Many women inhabit the world of "long-term care," the system that provides services and supports to help individuals live with functional decline. The welfare of these women deserves particular attention during our nation's trifecta of May celebrations: Mother's Day, Older Americans Month, and National Women's Heath Week.
National Women's Health Week is a relative newcomer to the list of May's annual festivities. But its goal to "empower women to make health a priority" should be embraced by those of us who provide services and supports to older adults, whether we do this as caring professionals or dedicated family members.
Empowering Older Women
It goes without saying that older women need to be empowered. They make up the vast majority of individuals receiving services and supports in nursing homes and assisted living communities, and in their own homes. AARP reports that women are also 60% more likely than men to need assistance with the daily activities -- like eating, bathing and dressing -- that most of us take for granted.
These older women deserve to live with dignity, self-determination and independence, even as they struggle to manage chronic illness, frailty and cognitive impairment. They also deserve a long-term care system that is integrated with our health care system so they can receive coordinated care to address both their acute and chronic illnesses.
Empowering Family Caregivers
While we're at it, the daughters, granddaughters, sisters and nieces of these older women could use a little empowerment of their own.
Two-thirds of the 43.5 million family members who care for older adults are women, according to the Family Caregiver Alliance. Many of these family caregivers are older women who spend their later years caring for husbands or very old relatives.
We expect a lot from these women. They're supposed to be there for an aging relative, day or night, to carry out time-consuming, burdensome, and increasingly technical caregiving responsibilities.
We expect older women to carry out their caregiving responsibilities while they deal with their own aging-related issues. We expect younger women to provide this care while they raise their children, pursue careers and, frankly, live their lives.
Is it any surprise that women manage all this while putting their own health and well being at risk?
The nation is beginning to focus on the health needs of family caregivers, and that work needs to continue. We have to ensure that these women don't make themselves sick while helping others remain healthy. Reaching that goal will mean finding the dollars to offer these caregivers easy and affordable access to a host of services, ranging from support groups and preventive health services to counseling and respite.
Empowering Paid Caregivers
The challenges facing a third group of women are dearest to my heart, probably because they tend to get the least attention.
We call these women "formal caregivers" or "direct care workers." They are the women who provide the bulk of the hands-on care provided to older adults by nursing homes, assisted living communities and home health agencies.
Think of the woman who helps your mother get out of her nursing home bed each morning. Maybe your caregiver comes into your mom's home to cook her meals or do her laundry. She may take your mom to the grocery store or the doctor. Along the way, she most certainly provides critical social interaction that keeps your mom from becoming too isolated.
Direct care workers get paid, but not nearly enough. Many qualify as "working poor" because they earn only a minimum wage. Some have incomes low enough to qualify them for food stamps and other government benefits.
Stress is the main health-related byproduct of their jobs, as they care for older adults with varied and serious health and cognitive issues -- all the while managing their own financial and family-related challenges.
Their physically taxing work, which involves lifting and transferring care recipients, often results in injury. As I reported in "The Long-Term Care Workforce: From Accidental to Valued Profession," direct care workers in nursing homes have higher workplace injury rates than either construction workers or truck drivers.
I'm most troubled by the fact that these workers don't have the tools they need to take care of their health. Many have limited access to employee benefits -- including the health insurance coverage and sick leave that would allow them to either prevent illness or heal quickly when illness occurs.
The Cost of Caregiving
Each Mother's Day, most of us take time to let our female relatives know how important they are to us. During Older Americans Month, we attend activities designed to thank older people for their contributions to our country.
Maybe it's time to use National Women's Health Week to show some appreciation for the women who care for aging Americans. I'd recommend these steps:
- Take time to get to know the woman who is providing care for your older relative.
- Calculate the price you pay for the benefits that your caregiver provides to you and your relative.
- Estimate the price your caregiver pays as she provides the services you count on. When you tally that price, be sure to include the toll that low wages, stress, physical injury and diminished health are taking on that worker's quality of life.
- Decide how you will even the score. (You're likely to come out the winner.)
The best way to complete step 4 is to become an advocate for your paid caregiver. Advocates care about the issues affecting the people who care for their relatives. They decide to become part of the solution. And then they take some meaningful action.
That action could take a variety of forms.
You could simply show your appreciation for the work your caregiver does each day.
You could actively support the efforts of the Eldercare Workforce Alliance and other groups dedicated to building a caring and competent eldercare workforce.
You could ask local, state or federal officials -- and long-term care providers -- to offer better compensation and health-related supports to the direct care workforce.
Think of your efforts, large or small, as the best present you could give the older woman in your life.
She's the one who will benefit most from a direct care workforce that feels valued, empowered and healthy.