Direct Caregiving in Older Adults: How Systems of Care Perpetuate the Grand Challenges and What Social Workers Can Do about It
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Nancy Kusmaul, Stephanie P Wladkowski, Direct Caregiving in Older Adults: How Systems of Care Perpetuate the Grand Challenges and What Social Workers Can Do about It, Health & Social Work, Volume 46, Issue 3, August 2021, Pages 218–226, https://doi.org/10.1093/hsw/hlab017
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Abstract
Direct care workers (DCWs) provide personal care, emotional support, and
companionship, helping older adults maintain quality lives (Phillips, 2016). DCWs earn low
wages, have little training, and experience high turnover rates (Dawson, 2016). While the
demand for DCWs grows, real wages continue to fall. Undervaluing DCWs threatens the
continuity and quality of care older adults receive (Espinosa, 2017). Through the social work
grand challenges lens, this paper discusses two qualitative studies, in home care (n=24) and in
nursing homes (n=23) that demonstrate that while DCWs help advance long and productive
lives, they experience extreme economic inequality and lack equal opportunity and justice. We
conclude with a discussion of social work’s role in advancing opportunity and justice.