Extracted from Workers Vanguard No. 1019, 8 March 2013:

‘These and future cuts in social programs will add enormously to the already crushing burden on families as they try to cope with providing care for aging parents or disabled family members. The Elder Care Study (2010) by the non-profit Families and Work Institute found that during the five years preceding the study, fully 40 percent of the country’s workforce had provided elder care to family members. On average, such care represents the equivalent of a part-time job and typically lasts for over four years. Although family caregivers often perform medical tasks such as administering IVs and injections, caring for wounds and operating dialysis or other specialized equipment, they normally receive no help from anyone except other relatives — no home visits by nurses, medical assistants or other health care professionals.

The percentage of adults providing personal care and/or financial assistance to an aged parent has more than tripled over the past 15 years, reflecting the rapid increase in the country’s elderly population. According to the 2010 census, the number of those 85 years and older increased by 30 percent during the previous decade. Many studies have documented the dramatic toll that the stress and anxiety of caring for aging parents takes on adult children’s health, from higher mortality risks and rates of hospitalization to greater incidence of chronic disease.

Overall, two-thirds of caregivers are women. As they marry and give birth at an increasingly later age, more are becoming part of the “sandwich generation”—adults who are responsible for the care of both young children and elderly parents at the same time. Today, nearly 40 percent of women caring for elderly relatives are still raising children of their own, with many of those women also holding down a full-time job. In this capitalist class society, the enormous costs of providing elder care, which should be borne by society as a whole, fall on individual working-class and poor families and, above all, women.

That cruel calculus makes perfect sense in terms of the functioning of the capitalist system. For the owners of banks and industry, government spending on caring for the aged is an unnecessary overhead expense that ultimately lowers the overall profit rate. As Karl Marx explained, profits derive from the exploitation of labor: Workers, who have to sell their labor power to survive, add value to what they produce, but they only get paid a sum that allows them to continue to toil and to raise a new generation of workers. The difference between the value added by the workers and what they actually get paid ends up in the capitalists’ pockets in the form of surplus value. However, the aged and infirm do not labor and therefore do not generate surplus value. In the interest of maximizing profits, the engine that powers the capitalist system, public spending on the aged and disabled should logically be cut to the bone.

The Nursing Home Pestilence

Providing professional care for elderly people in this country is big business, and it will become even bigger with the baby-boomer generation entering retirement age. At the center of that business are for-profit nursing homes, often run by giant corporations. As is true of all capitalist enterprises, nursing homes must drive down expenses in the pursuit of profits. Many nursing homes avoid admitting elderly patients who are afflicted with dementia or other chronic diseases — precisely those who need care the most — due to the high cost of looking after them.

Likewise, nursing homes minimize the number of registered nurses employed, almost never hire on-staff doctors and pay the direct-care staff (almost always non-unionized) a wage they could earn at McDonald’s. Often, even in the better nursing homes, there is not enough staff to ensure that residents are properly fed. What they do not stint on are tranquilizers and other drugs that allow them to cut corners in attending to residents. As one academic researcher told the New York Times (23 September 2007), nursing home chains “have made a lot of money by cutting nurses, but it’s at the cost of human lives.”

This also exacts a toll on the remaining nurses and other staff. Nursing homes are stress-filled, physically demanding workplaces where non-fatal injury rates are greater than in the construction, meatpacking and mining industries. Inadequate training and equipment, higher patient loads and mandatory overtime feed the problem. Nursing home workers, who are predominantly women, need to be organized into the trade unions that represent nurses and other health care workers. Backed by the industrial unions, whose role in production gives them far greater potential social power, this fight must be part of a broader campaign to organize all the unorganized, a struggle that is crucial to reversing the decades of attacks on labor.

Low-budget nursing homes that cater to impoverished recipients, especially those located in poor (working class) communities, are often simply foul-smelling hellholes … Such conditions often persist despite the best efforts of health care workers, who seek to provide quality care in defiance of the rapacious nursing-home bosses. In the case of Hurricane Sandy, it was the staff, often putting in 36-hour shifts, that carried out the emergency evacuations of dozens of stricken New York City nursing homes. There was no good reason why people could not have been evacuated in an orderly fashion before the storm hit. It was penny-pinching by Mayor Michael Bloomberg that left the elderly in harm’s way.

Under capitalism, nursing homes hardly even begin to address the social need for elder care. Only about one person in eight aged 85 or over is placed in a nursing home. Of course, many prefer staying with their families, especially with what is on offer at most old-age facilities. The whole setup is focused on profiteering. By raking in about $160 billion per year while holding down costs, private nursing homes have been quite successful in maximizing their shareholders’ return on investment. This industry provides an object lesson in how the capitalist system is incompatible with satisfying basic human needs’.





lenin nightingale 2015



  1. Lenin’s prophecy- care homes will survive for 10 years. Government will replicate China/Japan- family must care for their parents- in may come payments to them and legal requirements to do so. Should the state be responsible for our care- payment and delivery ?

  2. Pingback: Private Care Home Profit Made Simple | NURSE BLOG INTERNATIONAL

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