Preparing for the Elder Boom: Ai-jen Poo on Workforce Demands and Living a Better Life

2015.2.24.Flanders.MainAi-jen Poo, director of the National Domestic Workers Alliance and co-founder of Domestic Workers United. (Photo: Jobs with Justice / Flickr)Want to challenge injustice and make real change happen? That’s Truthout’s goal – support our work with a donation today!

“Caring for an elderly family member involves such a wide range of skills and expertise that only a superhuman person could do it,” writes Ai-jen Poo in her first book.

Lifting, medicating, filing 20-page government assistant forms, managing schedules … “It’s virtually impossible for one person to do it all. Yet, tens of millions of Americans, and millions more in years to come, are individually called upon to juggle all of those tasks,” she writes.

When those people aren’t family members, they tend to be some of the least protected and most precarious people in our economy: domestic workers.

Ai-jen Poo is director of the National Domestic Workers Alliance and co-founder of Domestic Workers United, the organization that spearheaded New York’s historic Domestic Workers Bill of Rights. Her book, just released, is called The Age of Dignity: Preparing for an Elder-Boom in a Changing America.

We could, and we’d better, start managing aging differently, says Poo. “We need to put care at the center.” And if we did that, we’d be well on the way to restructuring our entire economy in a positive way.

How do we get there? Poo looks to models in Japan and Germany, and the “village” movement that’s growing across the United States in which seniors are sharing resources and skills and purchasing power.

“Workers, consumers, families, employers … We actually all need each other,” says Poo. “What we’re trying to do is model a way of thinking about how we come together to create the economy of the future that recognizes everyone’s dignity.”

Ai-jen Poo is the recipient of a 2014 MacArthur “Genius” Award. We spoke in February in New York. Watch the conversation on The Laura Flanders Show, seen 9 pm Fridays on KCET/LINKtv; in English and Spanish on TeleSUR, or online, with all our archives at


Laura Flanders: Thanks for coming in. What is the picture on the front of the book?

Ai-jen Poo: It is the tree of life.

And why is that sitting there?

It’s about re-thinking how we live well, through every stage of life. This book talks about lots of demographic changes and the fact that there’s no question that the country is aging. It really poses the question, how do we live well as we age in the 21st century given all the change that’s happening around us.

How are we aging these days? First off what’s the elder boom? Then how are we actually managing it right now?

The elder boom is a direct product of the baby boomer generation reaching retirement age at a rate of about 10,000 people per day. In 2015, 4 million Americans will turn 65. My grandmother’s demographic of 87 and older is the fastest growing demographic in the country because people are living longer as a result of advances in healthcare and medicine. By 2030, we will have 20% of our population over the age of 65.

Who is the burden of all that falling on?

It’s really affecting all of us. Rosalynn Carter once said that there’s only 4 kinds of people in the world. People that are caregivers, or will be caregivers; people who need caregivers, or will need caregivers, and most of us are probably more than one of those identities at any given moment. I think that’s actually more true than ever before. By the year 2050, 27 million Americans will need some form of long term care assistance just to meet their basic daily needs. It’s an all-hands-on-deck situation where we’re going to need more families to step up, more individuals to prepare better, and more of a workforce. The caregiving workforce has to be stronger and larger than ever before.

Who are the majority of our caregiving workforce right now? Domestic workers is a pretty broad term.

It is: there’s the direct care workforce which is everyone who cares for, or whose paid profession is to support, either an elder or a person with a disability. A total of about 3 million workers. That’s not including everyone who’s working in the shadows, in the gray – they call it the gray market. It is a workforce that is many women of color, many immigrant women, and one where the average wages are under $9 an hour – and one that is not even protected by our basic minimum wage and overtime laws. It’s poverty wages, high rates of turnover and burnout because of just how challenging the work is and how isolating it is, completely undervalued and really unstable as a result.

How is it getting paid for? I’ve spoken to some of the people in this equation, the workers are not getting paid enough because the people who are trying to pay for their services are very strapped, too. Many of them, not all.

Everyone’s struggling in this equation. The workers are struggling to survive off of poverty wages; families are struggling to afford the care that they need – and right now we have no public program to support our long term care needs. It’s shocking that in 2015 we don’t have anything in place. If you’re very wealthy, you could afford long term care insurance, but even that often doesn’t cover what you need. If you’re very, very poor you could be eligible for Medicaid, but oftentimes that doesn’t support what you need, especially if you don’t want to go to a nursing home. There’s millions of us who are caught in this gap, really struggling to figure out how we’re going to get these basic care needs met.

