Formerly IGSW News | VOLUME 23 | SUMMER 2016

From the Director

Summer reading

PHI Report and One Worker's Story
Illuminate Worsening Crisis in Care

By Scott Miyake Geron

ScottThe same day I read "Raise the Floor: Quality Nursing Home Care Depends on Quality Jobs," a new report from the Paraprofessional Healthcare Institute, I also came across "The Cost of Caring," the true story of one immigrant woman and her life as a direct-care provider, in a new issue of The New Yorker magazine. It was a thought-provoking combination.

The report is the latest from PHI, the policy and advocacy organization, in their ongoing battle to improve long-term services and supports. They work on the national front, to create jobs that foster dignity, respect, and independence both for those who need services and for the frontline workers who provide it, increasingly in the home and community as well as in institutions. The report lays out the latest numbers that describe a current and worsening crisis in care: aging boomer generation, shrinking labor pool, and poverty-wage jobs. To stabilize the workforce: competitive wages, health coverage, consistent hours. To improve outcomes and stem the tide of turnover: better training, support, and opportunities for professional growth.

"The Cost of Caring," by Rachel Aviv, addresses the same crisis, but in a different way. In a personal, in-depth profile, a signature feature of the venerable New Yorker, we come to know Emma. She is a college graduate in the Philippines and becomes one of the many women who journey to the United States to work as home health aides, nursing assistants, and nannies so that they can send money home. Like so many of her compatriots, Emma sees no other way to meet her struggling family's expenses and send her children (nine daughters) to school. She arrives in 2000 with the intention of staying only a short time, but the family's needs increase. We follow her through a series of caregiving jobs over the next 16 years. She provides loving care to other people's families in New York, while mothering her own children over the phone, on Facebook, and through the money and care packages she continues to send to them in the Philippines. Emma works for less than minimum wage, sharing bunk beds in small apartments with other Filipinas in the same situation. But the deprivation that haunts her is the lost time with her children.

Each of these selections compellingly underlines the imperative for change that is long overdue. I hope that both will have many summer readers.

Scott Miyake Geron, Ph.D., is director of CADER and associate professor, School of Social Work, Boston University.

Boston University photo of Scott Miyake Geron

Back to Front Page

Copyright © 2016 Trustees of Boston University. All rights reserved. This article may not be duplicated or distributed in any form without written permission from the publisher: Center for Aging & Disability Education & Research, Boston University School of Social Work, 264 Bay State Road, Boston, MA 02215, U.S.A.; e-mail: