Our elders—grandparents, aging parents–require assistance with daily living activities, after a certain threshold. Even the most active seniors will, if the live long enough, reach an age where they require help dressing, showering, cooking, cleaning and depending on health, possibly even diaper changes. Though some dedicated and loving kids do all of this caregiving alone (not easy.) Most require a Home Care Assistant to help them on a regular basis. Even with such help, the amount of work left for the “kids” to do is fairly time consuming. But the unsung hero/villan of it all is the Home Care Worker. The person who will come into your parent’s home (group home or assisted living facility) and wipe their butts, cater too every persnickity whim and make life more manageable (and hopefully, enjoyable) for the elder.

How much would you expect to be paid to lift little old ladies who weigh more than 140lbs., regularly? How much would you want to paid to change an adult size diaper several times a day? How much would you want to be paid to be a personal assistant and errand boy to someone (cooking, cleaning, groceries, drug store, TV remote across the room, cell phone from upstairs, etc)? Oh yeah, and all the while you should keep a happy upbeat demeanor, no matter what your patient may say to offend or belittle you. It’s a HARD job. How about $10 an hour? Is that really enough?

Homecare workers are actually not even guaranteed $10/hr. That is the going rate at the moment whether you are in New York City or Richmond, VA. Strange, right? Most salaries vary slightly because of cost of living can vary so much city to city. But not for Home Care Workers, who according to U.S. Dept of Labor Wage and Hour Division, were not guaranteed minimum wage or overtime until September 2013. So, up until last year, Home Care Workers could get as little as $5 an hour, because no one was required to even give you minimum wage.

What kind of standard of care are we asking for our elders?

Not surprising, turnover is a huge issue in Home Care Workers. According to University of New Hampshire Policy Brief for the Carsey Institute, “High turnover rates are common among the home care workforce. The majority of direct care employers in new Hampshire agree that turnover is a problem and state that they need to hire one or more home care workers to meet current service demands. High turnover in this workforce contributes to lower-quality care.”

What does lower quality care look like?

According to the Federal Administration on Aging, “Each year hundreds of thousands of older persons are abused, neglected, and exploited.” Not just hundreds or thousands, but 100s of thousands of reported cases. How many more go unreported or fall JUST beneath the threshold of “Elder Abuse,” yet still make life miserable for the elder patient? According to the Elder Abuse Study of 1998, “reported elder abuse cases make up only the “tip of the iceberg.” The study estimates the incidence of older persons that were newly abused, neglected, and/or exploited, or experienced self-neglect, in domestic settings in 1996 to be at least half a million older persons. The study also found that for every reported incident of elder abuse, neglect, exploitation, or self-neglect, approximately five go unreported.”

So, we pay the people who will “take care” of our parents and grandparents, $10/hr, which is close to $20,000 per year (if they are lucky enough to find full time work). That salary still qualifies you for food stamps and general assistance in some places. They are to take care of our elders with no protections of us taking care of them by demanding better wages. In fact, our government does not provide them as much protection (minimum wage, overtime, sick time) as we offer janitors, waitresses and even fast food workers. And then, we are dismayed and ashamed that elder abuse is so high. Do we really have the right?

This is a capitalist society. You get what you pay for and a sucker is born every minute. So we are suckered into believing we can shaft an entire class of people from the American dream and they will still be the perfect ray of sunshine and assistance for our elders. You get what you pay for and you get back what you put out. Put out compassion, friendliness and a decent and consistent rate of pay and your elders have a better chance of receiving the level of care they actually need.

And just a tip: If you are paying less because that is all you can afford (the hours of care do add up), then, try to find bonuses to show that your caregiver is appreciated. Don’t forget birthdays, mother’s day, secretary’s day (close enough to warrant a massage gift certificate to say we appreciate you. Come on, find one on Groupon for $20 and be done). Those little acts of kindness and extra thank you’s go a long way. So does checking in and on your elder frequently. If you leave the hungry cat minding the bird cage with no supervision, you cannot be surprised by the bird’s state when you return.