught her numerous lessons that she carries with her into organizing projects, she reports, among them the importance of storytelling to transmit history, ethics and values from one generation to the next. Furthermore, Poo credits the power of personal example - her dad's pro-democracy activism while a student in Taiwan and the compassionate care her mother provides as an oncologist - for her own humanism.
There were additional lessons, too. Although her grandfather died a number of years back, she says that he received excellent care from a worker who now assists her 87-year-old grandmother, enabling her to stay in her Southern California apartment and participate in a host of community activities. Her family is lucky, she adds, because they have the economic resources to pay for the care that's necessary.
How about those who are less well-heeled? I ask. "We need a whole new program for long-term care," Poo says, "Germany and Japan are models we can look toward since neither country separates long-term care from other health services. Long-term care is simply part of government-supported comprehensive coverage. Working-age adults contribute through a salary deduction and are ultimately able to get the supports they need when they age or become infirm."
While this seems unlikely in the United States - after all, the Republicans have already attempted to repeal the Affordable Care Act 56 times since it was passed in 2010 - Poo says that she is undaunted. In fact, she says that activists will have an opportunity to raise this and other care-related issues at upcoming White House Conferences on Aging that will take place in Boston, Cleveland, Washington, DC, Phoenix and Seattle before year's end. "This is going to be a big year, with the potential to elevate the issue of aging," she says, grinning.
Indeed, these once-a-decade confabs could not be better timed, she continues, since current projections estimate that 20 percent of the US population will be 65 or older by 2030. "Home care is the fastest growing employment category in the country right now," she says. "If we want seniors to be comfortable and well-cared for, if we want caretakers to be well-paid and respected, things have to change on the familial, community and societal levels."
Poo understands that she is up against formidable cultural and legal odds, from the assumption that family members will have the time and resources to provide unpaid care to family elders, to the lack of federal protections for in-home employees. "As a nation, we've yet to fully embrace aging or account for the fact that paid caregiving - work typically done by immigrant females - involves a huge, and rapidly expanding, labor force that is not yet valued for its contributions. Worse, the interests of consumers and provider are too often pitted against one another. We need to recognize that, at some point, all of us will either be providing the care or needing it."
Poo stops for a minute, seemingly intent on finishing her tea. This allows me to absorb what she's just said. I'm suddenly slightly uneasy, a bit off-kilter, which I later realize is exactly what she was going for. "I hope people reading the book, attending a reading or listening to the message through another source will be prompted to open up some space to think about death and aging. I hope they find a way to balance their very real fears about age or infirmity with the joy that comes from being interdependent. I want people to see that accepting support when it's needed can be a sign of strength, rather than weakness. None of us would ever accomplish anything without the care of others."
Absolutely, I nod. At the same time, attitude is not everything and I wonder what she sees as the government's role in promoting and compensating in-home caregiving. First and foremost, she says, is undoing the lack of legal protections afforded to nannies and aides to the elderly. When the federal Fair Labor Standards Act was passed in 1935, Poo explains, it exempted both groups. "It's called the companionship exemption," she says. "To its credit, last year the Department of Labor tried to deal with the exemption by narrowing the definition of companion so that approximately 2 million domestic workers would have been covered by minimum wage and overtime protections. It was to have taken effect on January 1, 2015."
It didn't happen, she adds, and for the first time since we began speaking, she sounds dejected and maybe even angry. "The home care lobby sued the Department of Labor to stay the provision and the matter is now tied up in the courts," she says, sighing.
Again, she pauses, as if to contemplate the magnitude of the resistance. "To think that there are groups in the US that publicly state that home care workers should not be covered by minimum wage laws is appalling to me, especially since the US population is aging so rapidly. We should be expanding home care options and showing that we value the relationship between caregivers and those they care for. It shocks me that in many states domestic workers are still underpaid and disrespected."
Within a few seconds, however, the look of exasperation on Poo's face completely vanishes, her tone shifts and she begins speaking about the many victories that domestic workers have exacted since the movement began 15 years ago - not the least of them being the Domestic Workers Bill of Rights, a set of labor protections that have become law in New York State, California and Hawaii during the last five years. "My biggest joy is seeing workers organize, overcome adversity - and win," she says.
These victories sustain her, she continues. What's more, she credits the intrepid organizing of domestic workers across the country with inspiring the John D. and Catherine T. MacArthur Foundation to name her a 2014 "genius." "It took me a while to figure out what was going on when I got the call," she says, laughing. "It's not the kind of thing you ever imagine happening. I see my winning as a reflection of the MacArthur Foundation's willingness to really see the workforce that I represent and the excellent example these workers have shown the world. Often exploited domestic workers have taken what feels like an intractable issue and found a way to move forward. It's their movement that has energized people."
Poo plans to use the award - $625,000 - to establish an endowed fellowship for domestic laborers. "As soon as the book tour finishes in April, I plan to try and find donors to match the MacArthur grant so that every year, two or three workers affiliated with the National Domestic Workers Alliance can take a year off from caregiving to study community organizing, leadership development and learn about the legislative process." The soft-spoken Poo becomes increasingly animated as she describes the program she hopes to establish. "Domestic workers are incredibly tenacious and committed to organizing," she says, "which is why this fellowship is so important."
Does she ever get discouraged or overwhelmed? I ask in closing. "As long as domestic workers are willing to stand up and organize, I'm willing to do my bit, but I do get tired sometimes," Poo admits. As for the necessary recharge, the 1996 Columbia University graduate says that she relaxes by doing yoga. "I practice several times a week; it has helped me maintain focus and weather every storm." She smiles, then looks at her phone, notes the hour and begins to bundle up. It's time to head to the Brooklyn Historical Society for a panel on aging, the care crisis and the essential work of domestic labor.