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This is an awkward time to promise home care workers a raise

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One clue to what Donald Trump might think about the importance of long-term care services is that Jamaica, New York, is home to a 228-bed nursing home named after his mother, Mary Trump.

Trump and his father, Fred Trump, donated some of the money used to build the facility

Hillary Clinton also helped cement her ties with labor organizations during the primary season by meeting with home care workers.

Related: Hillary Clinton courts home care workers

On the day Clinton accepted the Democratic nomination, the organizers of the Democratic National Convention started the main-stage events by sending out Henrietta Ivey, a Michigan home care worker who’s been campaigning to make the minimum wage for home care workers like her $15 per hour.

“I work two jobs at minimum wage and can barely make ends meet,” Ivey said. “No working American family should have to be forced to live in poverty.”

On the one hand, it’s great that both Trump and Clinton have an interest in long-term care issues (and running mates with practices experience with long-term care finance issues).

On the other hand, that Democrats think this is a good time to intentionally increase all home care workers’ hourly wage to $15 per hour seems… impractical.

In the real world, many families struggling to pay for home health care already strongly prefer undocumented workers to licensed aides, because the hourly costs and paperwork associated with obeying the rules are so daunting. Even today, when the country has a reasonable ability to pay for long-term care services, it seems as if raising the minimum wage might simply further increase the appeal of off-the-books workers, not do much to help the finances of people like Henrietta Ivey, who are working within the official system for the conscientious, law-abiding employers.

In 20 years, when large numbers of baby boomers are moving into the oldest-old stage of life, the idea of trying to use something as flimsy as a minimum-wage law to control the Silver Tsunami may be about as practical as trying to control the ocean with a teaspoon. We’ll want to do this. We’ll want to do that. Peep peep peep, we’ll say, as the ocean washes over us.

On the third hand, what kind of monsters are we if we treat the people who care for our elders badly? How can we expect badly treated long-term care workers to provide anything like decent care?

I think the answer is that we have to be enthusiastic about copying Japan’s efforts to develop robots that can help with providing long-term care; investing in electronic exoskeletons and similar products from companies like ReWalk that might help make older people with disabilities more mobile; and creating the laws, zoning rules and other physical and regulatory infrastructure needed to help older people move into small, cosy group homes.

If large numbers of Americans want to “age at home,” we’ll probably have to redefine “home.”

In a few decades, we may have many more people who need care, and much less inflation-adjusted cash per person who needs care. The way to cope with that math, while making sure home care workers get a decent wage, is to give home care workers to care for several people at the same time without breaking a sweat.

But people should have the option of living in casual homes that really feel like homes, not hospital wings, without all of the costly red tape that might apply to an assisted living facility, and without all of the ugly pink and blue wallpaper and stiff furniture that finds its way into so many long-term care facilities.


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