Joan Steede, a home health care worker from Phoenix, pushing for action on the Build Back Better plan. (Photo by Diannie Chavez/Cronkite News)
Joan Steede, a home health care worker from Phoenix, pushing for action on the Build Back Better plan. (Photo by Diannie Chavez/Cronkite News)

“There’s no middle class anymore when it comes to home care.” 

Joan Steede has worked in the homecare industry for around 30 years. She’s spent the last decade providing hospice home care in the Phoenix area. 

She visits people’s homes and takes care of people in their final days by helping them dress, bathe, and stay clean. 

“Sometimes I’m there six straight days, 24 hours a day,” Steede told The Copper Courier. “And I stay until they’re gone because the families are not equipped to handle it.” 

The work is physically and emotionally demanding and requires a specialized set of skills. Steede described a time when she arrived to a home to find a woman crying as her husband, who had just returned from the hospital after having a stroke, laid in bed after soiling himself. 

“I said, ‘That’s why I’m here.’ … An hour later, her husband has shaved, hair washed, clean, and sitting up. And he feels like a human being. That was one hour,” Steede said. 

Yet, her wage starts at $15 an hour. The most she’s ever earned is $25 an hour, she said. 

A Workforce in Poverty

Low wages among healthcare workers are proving to not just be demoralizing—they’re destroying the industry’s workforce.

A Morning Consult poll from last fall found that nearly one in five health care workers quit their jobs during the COVID-19 pandemic, and another 31% have considered leaving. 

Care workers cited low pay, burnout, and COVID risks among their top reasons for leaving. 

Arnulfo de la Cruz, president of SEIU 2015, California’s long-term care worker union, said he worries about what will happen to the country’s aging population as more people need care with fewer people to provide it. The union does not have a local setup for care workers in Arizona. 

“The average age of a caregiver in our union, I think, is about 55. …. We better figure out how to attract the future workforce, because right now it’s causing havoc across the care industry,” de la Cruz told The Copper Courier. 

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De la Cruz said health care “generally across the board, it’s a workforce that’s living in poverty.”

“If you look at who’s doing the work and what they’re being asked to do and how much they’re being asked to do with the resources that they have, it’s unsustainable,” he said. 

Retirement coupled with resignations leaves a depleted workforce, even as care workers are expected to become one of the most in-demand professions in the country. A 2021 study from PHI International found that from 2019 to 2029, the home healthcare workforce will add an estimated 1.3 million new jobs, more than any other occupation.

Steede said even with the low worker pay, she knows it’s extremely difficult for most families to afford home care—she was working at AAA a decade ago making $40,000 a year when her mother had a stroke. She had to quit to go take care of her. 

“You have enough money to live comfortably or you’re so poor that you can’t get the things you need to be comfortable,” she said. “There’s no middle class anymore when it comes to home care.” 

Hard to Stay

Along with low pay comes a lack of benefits provided in other jobs, Steede said. 

When her husband killed himself in 1990, she said, she took one day off and then was back the next day. 

“Why? I didn’t have sick leave, I had two kids now and no husband,” she said. 

De la Cruz said care work is often undervalued and lacking benefits because it’s something that’s done “in the shadows,” out of the public eye. 

“I think the nature of care work, which … is rooted in black and immigrant women in this country, is classified as domestic work, has not historically been seen as deserving of real wages and benefits,” he said. “And I think as much as we’re fighting for actual improvements on wages and benefits, I think we’re also fighting for a place in this country where caregiving is recognized as being an incredibly difficult job that requires real skill.” 

Steede said she knows she could make more money into another profession, but caring for the elderly and disabled is more fulfilling for her. 

She has two children who have also gone into caregiving. When they see other positions like barista or grocery store worker paying closer to $20 an hour, she said, it makes it tough for them to stay. 

“I tell them, ‘Hang in there.’ The government and the country will someday recognize the value of home care, that staying in your home, around your family, in the middle of a pandemic is priceless. It’s priceless,” she said. 

De la Cruz said many care workers work side jobs to help supplement their income— something one of Steede’s children does, washing dishes at a golf club in Scottsdale. 

More Investment

Some healthcare workers like Steede are calling for more investment to help make the job more attractive and sustainable. 

Steede said if a government initiative could lead to her earning just $3, $5, more per hour, she “could have a living wage where I wouldn’t have to work so much.” 

De la Cruz and SEIU 2015 have been working in California to introduce uniform standards across the nursing home industry, increase the wage floor for workers, provide better access for training opportunities, and more. He wants to see that happen on a federal level. 

“We think that if we can get to 20 an hour, if we can get full family healthcare, if we can establish a retirement system … if we can start to put together a package of what caregivers are saying that they really need in order to make this a sustainable profession, then I think that the future would look bright,” he said. 

Steede and de la Cruz supported President Joe Biden’s Build Back Better Act, which passed the House but was blocked by Republicans in the Senate. 

According to a White House fact sheet, the framework would make homecare more affordable in Arizona and increase wages for workers. 

“It set the space to talk about the need to invest in care and that the resources to invest in care should be tied to a set of standards,” de la Cruz said. 

He said as the midterm elections approach this year, he wants politicians to remember that care work affects everyone, and investing in it is popular with voters. 

“Investing in care is going to support families in every zip code, not just based on political party,” he said. 

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