You talk in the book about what you’ve learned from your mother and you grandmother and how this came to be your issue. You’ve touched on that here but how did it get to be so personal for you?

It’s spending almost the last 20 years working alongside domestic workers and just seeing the enormous pride that they take in the work that they do and the enormous disconnect between that – what they give to our families every day – and how our society and our economy actually values them and their work. On top of that, I had the great fortune of growing up with my grandparents really involved in my childhood. My grandfather ended up in the last 3 months of his life spending them in a nursing home where he was alone and afraid. I will never forget the images of visiting him there and what it felt like to see him dying inside. He wanted to stay at home – that’s what he wanted. We weren’t able to give that to him.

On the other hand, my grandmother who I’m going to visit tomorrow in LA and celebrate our birthdays together – she lives life on her own terms at 89. She goes to church twice a week; she sings in the church senior choir; she’s got a ma-jong group; she gets her hair done, permed, once a month. She’s still living well because she’s supported by a home care worker. It came full circle for me: that if we were to really value this work that’s so fundamental to families getting the support they need. It’s about valuing the people like my grandmother who we love, who cared for us, and it strengthens the economy.

What are the roots that you’ve discovered of this undervaluing? You quote Governor Paterson of New York when you were trying to pass the Domestic Workers Bill of Rights, and what he said about the origins of the way that we don’t protect domestic workers.

He talks about it and we talk about it as part of a long legacy of racism embedded in our laws.

How so?

In the 1930s … A lot of people don’t know this history. When the New Deal was passed along with our cornerstone labor protections like the Fair Labor Standards Act or the National Labor Relations Act, Southern members of Congress refused to sign onto those bills if they included protections for farm workers and domestic workers – who were, of course, African American, at the time. In a concession to those members of Congress from the South, Congress passed all of those bills with those exclusions in place. We’re still struggling to this day to gain minimum wage and overtime protections for home care workers. They’re still excluded under this loophole called the Companionship Exemption, which is all about not recognizing this work as real work.

I remember that we talked about this for an article that I wrote for The Nation: “Can Caring Across Generations Change the World?”

That’s right.

Back, I guess about a year after Barack Obama had been elected. The expectation was this would be changed on his watch.

Yes. He committed to it. Both Secretaries of Labor have committed to it, moved it forward, and it was supposed to go into effect, that 2 million home care workers would be protected on January 1, 2015 under basic wage and hour laws. Until a lawsuit in DC District Court essentially got onto the desk of a judge who essentially vacated the entire rule. We’re now really fighting to appeal that decision and really figure out how is it that after 75 years of exclusion, in 2015 – when we need to be strengthening and growing this workforce – we’re still fighting for these basic protections.

While we’re talking about obstacles your movement took another hit, or should I say we all took another hit when in the Supreme Court case Harris vs. Quinn it looked as if they were once again undermining the rights of domestic workers. In a nutshell, could you explain what happened there?

There’s a lot of misunderstanding about the role of unions in our popular culture. I would say the home care unions in particular. The home care union in Illinois – I was there for the 30th anniversary of the founding of it and met some of the founders who are now in their 90ss, pushing 100 – African-American women who migrated from Mississippi and Alabama to Chicago in search of a better life for their families, doing caregiving work because they loved to take care of people, earning $0.50, $1, $1.50 an hour. They formed this organization because they believe in the profession, the dignity of this work. Through having a union, they were able to increase their wages from something like $2 an hour to $12 and establish a training program and make this work better, improve the quality of care.

It really has been a win-win to have these jobs be recognized, dignified jobs. This court case really highlighted one very particular aspect of unionization, which is that unions are negotiating for wages, training, and all kinds of benefits for the entire workforce. As a result, they’re taking a portion to support union programming out of wages. Somebody didn’t want that to happen and the case went all the way up to the Supreme Court. But the truth of the matter is the union still exists and people are joining because it really was the path out of poverty for this workforce and for many it still is.

Let’s talk about your strategies for how we change the situation. Clearly we need major change and we need it fast. You talk about a “care grid.” Maybe you could lay out some of the policy components of that. Then I want to talk about who the components are of your alliance and where the stumbling blocks are with that. First the “care grid.”

