The MacArthur ‘Genius’ and director of the National Domestic Workers Alliance discusses her new book, The Age of Dignity: Preparing for the Elder Boom in a Changing America.
Activist/Author Ai-jen Poo
Tavis: By 2035, 11 and a half million Americans, 11 and a half million, over 85. How do we build systems and structures to properly care for this demographic? Ai-jen is the co-author of “The Age of Dignity: Preparing for the Elder Boom in a Changing America”.
She is a MacArthur “Genius” and co-director of the campaign, Caring Across Generations. Ai-jen Poo, good to have you on this program.
Ai-jen Poo: Thank you for having me.
Tavis: Let me start by asking the obvious question. How–I was going to say bad. That’s the wrong word. How significant a challenge in terms of numbers is this going to be in the coming years?
Poo: It’s really a massive shift that many of us haven’t thought of, but is inevitable. So the baby boom generation is reaching retirement age at a rate of a person every eight seconds.
Tavis: Every eight seconds?
Poo: In 2015 alone, four million Americans will turn 65 and then people are living longer than ever because of advances in healthcare and medicine. So what that means is, by the year 2030, 20% of our population will be 65 and older, which is double what we’ve ever experienced.
Tavis: And the challenges that presents us in terms of caring for them are what?
Poo: Well, I think it’s both challenges and opportunities. On the challenge side, we have no system set up to support the 27 million people who will need long-term care, support or assistance by the year 2050.
On the opportunities side, people are living longer, which just means more time to learn and teach and work and connect and do all the things that we want to do especially across generations.
Like today, grandchildren. Millennials are more connected to their grandparents than any other generation in history and that’s potentially a good thing if we set up the supports to enable people to live well as they age. And that’s really what the book is about.
Tavis: Define for me what you mean when you say long-term care.
Poo: I mean the kinds of assistance with activities of daily living that allow for people like my grandmother who’s turning 89 soon–she actually lives in Alhambra. You know, she needs help more and more with things like shopping for groceries or making sure that all her medication is in order, getting her to appointments, cleaning, some of the heavier lifting.
And as time goes on, she’ll need more of that kind of support with activities of daily living and she may one day need more support with bathing and things like that. Long-term care workers and family caregivers provide that kind of support. So it’s not really illness, but more kind of the way that we just end up needing more support as we grow older.
Tavis: If people are living longer and they’re going to need more long-term care, I think that means there’ll be a lot of jobs available, potentially.
Poo: That is it, exactly.
Tavis: But I’m trying to square the fact that there are going to be jobs available for people to go into the field of caring for the elderly. I’m trying to juxtapose that with how little we regard and how little we pay for people in those kinds of fields of service. So make some sense of all that for me.
Poo: That is exactly the key question here, is who will take care of us and how will we value them? How will we make this a profession that is a job that you can take pride in and support your family on, where one generation can do better than the next? Because really these are the 21st century jobs of the future.
Home care is the fastest growing occupation in the country because of the huge need in our families and it could be the kind of job–just like manufacturing jobs in the 20s and 30s used to be sweat shop dangerous jobs.
A lot of immigrants did them in the shadows. And we turned those jobs into good jobs where each generation could do better. And opportunity. There are real pathways to opportunity.
That’s what these jobs can be and they must be because these are not outsourceable jobs. These jobs aren’t going anywhere and we really undervalue them. I mean, these are the jobs that make everything else possible. They make it possible for us to go to work and to know that our loved ones are cared for.
Tavis: And you’re right. They’re not outsourceable to another country and they’re not the kinds of jobs that can be done by a computer. This is a human to human kind of relationship we’re talking about, obviously.
But it raises me the question that you started to address a moment ago, which is how do we value these workers in terms of what we pay these people, these domestic care workers. Give me some sense of how–are they unionized? And how are they being treated or maltreated by society writ large?
Poo: Some are union and most are not. The average wages are around $9 an hour which, as you know, is not enough to support any family on. And oftentimes the hours are either too long or not enough hours. There’s very little control over hours and so what gets created is a situation of high rates of burnout, a lot of need for public assistance.
I was just talking to a home care worker who said she doesn’t earn enough to put nutritious meals on the table, so she often has to live off of hardboiled eggs and bananas. So in a situation where the people that we’re counting on to take care of our families can’t take care of their own or their own health. Then we know we have a real problem.
Tavis: So how are families then going to be challenged if they don’t have means? I mean, I’m trying to, you know, keep all this in context. So people are making less and less. The unemployment numbers are off the charts.
Kids go to college now, even to ivy league schools, and they come out and they can’t find the kind of job they want or the kind of job they went to school for, so they’re working–I’m not trying to diss Starbucks–but they’re working at Starbucks or working at an Apple store somewhere.
