A recent survey reveals that people living in America want the nation’s direct care workers to receive higher pay, better training and increased government oversight to ensure good jobs that support older adults and people with disabilities. America’s 4.6 million direct care workers are a lifeline for older adults and people with disabilities, providing crucial hands-on care—including daily activities like bathing and clinical tasks like blood pressure readings—to individuals living in their homes and in other long-term care settings.

But while these workers may provide crucial support, our recent survey finds that most people don’t feel these workers receive the crucial support they need. We strongly agree.

Direct care workers in the United States have long been undervalued despite playing a critical role in our country’s health care system. Each day, these workers take on a significant amount of physical and emotional labor to manage the complex needs of clients and residents. Maintaining a robust direct care workforce is also one of the most effective and straightforward ways to assist family caregivers.

Many don’t realize the cost or complexity of the care provided by direct care workers until they or a family member need it. Although 66% of people will someday need a direct care worker in their lives, most wrongly assume that they won’t. This broad disconnect in perception versus reality contributes to the lack of value placed on direct care jobs.

Despite the high demand, wages remain shockingly low. Direct care workers have a median payrate of $13/hour and often face a lack of benefits associated with part-time work as full-time positions become increasingly rare. These conditions force nearly half (44%) of direct care workers to live in or near poverty. According to recent research, these challenges have a heightened effect on people of color—particularly women of color, who make up 53% of the direct care workforce. The low wages of direct care workers come as a surprise to people, as most (72%) overestimate how much direct care workers are paid. When they learn the actual median wage for direct care workers, the majority of people (73%) feel they should be paid more.

The direct care workforce carries out complex, important work that deserves respect and support in both practice and policy. Direct care work has historically and erroneously been described as low-skill, when in fact it requires a broad set of skills and knowledge, especially as the complexity of care needs increases among care recipients.

In our survey, most people (60%) said that direct care workers would benefit from more training and nearly all said that government oversight is important to better protect workers on the job and the people they support. Modernizing and strengthening existing training requirements and infrastructure will help meet the needs of today’s direct care workers and their employers. It will also help equip future workers to provide specialized care to certain subsets of America’s aging population, such as LGBTQ+ people, people with limited English proficiency or those dealing with chronic and prevalent conditions such as dementia or HIV/AIDS, to name a few.

It’s time to recognize, train and integrate direct care workers as full members of the care team. Moving towards this model will benefit those currently receiving care in their homes and in other long-term care settings and the majority of us who will need care in the future. While higher pay, more training and stronger government oversight are pieces of the solution, we endorse additional options such as better advancement opportunities for direct care workers, increased research and stronger data collection systems at the state and federal level and equity-explicit solutions, such as immigrant-related supports.

There are so many possibilities to better support direct care workers, but it will take collective action and advocacy from family caregivers, long-term care clients and residents, health systems and others who believe that direct care workers are essential and deserve good-paying jobs with benefits to turn those possibilities into reality. Ways that you can help today include:

  • If you or someone you love has been supported by a direct care worker, share stories with your friends, family and social media networks about the value direct care workers brought to your experience, alongside facts including how much direct care workers are paid and the projected numbers of direct care workers needed to care for our aging population. You can also connect with a local direct care worker advocacy organization or labor union to amplify their efforts advocating for higher wages and better protections.
  • If you are a direct care worker, talk about your experiences and the struggles you’ve encountered on the job with your friends, on social media or in a letter-to-the-editor submitted to your local newspaper. Additionally, connect with your state and federal representatives to demand higher wages, more training and closer oversight.

Join us in taking action now to ensure that direct care workers are fully supported. Together, we can raise our voices to make a difference.

Learn more by visiting JohnAHartford.org and PHInational.org.

Rani Snyder is Vice President of Program at The John A. Hartford Foundation, where she oversees the foundation’s grantmaking to improve the care of older adults.

Robert Espinoza is Vice President of Policy at PHI, where he oversees its national advocacy, research, and public education division on the direct care workforce, including its strategic direction and federal advocacy.