The Growing Need for Home Care Workers: Improving a Low-Paid, Female-Dominated Occupation and the Conditions of its Immigrant Workers

Direct care workers who provide assistance in clients’ homes, also known as home care workers, are a large and growing share of the U.S. labor force. In 2015, 1.7 million workers provided in-home, personal assistance to the elderly, the chronically ill, and individuals with disabilities, and this number was almost double the number working as home care workers in 2005. While this is still a female-dominated occupation—88% of the workers providing in-home care were female in 2015—the share has fallen somewhat from 92% female in 2005. Home care workers are included in two occupational categories, personal and home care aides and nursing, psychiatric, and home health aides, used to describe direct care workers in federal data sets; there were about 4.4 million direct care workers in both occupations in 2015. Here, we further identify direct care workers in these two occupations who work in the industries of home health care services or individual and family services as home care workers: about 38% of the total direct care workforce in the two occupations identified. Home care workers are also growing as a share of direct care workers. Among all personal and home care aides, those working in homes grew from 43% to 51% of the total between 2005 and 2015, and among all nursing, psychiatric, and home health aides, the share working in homes grew from 20 to 30% of the total across the same 10 years (see Appendix).