Will the Elder Boom Spur a Caring Revolution? Ai-jen Poo’s Inspiring Vision

We need to shift the stories we tell ourselves about the value of elders, the care they need, and later life itself.
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Photo by Lighthunter / Shutterstock.

In the early ’80s, when I began assisting elders and their families as a medical social worker, it was apparent that those at the bottom of the health care pyramid—home care workers and aides in nursing homes— have the greatest effect on the lives of vulnerable adults. They need respect, training, and pay commensurate with the impact of their roles. Like other advocates all over the country, I have spent more than three decades shouting from the rooftops that caregivers, both paid and unpaid, hold together the fabric of our society and should be honored, supported, and recognized. We have long insisted that federal dollars spent on nursing homes, where no one wants to be, should be shifted to care at home, where people would rather stay.

Now, more than a generation later, a 41-year-old activist named Ai-jen Poo has come to these same conclusions. What excites me is that she sees a way to make this vision come to pass, at long last. A MacArthur “genius” award-winner, Poo led the way to the passage of a Domestic Workers’ Bill of Rights in New York State in 2010, a state law that gives these workers basic rights such as overtime pay and one day off per week. She helped start a national organization, Caring Across Generations, to make it possible to provide long-term care at home by creating a national network of home care jobs with living wages. In her new book, The Age of Dignity, Poo writes, “Care is something we do; it’s something we want; it’s something we can improve. But more than anything it’s the solution to the personal and economic challenges we face in this country. It doesn’t just heal or comfort people individually; it really is going to save us all.”

I have waited my whole adult life for this—for us to tell the real story about how our society is held together.

It is one thing to declare this necessity and another to accomplish the requisite societal changes. Poo says we should invest in a Care Grid, which would establish this network of well-trained home care workers, just as we invested in an electrical grid and a national highway system years ago. To realize this vision, she identifies three arenas of society where we need to push for change: cultural, behavioral, and political. Culturally, we need to shift the stories we tell ourselves about the value of elders and later life itself. In our personal actions and behaviors, we have to find ways to come through for our neighbors, friends, and family members in their times of need. In the arena of public policy, we must protect and support the immigrant work force, empower Medicare and Medicaid to negotiate lower prices for drugs, and raise public revenue to support care by enforcing a higher corporate tax rate and instituting taxes on financial speculation.

My excitement plummeted as I tried to imagine Poo’s vision translated into line items in the federal budget or even groundbreaking legislation. How could the Care Grid become a reality within our dysfunctional political system, which has become dominated by bitter partisanship and campaigning by those who wouldn’t want to see ideas like Poo’s implemented? Is our democracy too broken to move forward?

I finished the book and reached Ai-jen Poo for a phone interview. When I posed this question, her enthusiasm wasn’t dampened by my bleak view. She insisted that the need for home care is an issue around which even the most conservative and liberal voters can converge. “With our explicit work to reach senior voters on these issues, we found that home care choices were an entry point,” she told me. “You can have a conversation with just about anybody and end up talking about values. … There’s actually quite a bit of common ground in unexpected places.”

“Our job is to make the impossible not only possible but inevitable.”

I pushed my dire position further, pointing out that it was highly unlikely that those who hold the power and the money in this country would agree to pay for the Care Grid, as much as the majority of our citizens might desire it. “There will always be dogmatic arguments against anything that costs anything,” she countered. “But I also believe there are enough practical-minded Americans out there who know that this is something individual families can’t handle on their own. … This is a front-end investment, like national security. We can prove that it saves us money in the long run.”

She went on, putting my pessimism to shame with her confidence that we will eventually do the right thing in this society. She pointed out that the number of children being raised in three generation households keeps going up and that this has created more awareness across our culture of the needs and contributions of elders. “I think that millennials are more connected to their grandparents than any generation in history. We actually call baby boomers and millennials the new power couple—the way that boomers were such culture drivers and redefined many of the cultural norms. … These two generations together will be defining the future of politics in this country.”

Labor organizer and author of The Age of Dignity, Ai-jen Poo. Photo by Lane Hartwell.

Poo sees the increasing visibility of caregiving relationships in popular culture as another key driver of a new perspective on aging in America. She maintains that cultural change “requires a 360-degree storytelling environment,” and that “it’s everything from … the creation of narrative films and television shows … that make these stories and relationships visible in popular culture and media to inspiring influential storytellers to tell their stories.”

While I was still skeptical that such storytelling could translate into political action, she flattened my doubt once and for all in a few impassioned sentences. “So much of politics actually is emotion, people’s experience of life. The power of human story speaks to that side of us,” she explained. “When we tap into the emotional life of people, that is a much more creative space, a space of imagination and possibility.”

“There’s actually quite a bit of common ground in unexpected places.”

This is where she got me. I think Ai-jen Poo is right. Cultural change is about feelings as well as beliefs, and stories about lived experiences are surely the way we will get there. Just about everyone finds out eventually that what matters the most when we are frail, ill, or dying is the kindness of the hands that touch us. The political will to support the dignity of those who are not able-bodied—frail elders and other people who need assistance in their daily lives—will come from all of us speaking up, telling our tales about the home care workers and family caregivers who are the unsung heroes of our world. One by one, friend to friend, we must talk about what we have witnessed and experienced in the dark of the night, both as caregivers and as those receiving care.

I have waited my whole adult life for this—for us to tell the real story about how our society is held together. Maggie Kuhn founded the intergenerational group the Gray Panthers in the 1970s with the motto “Age and Youth in Action.” In the 1990s, when she was in her late 80s, she was still waving her microphone around, proclaiming, “Interdependence—not independence—is the truth of our lives.” Our society might finally recognize this, now that there are so many of us who are living to the age of physical vulnerability.

The confluence of our individual narratives could become a tidal wave, a demand for change that will sweep away political inertia. This is how it happens, how something personal becomes larger than ourselves and finally turns into a national conversation and then a movement. Maybe it will be big enough to restore our democracy, to make us a nation that provides what most people wish for and almost everyone ultimately needs.

“When we tap into the emotional life of people, that is a much more creative space, a space of imagination and possibility.”

Now I am sounding exactly like Ai-jen Poo. Despite my relentless invocation of the forces that conspire against change, she depicted her vision with so much grace, fervor, and intelligence that I was ready to take to the streets again. I asked, finally, how she recharges herself when she gets tired or discouraged. “I think of the caregivers I know—their courage, resilience, dedication, and heart. … Most things that have ever been worth fighting for were at the outset deemed impossible. Our job is to make the impossible not only possible but inevitable, and it is completely within our power to do so.”