Daughter Care: The Cost to Women of Long-term Care

My sister and I took care of our mother during the last months of her life. She developed fast-growing brain tumors and, mercifully, was incapacitated and bedridden for only a few months before she passed away. We quickly became exhausted and unable to physically care for her without professional help as she declined. It was a shock to discover how expensive it is to hire home health support and how little the long-term care insurance, for which she had been paying over decades, would reimburse. None of us had the financial means to pay for much support for very long. She passed quickly, but a family can rapidly become financially drained trying to care for family members. Realistically, women pay the biggest price for both elder care and childcare—as unpaid family caregivers. Roni Caryn Rabin of the New York Times writes that, as our population ages, “the essential role that daughters play in the American healthcare system is well known but has received little attention.” Rabin notes that a crisis is emerging for women and their employers as the population ages and the number of dementia patients increases. Rabin cites a recent report in JAMA Neurology that states that, “by 2030, one in five Americans will be 65 or older, and the number of older Americans living with dementia is expected to increase to 8.5 million, up from 5.5 million now.” Rabin notes that while more men have gotten involved with some care giving for older adults, the burden is not shared equally and disproportionately falls on daughters and female spouses for care of parents and in-laws. What are the costs of unpaid care giving for women? Rabin reveals the following:

  • A report from the Alzheimer’s Association states that employed women who are caregivers are seven times more likely than men to cut down from full-time to part-time employment because of care-giving duties.
  • Women are more likely to take a leave of absence from work and lose employment benefits.
  • Women are more likely to be penalized at work, or forced to quit, because of care-giving responsibilities.
  • Women are more likely to lose opportunities for advancement, retirement funding, and their ability to send kids to college because of elder-care responsibilities.
Liz O’Donnell, writing for the online journal Cogniscenti, offers this advice to daughters who are caregivers:
  • Don’t quit. The job market for women over fifty is not promising.
  • Hang in and continue to build your skills and network.
  • Protect your career and your family member.
In a previous article, I wrote about the negative impact on women’s employment levels due to care-giving responsibilities. We need comprehensive family support policies such as those available in Europe for affordable childcare, paid family leave and elder-care support. Family support policies are good for all of us and for our economy.   Photo courtesy of Chad Miller. CC by-sa 2.0  ]]>

Unfinished Business: Women Men Work Family by Anne-Marie Slaughter: A Book Review

In her book, Unfinished Business: Women Men Work Family, Anne-Marie Slaughter takes us a step further down the road to understanding why progress continues to be slow for gender equality in the workplace and what needs to change. While three years ago Sheryl Sandberg’s book, Lean In, triggered an important national conversation about the challenges women face in the workplace, it was criticized for focusing too narrowly on solutions for privileged women and too little on the different needs of working-class women. Sandberg’s book was also criticized for putting too much of the responsibility on individual women for not “leaning in” enough to progress in their careers. Slaughter takes this conversation to the next level and argues that we must take the blame off of individual women and broaden the conversation to include the issues faced by women at all income levels and in all occupations, as well as acknowledge the restrictions placed on men’s life choices by existing gender stereotypes and workplace and societal structures and policies. Slaughter suggests that we need to change our lens to talk about competition versus care or breadwinning versus caregiving, instead of talking about work-life balance. When we use this lens and this language, we begin to shift the focus from work-life balance being a middle-class women’s issue to a focus that is more inclusive and that leads to broader strategies for change. In fact, Slaughter notes that the problem is not only that there are not enough women at the top of organizations, it is also that there are too many women at the bottom—62 percent of minimum wage jobs are held by women—and some common threads cause the problem at both ends of the income ladder. Slaughter argues that the real problem is that competition, the human drive to pursue our self-interest, is valued over care, the human drive to put others first. Women and men are motivated by both competition and care. The problem is that competition, or “breadwinning,” has been defined as more valuable and as the domain of men. The domain of caregiving has been defined as women’s; discrimination against and devaluing of caregiving provides a common thread linking the experiences of women at the top and at the bottom. Here are some examples of the link provided by Slaughter:

  • A young female lawyer or banker who begins to work flexible hours to be home with her kids for dinner, or who works part time, or who steps out of the workforce for a while to be a full-time caregiver is quickly disqualified from advancing in her career. Joan Williams describes this as hitting the maternal wall. Neither her advancement nor her earning capacity will ever recover.
  • A single mother who has no choice but to be both the sole breadwinner and family caregiver is likely to be in a low-wage job with no sick leave or childcare benefits. Half of single mothers in the United States make less than $25,000 a year, and being a single mother is the single best predictor that a woman will end up in bankruptcy or poverty in old age.
  • In our society, caregivers are among the lowest-paid American workers. Low-income African American and immigrant women are heavily overrepresented in the most poorly paid care jobs.
Slaughter suggests that the solution is not to devalue competition, but to elevate the value of care in some of the following ways:
  • We need to raise the pay and benefits of care jobs to reflect a valuing of caregiving work.
  • We need to let go of old gender stereotypes and expand our language to include same-sex parents and gender identities beyond male and female.
  • We need to expand our language to talk about working parents or working caregivers rather than working mothers.
  • We need family-friendly policies, like flextime, that are more than lip service and that do not penalize the caregivers, women and men, who need and want to use them;
  • We need careers redefined to reflect the demand to customize jobs to meet the requirements of workers in different life phases without penalty.
  • Our government needs to invest in an infrastructure of care that includes subsidized high-quality and affordable childcare and elder care, paid family leave, and other supports for caregiving.
While Slaughter does not provide many specifics about how to enact the many big changes that are needed, this book is worth reading to understand more about the next steps on this journey of change that we are all on.]]>