The care grid is a kind of all-hands-on-deck. Communities, families, public policy makers, all of us, private sector, non-profits, coming together and establishing an infrastructure that supports care in three dimensions: Accessibility and affordability for families, high quality care, and high quality jobs for the workforce. Those are three core components of the care grid for the future. We think that it’s going to be everything from the village movement that’s growing around the country where seniors are forming communities and through sharing, essentially, resources and skills and purchasing power, they’re able to do everything from strengthen their caregiving supports to buy groceries at a reduced rate, to actually supporting transportation. Villages are one example of a community-based solution.

An example of a public policy solution is the Keep Me Home Initiative in Maine where they have a comprehensive policy agenda to support seniors to age in place. It includes everything from changing transportation systems to raising wages for caregivers. We are going around the country asking families to have a conversation about how they’re going to prepare for their future caregiving needs. We’re asking families to talk to each other about making plans for the future, and also thinking about what they imagine will be the joy of caring for one another in the future so we can all turn towards the solutions we need and also call upon our elected officials to create the public policy infrastructure and supports that we need.

That’s going to take more than just a movement around domestic workers. You’re describing a movement that is way broader than just the workers’ movement.

That’s right.

It goes, or it takes me back to your Tree of Life idea of how are we living our lives? For many of us, we have our careers, have our jobs, and then we think “Oh my gosh, about now I better start worrying about the future and about care, or maybe my parents’ care or my kids.’” You talk about the “sandwich” generation. What you’re describing is a fundamental shift in how we think about all of our lives. Does it have implications for the way we structure the economy too?

Absolutely. The fact of the matter is that the interests of consumers, in this case seniors and people with disabilities, and the families that they’re a part of, the workers who care for those families, and the families that they’re a part of are completely interdependent. There’s no way around the connection between a worker being able to live and support their family on their wages and the quality of care they’re able to provide for the people that they support. It’s completely interconnected and interdependent. If we’re going to solve the caregiving needs of the country for the future, we have to think about those interests as one. The truth is that in the economy at large we are actually all interdependent. Whether it’s as immediate as you feel it in the family structure, workers, consumers, families, employers … We actually all need each other. The care movement, the caring majority that we’re trying to build through Caring Across Generations, what we’re trying to do is model a way of thinking about how we come together to create the economy of the future that recognizes everyone’s dignity.

It’s a kind of post-industrial model of how you make progress. You talked about unions, I know you’re a union supporter, but this is not a union model where you do collective bargaining and try to get a bonus or a boon for your group. You’re talking about something else. How do you support it? Harold Meyerson writing at the beginning of the year talked about the dangers of this model also because how do you raise your funds if you’re not about organizing tons of people to be members and pay dues?

The AARP is a membership organization where people pay dues. When people believe in something, they contribute to it. We hope to have a movement where that is the case. We also hope to have a movement that really meets people’s needs, where people can really see their hopes and dreams reflected back and that they’ll invest in the movement as part of an investment or a down payment in the future they want to see.

Is there a model out there in the world in addition to the village movement here in the States that inspires you?

There’s so much. Japan and Germany have long-term care as a part of a holistic social insurance program that they have, that is about healthcare and retirement security and all in one. I think that kind of a holistic program where you can expect some universalisms actually makes a lot of sense, particularly in an economy where so much is changing, where work is changing and so many people are working in temporary or part time or self-employed contexts. We need to establish more of a universal baseline, a 21st century safety net, so to speak, that acknowledges the varied ways in which people are working in this economy.

Imagine yourself at 80. What’s your fantasy, your vision where you’re trying to get?

In the book, I do this exercise because my friend Sara Horowitz from the Freelancers Union always asks me to do this exercise – which is to imagine if we could just erase, wipe the slate clean, what would we want our futures to look like? I was thinking it wouldn’t be so, so different in that it would involve a lot of yoga, friends, community. But I think what felt different about imagining it in my book was just the notion that through every stage of life we would be connected, connected to other people, connected to other generations, and that we would have the support we need and the resources and the resources in terms of relationships. We need to live well, with dignity. For me, that means yoga and gardening and happy hour. For everybody it will mean different things with some universal sense of support there.

Ai-jen, thank you so much. And thank you for the book, The Age of Dignity, Preparing for the Elder-Boom in the Changing America, it’s just out. Great to have you.

Thank you.

Thank you.

Ai-jen Poo’s book is The Age of Dignity: Preparing for an Elder-Boom in a Changing America. For schedule and guest information from The Laura Flanders Show, subscribe at