Who Cares for Them? Workers in the Home Care Industry

Who Cares for Them? Workers in the Home Care Industry

Who Cares for Them? Workers in the Home Care Industry

Who Cares for Them? Workers in the Home Care Industry


Large and growing numbers of the frail elderly and disabled depend on paid workers to assist them in daily life. Identifying critical factors that affect the work conditions and job satisfaction of the home aide work force, the authors also describe demonstration programs that document the potential for work life changes in the home care industry--changes that will improve quality of work life, reduce turnover, and contribute to greater continuity of care. Managerial strategies and the policy changes necessary to implement these innovations are thoroughly explored.


Labor markets in the United States are segmented by occupation, race, and gender. Moreover, "the labor market segments in which women are concentrated tend to be disadvantaged in terms of skill, status, security, and earnings" (OECD, 1985:38). The lower ranks of the home care industry, occupied by the home aide work force, clearly constitute a "disadvantaged segment." This chapter first describes the general labor market trends that have affected home care, then presents more detailed data on the characteristics and working conditions of the home aide work force.


The U.S. home care industry has been affected by three major structural changes that have occurred in the labor markets of the industrialized nations since World War II. First, there has been a rapid increase in the participation of women in the labor force. Second, overall employment in the service sector has overtaken that in agriculture and manufacturing. Third, and related to the preceding, the demand for part-time workers has outpaced that for full-time workers. Each of these changes will be discussed in more detail below.

Participation of Women

Between 1950 and 1980, the number of "economically active" men in the Western industrialized countries of the world grew by 25 percent, while the number of "economically active" women grew almost three times as much--by 74 percent (Paukert, 1984: 10). Although women started from a much smaller . . .

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