Activist Ai-jen Poo Shares Stories from the Frontlines — and in the Shadows — of Domestic Care


Few catchphrases garner as much play in medicine as “team-based care.” But for all the talk of better integrating the people and services in today’s complex healthcare ecosystem, we rarely acknowledge the vital role of domestic workers as part of the care team for our nation’s aging and often most vulnerable population.

Ai-jen Poo, founder and director of the National Domestic Workers Alliance (NDWA), and author of The Age of Dignity: Preparing for the Elder Boom in a Changing America, is on a mission to change minds and shape policies that ensure our domestic caregivers are counted.

In this episode of Relational Rounds, we sit down with Poo to explore domestic labor from its history in slavery to its present associations with the work of women and immigrants, examining the complicated factors that have stymied progress in recognizing our nation’s home health aides.

According to The Age of Dignity, there are an estimated three million home health providers in the U.S., representing the fastest growing occupation in the country. It’s these workers who are most consistently in contact with the highest utilizing patients, managing chronic illness, navigating multiple providers and care plans, and forging relationships with patients and their families.

But much of the progress that has been made in similar industries hasn’t been realized in the domain of domestic work. Indeed, it was just two years ago that Poo and her colleagues at the NDWA succeeded in efforts to include home aids in the Fair Labor Standards Act.

Among the reasons why, the NDWA’s 2016 Home Economics report notes that two-thirds of caregivers for the elderly are foreign born, half are undocumented, and most are women. In many ways, the odds are stacked against them.

“That’s why it’s so essential for domestic workers and the primary care community to come together to advance better care for all – providers and patients,” says Poo.

Poo goes on, “This is everyone’s issue — parents, children, friends. We need to start investing in domestic workers, and providing them with the training, career pathways, and coordination essential to a strong, supported, caregiving community.”

Listen to the entire episode to hear Poo’s hard-won wisdom as she speaks on the imperative of building a home healthcare workforce and what primary care professionals can do to be a part of the movement.

Subscribe to Relational Rounds on Apple Podcasts, Google Play and Stitcher, and follow Poo’s work at the NDWA and Caring Across Generations.

Elizabeth Métraux

Senior Advisor for Thought Leadership at PCP, Elizabeth regularly speaks and writes on the art, science, and power of language, as well as performs as a storyteller in the Boston area.

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