Direct Caregiving in Older Adults: How Systems of Care Perpetuate the Grand Challenges and What Social Workers Can Do about It

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.