In The Age of Dignity: Preparing for the Elder Boom in a Changing America, Ai Jen Poo uses a lot of numbers: 10,000 people turn 65 every day; the average cost of a year in a nursing home is $83,000; by 2050, the number of people needing long-term care is projected to grow from 12 million to 27 million; those taking care of elders (mostly immigrant women) make an average of $13,000 a year. But the real heart of her book is stories about seniors and the people who care for them.
Poo, a MacArthur “Genius” Award winner, director of National Domestic Workers Alliance, and co-director of Caring Across Generations, starts her book with a story about her paternal grandfather who picked her up from school every day, loved Wheel of Fortune, and taught Tai Chi. At the end of his life, her family couldn’t care for him and he went into a nursing home. Poo describes visiting him there where he lay in a dark room with a half dozen others who were inert or crying out in pain. He died within a couple months.
Then there is the experience of her maternal grandmother, engaged in her late eighties, playing mahjong, singing in her church choir, and regularly getting her hair done at a Chinese salon close by her home.
The difference, Poo recently told an audience at an event called "Women, Leadership, and the Future of Care," at San Francisco’s Rosenberg Foundation, was her grandmother’s caregiver, Mrs. Sun. Poo would like to see everyone have a Mrs. Sun, and in The Age of Dignity, she lays out some ways for that to happen—to establish what she calls a “care grid.”
Poo, who successfully organized domestic care workers in New York to pass their first state bill of rights, says she decided to focus on the issues in her book because they kept coming up again and again in her work.
“There was just a real gravitational pull towards it,” she said. “As we were struggling to raise wages and get sick pay and benefits for our work force, we saw how not all employers can afford that. It demonstrated a lack of a support system for families who need elder care in particular, and if we don’t come up with a plan and invest now, it’s only going to get worse for everyone.”
In her book, written with Ariane Conrad, Poo writes about the fraying safety net; the “sandwich generation,” stuck between caring for both children and aging parents; and offers a combination of community-based and policy solutions to improve both the jobs of health care providers and access to care.
To get to the place Jen describes—a place where most people can stay at home as they age and their caregivers are paid a living wage—seems daunting, considering where we are now. But that’s OK, Poo says.
“With the scope and scale of what we’re up against with economic inequality, if solutions actually feel politically viable, like they should work, they’re probably not adequate,” she said. “We’re so polarized and so out of sync with one another, that there’s probably something wrong if the solutions seem easy.”
Poo says she has faith in the impossible becoming inevitable, because she doesn’t know a single person who doesn’t have a stake in addressing this issue.
“Two decades ago, no one would have imagined we would have made the kind of advances in marriage equality we have,” she said. “We’re up against lots of challenges, but this issue brings people together across race and class and generations—we all care about our families.”
Some initial steps we can make include giving tax credits to cover elder care and moving forward on President Obama’s executive actions on immigration and establishing a minimum wage protection for home care workers, Poo says. She’d also like to see more training to improve home care.
Poo lists three fronts where we need change: a cultural shift in how we think and feel about aging and care giving; behaviorally, having conversations about how people in our lives want to age and being aware of our obligations as employers of care givers; and changing policies to create economic supports, such as insurance tax credits and subsidies for care.
Poo says she sees examples in popular culture that show how we think of aging is changing.
“Meryl Streep is at the peak of her career,” she said. “It seems there are more stories about older people and changing families like Still Alice about Alzheimer’s and the Second Best Exotic Marigold Hotel. We have a long way to go to see our stories reflected and to make domestic workers more visible, but the tide is turning.”
Growing up with her grandparents had a huge impact on her, Poo says. They taught her a lot and brought perspective and richness to her life. She would like everyone to experience that—and to value older people.
“I want there to be some reciprocity,” she said. “I’d like them to feel valued and seen as they helped me feel valued and seen as a child.”