Closing the Circle of Care for Our Veterans

We are at our best, as human beings and as Americans, when we take care of one another. That's something Air Force Captain Merritt Eugene Lawlis (or Gene, as he's known to everyone but the armed forces) knows well.

When Gene was shot down in the South Pacific in World War II, Japanese troops imprisoned him and his surviving crewmates in a POW camp for five and a half months. "He's about 6 feet tall, and he usually weighs about 170 pounds, but he was down to 125 when the war ended," says his wife Naomi. "All they had to eat was two little rice balls a day, so they got beriberi. They didn't get any medical care, either. His plane caught fire when it went down, and his leg was pretty badly burned. They got malaria, because there were flies all around. At least a couple of the boys died."

As he described in Winking at Death, a memoir about his time as a prisoner of war, Gene saw himself as a leader even in captivity, working hard to maintain hope in his small and dwindling group. "He was the highest-ranking person in there, so he felt like he had to keep up the spirits of the other men," says Naomi. "He would sing and whistle, things like that. They tried to make cards and told each other stories -- all the things that prisoners of war always do."

Now 94 and living in the health care section of Meadowood, a retirement community in Bloomington, Ind., Gene can relax and let other people help him for a change. ""He couldn't get along at all now if he didn't have these people to take care of him," Naomi says of the nursing assistants who assist Gene. "He's just too weak. He walks with a walker and has trouble standing up, so he needs help with bathing and getting dressed and so forth. I'm 92 myself, so if I were trying to take care of him, I'd be completely overwhelmed. I don't know what we'd do without them."

The nursing assistants who help Gene with those personal care tasks are part of a growing army themselves. About 4 million nursing assistants, home health and home care aides, personal care aides and other front-line caregivers currently provide personal and health care services in the U.S., assisting people in nursing homes and other institutions as well as in their own homes. Their ranks are expected to swell by about 1.5 million by 2020, making these workers one of the fastest-growing workforces in the nation. That's mainly due to the aging of the baby boomers, but thousands of elderly or wounded veterans also need long-term care and services.

"They're very caring, very cheerful," Naomi says of the nursing assistants who help care for Gene. "The people who do this work do it because they want to help people." But by choosing to help other people, direct care workers put their own families in financial jeopardy. Nationwide, they average just $10.59 an hour, and about 47 percent live in households that rely on Medicaid, food stamps or other government assistance.

The situation is particularly difficult for home care workers, who have lower wages than their peers in institutional settings (less than $10 an hour on average) and higher rates of uninsurance (about 38 percent of home care workers employed by agencies have no health insurance, compared with about 27 percent of the nursing assistants in nursing homes). Worse yet, home care workers are not even guaranteed minimum wage and overtime pay under the federal Fair Labor Standards Act.

It's time we closed the circle of care and made sure all direct care workers earn a living wage and basic labor protections. If we don't do right by our caregivers, how can we expect them to do right by the veterans who have sacrificed so much for us?