Not For The Fainthearted

Abstract

This chapter discusses the training and working conditions of home health aides (HHAs). The largest home care agency franchisers employ tens of thousands of HHAs. Home care is a lucrative business, and part of that profitability is based on keeping wages as low as legally possible. Because the job is hard and the salary is minimum wage, the workers are usually women of color, or white women with a limited education, who do not have a wide choice of jobs and are trying to survive on the low end of the income-inequality gap. Many aides are African Americans, and many others are first-generation immigrants or their daughters. Indeed, the home care industry in both urban and rural settings depends on immigrant labor. The chapter then looks at the experiences of HHAs from Cooperative Home Care Associates, a home health care agency located in the South Bronx, which provided home health aides to elderly and disabled Medicaid recipients.