While investments in public health during the last century mean that Americans are living, on average, more than 25 years longer, similar investments in the infrastructure needed to care for an older population are lagging behind.
The shortage of direct care workers, in particular, . Nationwide, the median wage for direct care workers is a little more than $14 per hour. It's also known for .
These are the people you might call if your father has a catheter and needs help bathing, or your grandmother can no longer vacuum and needs help with housekeeping and meals.
鈥淚 make $18 an hour after 30 years. I can go to ALDI鈥檚 and start at $17 stocking shelves. It's very disheartening to think that that's all we're worth.鈥�Patti Merrill, certified nursing assistant
The people who do this work are mostly women. Outside Vermont, they鈥檙e often women of color and immigrants. They鈥檙e undervalued and overworked.
Federal data show since January 2020, have quit, citing the pandemic as well as low pay and lack of opportunities to advance.
That comes as America and Vermont ages. By 2060, the population of adults age 85 and older in the U.S. is expected to triple. But the number of adults aged 18 to 64 who could be potential caregivers is expected to remain about the same.
Melissa Fox, licensed nursing assistant for 32 years
If you want to pay out-of-pocket for this kind of help, you might call your local visiting nurses. At the , which serves Rutland and Bennington counties, waitlists for home health and personal care aids are 25 to 30 names long.
Melissa Fox is a licensed nursing assistant who鈥檚 also certified in hospice care. She lives in Pittsford and has been with the VNA for 32 years.
Her days start early, often before 7 a.m. Most mornings, she says goodbye to three cats, gets in her car and drives to her first appointment.
On this particular morning, it鈥檚 a gentleman with quadriplegia whom she visits three days a week. Before she even leaves the car, Fox checks in to work with her iPhone. The GPS tracks her throughout the day, and is used as a safeguard to ensure caregivers visit each patient on their list.
Then she grabs her bag, gloves and her mask and heads inside.
"So I help him with his catheter care. Actually, I don鈥檛 just help him, I do it because he can鈥檛. He鈥檚 what we call total care,鈥� Fox explains. 鈥淭hen, getting him cleaned up and dressed. And then I鈥檒l get his breakfast for him. So he鈥檚 able to come out and go through the day, and live like we take for granted, basically.鈥�
Fox says her work varies from client to client. Many she鈥檚 taken care of for months.
She works full-time, so she earns benefits. She also earns 50 cents per mile along with quarterly stipends to cover transportation.
Her last stop of the day is a woman who鈥檚 getting hospice care.
鈥淚鈥檒l be heading in to get her cleaned up. She鈥檚 a bed bath client, dementia, Alzheimer鈥檚 鈥� not a lot of communication,鈥� Fox says. 鈥淏ut she does smile. She does holler also, but she鈥檚 a wonderful person.鈥�
Fox says most days, she sees five to seven patients and is back home to her cats by 4 p.m.
That last patient, the one with Alzheimer鈥檚, has since passed away. Fox says letting go is one of the hardest parts of the job.
鈥淧atients become like family, especially when we鈥檝e spent months caring for them," she says.
She鈥檚 often been asked why she hasn鈥檛 become a registered nurse, since they earn almost twice as much an hour. She doesn鈥檛 like all the paperwork, she says, the time on the computer. She likes being hands-on, and she thinks she was called to this work, that God had a hand in it.
鈥淚 like that I鈥檓 helping people. I mean, it's rewarding, it truly is. And I'm good at it," Fox says.
After 32 years, Fox earns less than $20 an hour.
Patti Merrill, certified nursing assistant for 29 years
Patti Merrill also works for the VNA & Hospice of the Southwest Region. She鈥檚 been a certified nursing assistant since 1993, and in her West Rutland living room, she talks about the ups and downs of the job.
"For some people, you're the only outside world they have,鈥� she explains. 鈥淪o you know, they want to talk, they want to visit, and that鈥檚 the hard part, because that鈥檚 all they want to do. And you know, you can鈥檛 do that, you鈥檝e got to be able to do your job, so you kind of have to work both of them in.鈥�
Merrill turned 60 this year. She says her clients used to always remark that she looked much younger than her age. But next year will mark 30 years with the visiting nurses.
鈥淵ou know, it's getting to the end where you鈥檙e just, been doing it so long, your body says enough," she says. "It's rough on the back. And that鈥檚 your biggest thing, because if you blow your back out, you're done. Because we lift on people. I'm 5 feet tall. And when you get somebody that's 5 feet 7 or 5 feet 8, it's hard."
Asked about the shortage of caregivers like her, Merrill nods.
鈥淚n fact, we had another one that just put in her notice," she says. "So it's like, five within the last two to three weeks. I think they're burned out. The driving, the price of gas, the lack of money.鈥�
鈥淚 make $18 an hour after 30 years,鈥� Merrill says. 鈥淚 can go to ALDI鈥檚 and start at $17 stocking shelves. It's very disheartening to think that that's all we're worth.鈥�
Despite the low wages, she says she can鈥檛 imagine not going to work or protesting with a strike.
鈥淚 can't do that to my clients,鈥� she says. 鈥淭hat鈥檚 the hard part. I can't walk away from them. Not right now. As much as I want to, I just can't, because some of them don't have anybody."
Merrill says most days her husband asks her if she has quit.
"He does, every day he asks me," she says. "But I鈥檓 not there yet.鈥�
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