The Age of Dignity: Preparing for the Elder Boom in a Changing America

As more and more baby boomers hit 70 and above, the need for people who can provide day-to-day care increases. Ai-Jen Poo makes a convincing case that these caregivers are the most critical workers in America as we hit our stride in the 21st century. The need is even more significant because there is a growing “sandwich generation” of middle-aged baby boomer children who have to care for their children and their parents simultaneously. After setting the stage by explaining the massive need for caregivers, the author describes the horrific conditions many caregivers work under with little chance for change. She shows through statistics and actual caregiver experiences the stigma of disrespect caregiving roles carry in this country, and the pay is often abysmal. Additionally, the very people maligned by the press, our immigrants, many without legal status, are essentially the ones doing this work. Poo explains that many immigrants doing this work come from cultures where caregivers are revered, and the elderly are considered critical members of society for their life experiences. The book makes an excellent case for US societal change at many levels needed to build up an army of caregivers to help us through the coming elder boom. Without a plan in place and government programs that work, the growing needs of an aging baby boomer population will likely crush our economy and our GDP and create a genuine humanitarian crisis. Poo describes a few ways to manage this and elucidates the changes to current programs and systems that will at least give us a start. The most compelling and critical aspects of meeting this need come through when she talks about caregiver and client dignity. It is most important that we raise the dignity of both these groups. Caregiving is looked down on in our society as the lowest of jobs, part of the disrespected domestic service industry in America, a lower caste in a country that espouses equality for all. Poo is insistent on change and walked her talk by founding the Domestic Workers United in New York State. This organization spearheaded the passage of the Domestic Workers Bill of Rights in 2010. She continues her fight for domestic workers of all stripes. She is a 2014 MacArthur Genius Award winner. I recommend this book as required reading for anyone in the health industry that services people over seventy and those of any age requiring end-of-life care. Every American between 25 and 60 should read this book to understand what we are against in the next few years.