Decent Care

Earlier this year, we took a big step toward decency. Let me tell you why.

In the late 1990s, a "McJob" ‒- a low paid job with few future prospects, like a fast-food job ‒- was the most common way to earn a living in the United States. Quietly and quickly, the fastest growing job category has shifted to a form of work that is far less visible and, until now, far more precarious: home health aide.

For many of us, the mention of home health aide may bring to mind a bouncy 18-year-old girl in a candy striper uniform ‒- but we would be wrong. Home health aides are overwhelmingly female, overwhelmingly women of color and are women, not girls, often with families of their own. Up until now they have worked in the "shadow economy": a barely-regulated space lacking all of the protections of even a McJob. No insurance, no minimum wage and no overtime protection.

Up until September 17, 2013, this work has been treated as not work, or at least not work that rises to the level of receiving federal protections for workers. This shadowy, off-the-record approach to home health work has had several costs. First, it linked home health aides' labor to a long history of underpaid, indentured and enslaved labor in the home. Second, it reduced the complex work of caring for dependent adults to something that women ‒ and particularly women of color ‒- are naturally good at doing. Why pay well for work that is intrinsically rewarding? And finally, it was indecent. Failing to offer even the most minimal support and defenses to the people who work to care for the most frail among us is a sorry statement on our society. It devalues care, the home and frail people in one fell swoop.

Thanks to a suit introduced in 2007 by the late Evelyn Coke, a home care aide in Queens, home health workers will finally have federal rights. Coke worked for most of her life in other people's houses to make sure their bodies were clean, clothed, safe and fed, but she never had the protection of the Fair Labor Standards Act. This recent legal victory moves Coke's compatriots one step away from servants, elevating them to the status of a McJob.

This major victory is one more step toward decency. Labor rights activists often work toward dignity (and I'm not sure we are there yet) but when it comes to decency, we have made progress. Home health aides link back to a tradition of capitalizing on the caring labor of racial minority women in homes by paying poorly or not paying at all for their service and sometimes-loving care. Racial minority women ‒- and particularly recent immigrant women ‒- have often been employed in informal labor arrangements that included extraordinarily long days, working on holidays, wages well below the minimum wage and absolutely no access to recourse if they were treated unfairly. Evelyn Coke's victory moves us one step away from that history.

We talk about decent service and care, but until the passage of this law, we have not had the decency as a society to protect or even recognize the emotional, spiritual, psychological and physical labor of the people who work in our homes and aide us in simply being people. Home health aides are the quiet assistants who ready us for living if we are recovering from an injury or need help with the activities of daily living and the management of disease. They ride buses and drive their own cars to the homes of (mainly) elderly or any person who needs help to get through their day.

And there are sacrifices. As shadow economy workers, they are routinely in danger of exploitation, injury and abuse. They spend hours bent over, raising and turning bodies, cleaning sheets, changing clothes, ministering to others. They did not get their full due with this ruling, but they did move a giant step closer to being treated decently, which after all is what we expect and ask from them every day.

This decision will be remembered for years to come. It is a huge victory. Here's hoping we use this moment of decency to honor, and begin to offer support for, the people who care for us during our most vulnerable stages of life.

Karla A. Erickson is an Associate Professor in the Department of Sociology at Grinnell College. She is the author of the forthcoming book 'How We Die Now'.