That’s not what they went to school for. So I’m trying to figure out where families are going to get the resources to take care of their own kin.
Poo: Right. Well, that’s where the opportunity lies. If we invest in a caregiving infrastructure like training, career pathways for care providers and also economic supports for families to afford the care they need like caregiving tax credits, social insurance programs that could support long-term care more comprehensively, then we actually support families to afford the care they need and workers to have a pathway to really good jobs for the future.
And that’s the win-win potential here, but we’ve got to actually make that happen.
Tavis: I’m also concerned about the flip side of all this, which is not just valuing domestic care workers, but valuing the people they’re taking care of.
Tavis: That is to say, this whole notion of elder abuse. Whenever you see one of these stories on the news about the way that, you know, certain elderly people have been maltreated, abused in facilities oftentimes–I know this personally. My mother took care of my grandmother called Big Mama, took care of Big Mama until she was almost 90 at our family home, did not want to put her into a facility.
Eventually, we had to put Big Mama in a facility because it just got to be too much for her. She couldn’t lift her by herself and get her to the bathroom and those kinds of things. So against every fiber of her being, she had to put my grandmother, Big Mama, into a home.
My mother, though–my staff knows my mother [laugh], so they know that Joyce don’t play. So was literally at that nursing home every single day and she made them turn my grandmother, turn her and clean her and all the stuff she needed, my mother was there, though, every single day to demand that.
But I wonder sometimes what happens when there aren’t family members at–and I don’t mean to demonize all these facilities or cast aspersion on them, but there are too many examples of elder people in facilities who are not being treated for and cared for the way that they should be.
Poo: That’s right. You’ve pointed to a number of problems here. One is the problem with institutions. A lot of institutions are very cold environments. My grandfather was in the same situation where he actually passed away.
He spent the last three months of his life alone and afraid in a nursing home and I still live with the feeling of deep, deep regret that that happened. He was terrified in that institution and many institutions are cold and dehumanizing in that way.
Tavis: But they’ll take your money, though.
Poo: They will, and we just need more choices. So the other problem you pointed to is that there just isn’t enough support for people who want to age in place in their homes and communities. That’s where the home care workforce comes in. If we have a workforce who can do that work, then we’re in a much better position.
The third point that you made that I thought was really important was how do we support your mom, the family caregivers, in that situation to be able to not feel isolated and to be able to fully enjoy what they’re providing, which is a real gift to their loved ones in caregiving for them?
Tavis: Tell me then about this care grid that you advance as one of the ways that we can address these issues.
Poo: It’s about us as individuals, our families, preparing, coming up with a plan. So one of the things I’m doing is I’m going on a book tour called Caring Across America and I’m asking families to take this question home with them and ask each other how can we as family develop a plan for our future caregiving needs?
And the second question is really about what do we anticipate will be the joys of caring for one another? And we focus on joy so that we actually can start to plan in a way that feels productive and not fearful and something to avoid, but something to actually look forward to.
And then I think it’s about holding our elected officials accountable. It is absolutely unfathomable that in 2015 with the boomers reaching retirement, we have no program to support long-term care comprehensively. What are we going to do?
Tavis: And what happens to Social Security?
Poo: Social Security needs to be secured, but it doesn’t cover the cost of long-term care. Anyone in this position knows that long-term care can be incredibly costly. And even if you can afford long-term care insurance, oftentimes it doesn’t cover what you need.
So we need to secure Social Security, but we also need additional supports because caregiving is really a big piece of the capacity that’s needed for the future.
Tavis: So with all these challenges and opportunities that you laid out tonight, are you hopeful?
Poo: I’m incredibly hopeful. One, I’m hopeful because if ever there was a culture-driving generation, the boomers were it. And I believe that the generation who brought us rock and roll can also bring us a different approach to aging and caregiving in this country and I have no doubt that they will.
And then the question is, how can we really support the caregiving workforce for the future? We need these jobs to be good jobs that you can take pride in and they are such dignified jobs.
I’m sure you know a caregiver in your life and you know what incredible work it is. It’s hard work, it’s skilled work, and it’s work that deserves real recognition. If we can figure out those two pieces, I think we’re on the path to opportunity.
Tavis: There you go. Challenges and opportunities. The new book from Ai-jen Poo is called “The Age of Dignity: Preparing for the Elder Boom in a Changing America”. Ai-jen Poo, thanks for the work and thanks for the text.
Poo: Thank you.
Tavis: Good to have you on.
Poo: Great to be here.
Announcer: For more information on today’s show, visit Tavis Smiley at pbs.org.
[Walmart Sponsor Ad]
Announcer: And by contributions to your PBS station from viewers like you. Thank you.