Elder Care in Crisis: How the Social Safety Net Fails Families

Explains why there is a crisis in caring for elderly people and how the COVID-19 pandemic exacerbated it

Because government policies are based on an ethic of family responsibility, repeated calls to support family members caring for the burgeoning elderly population have gone unanswered. Without publicly funded long-term care services, many family caregivers cannot find relief from obligations that threaten to overwhelm them. The crisis also stems from the plight of direct care workers (nursing home assistants and home health aides), most of whom are women from racially marginalized groups who receive little respect, remuneration, or job security.

Drawing on an online support group for people caring for spouses and partners with dementia, Elder Care in Crisis examines the availability and quality of respite care (which provides temporary relief from the burdens of care), the long, tortuous process through which family members decide whether to move spouses and partners to institutions, and the likelihood that caregivers will engage in political action to demand greater public support. When the pandemic began, caregivers watched in horror as nursing homes turned into deathtraps and then locked their doors to visitors. Terrified by the possibility of loved ones in nursing homes contracting the disease or suffering from loneliness, some caregivers brought them home. Others endured the pain of leaving relatives with severe cognitive impairments at the hospital door and the difficulties of sheltering in place with people with dementia who could not understand safety regulations or describe their symptoms. Direct care workers were compelled to accept unsafe conditions or leave the labor force. At the same time, however, the disaster provided an impetus for change and helped activists and scholars develop a vision of a future in which care is central to social life.

Elder Care in Crisis exposes the harrowing state of growing old in America, offering concrete solutions and illustrating why they are necessary.

Emily K. Abel is Professor Emerita at the Fielding School of Public Health, University of California, Los Angeles. She is the author and co-author of many books, most recently, Sick and Tired: An Intimate History of Fatigue and Limited Choices: Mable Jones, a Black Children’s Nurse in a Northern White Household.