Families are overwhelmed and unprepared:

Roland had early-onset Alzheimer’s. Before long, he was let go from his job, and his wife, who ran a small cleaning operation, cut back her hours to care for him. It was “by far the hardest thing I have ever done,” says Debbie, a petite woman with shoulder-­length, blond hair and blue glasses. “Never could I have prepared for it, ever.”

nearly 70 percent of family caregivers say they are compelled to make adjustments at work, turning down promotions, taking leaves, and sometimes quitting their jobs altogether. A 2011 study from the National Alliance for Caregiving estimated that elder care duties cost the average American woman about $324,000 in lifetime earnings.

Few people want to work as a professional caregiver:

Why aren’t people jumping into the profession? Well, caring for elderly or disabled people is a low-status job with meager protections, and though rewarding at times, the work is often grueling, unpleasant, and emotionally draining.

Domestic labor has for centuries been left almost exclusively to wives and daughters—or to slaves, immigrants, and other impoverished women. In the 1930s, when Congress passed the Social Security Act and the first major federal labor laws as part of the New Deal, domestic and agricultural workers were excluded—at the request of Southern congressmen—from minimum wage and overtime protections and the right to unionize. During the 1970s, black domestic workers formed groups like the Household Techni­cians of America to fight for the rights other industries enjoyed. Their efforts paid off in 1974, when Congress amended the Federal Labor Standards Act to cover most domestic work. But the lawmakers still excluded “companions” of the elderly, lumping them in with the “casual babysitter.”

So what do we do?

The idea is to fund the creation of a new workforce and eliminate the ragtag safety net that leaves families in the lurch. UHC would tax wealthy Mainers to cover home care for any senior who needs it. It would also raise wages by requiring that at least 77 percent of the funds the program pays to home care agencies goes toward compensating the workers. (Relatives caring for family members could receive a stipend.)

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