John Hersey
Letty, an elderly Filipina, lives with two of her children in a three-bedroom bungalow in a working-class neighborhood of Los Angeles. She first moved to the United States in 1985, entering as a tourist after she was unexpectedly widowed in her late forties and left with the responsibility of having to support five of her seven children through school. Letty initially settled in New York City, where she worked as a live-in nanny for a wealthy family on the Upper East Side. After a few years, two of her children relocated to the United States. They entered legally as professional migrants with H-1B visas sponsored by a small accounting firm in Los Angeles. Letty soon followed them to California. She became an American citizen through the sponsorship of her son.
Whether she is caring for children or the elderly, Letty has continuously worked as a domestic worker for more than 30 years in the United States. I first met Letty in 1995, when I interviewed her for my dissertation research on domestic workers that later became the book Servants of Globalization. When I touched base with her after more than 20 years, Letty still worked as a domestic worker. At the age of 78, she helped care for a 96-year-old woman as a “reliever” during the weekends. About a decade earlier, after one of her patients—weak from dialysis—fell on her and fractured Letty’s femur, she transitioned to weekend-only work. She said she could manage the work because her patient didn’t require ambulatory care.
Letty did not receive any sort of disability compensation for her workplace injury. This is not unusual. In fact, Letty has never received any sort of employment or state benefits for her labor, including unemployment, medical insurance, or a pension. This is despite the fact that she is a citizen, and the fact that the U.S. government requires employers who pay household workers at least $1,900 in annual cash wages to deduct Social Security and Medicare taxes.
The informal nature of her employment has clearly worked against her. One employer even deterred her from accruing sufficient credit to later qualify for Social Security benefits by discouraging her from paying taxes. Not having done so is Letty’s biggest regret: “I should have gone home with my pension now … I was already paying my income tax for two years, and then Mona [her employer] said, ‘Letty, don’t pay [those] taxes, because you’ll pay more than what you get.’ That’s what she told me. So that is why I stopped paying.”
Letty would like to return to the Philippines “for good,” but with neither savings nor a pension she depends on approximately $700 per month of Supplemental Security Income (SSI), a retirement benefit for Americans with limited resources. Letty subsidizes this with her two-day earnings of $250 each weekend as a part-time elderly caregiver. While receiving a monthly SSI payment allows Letty to partially retire, it makes the option of retirement in the Philippines elusive. This is because SSI recipients cannot leave the United States for more than 30 days without risking forfeiture of their stipend. Also preventing Letty from retiring is the continued financial dependence of her family in the Philippines—four adult children, three of whom are single parents, as well as grandchildren.
Letty lives a modest life in Los Angeles, living rent-free with her son and relying on the assistance of her three children in the United States. Still, she is unable to retire, which undermines the common assumption that migrants, even if earning low or sometimes below-poverty wages, will eventually accumulate enough savings to allow them to retire in their home country. Without question, many do. Yet, Letty’s situation suggests that not all are able to do so. Economist Teresa Ghilarducci likewise found that most Mexican migrants in the United States do not have sufficient funds for retirement even though the majority receive some Social Security benefits.
Letty’s story is emblematic of the emergence of an international division of elder care—a chain in which elderly are paid to care for other elderly. The challenge of retirement for migrant domestic workers such as Letty suggests our need to pay attention to the rise of older migrant caregivers, and the challenge of retirement for domestic workers generally.
A Global Overview of Migrant Domestic Workers
A large number of the world’s migrant workers—an estimated 11.5 million—are domestic workers. According to the International Labour Organization, domestic workers comprise some of the most vulnerable workers in the world. They are said to constitute 24 percent of the 16 million estimated victims of labor trafficking worldwide. This suggests that approximately one-third of migrant domestic workers are victims of human trafficking. The United States is no exception. The Polaris Project found that 23 percent of approximately 8,000 labor trafficking cases between 2007 and 2017 in the United States involved domestic workers.
Labor trafficking, by definition, refers to the transportation of a person under some cloak of duplicity for the purpose of their exploitation. An example would be a domestic worker recruited from the Philippines to work in Lebanon for a salary of $400 a month only to learn that their employer intended to pay them only $250 per month. What makes migrant domestic workers susceptible to such mistreatment is not just the informal and isolated setting of their occupation but also the legal terms of their residency.
In most countries, the visa of domestic workers is contingent on their live-in employment in one household, where their employers are the main assessors and administrators of the law. This is the case not only in countries such as Lebanon, Israel, Malaysia, and Singapore but also the United States, where domestic workers sponsored by diplomats or returning expatriates are bound to work solely for their sponsoring employer.
The susceptibility of migrant domestic workers to labor trafficking suggests not only the likelihood of their poor labor conditions, including low wages, but also the challenge of ever meeting their migration goals. We see this in the case of Letty, who finds herself duped by employers against contributing to her retirement as they themselves avoided doing so. In the Philippines, domestic workers bound to work under a two-year contract in the Middle East are forewarned in a government-run predeparture orientation seminar that they will likely have to migrate more than once before they can meet their different goals of migration, including purchasing a house, sending children to school, and accumulating enough savings to open a small business in the Philippines.
In Italy, at Rome’s central train station of Termini, one is likely to find groups of unemployed elderly Filipinas actively looking for live-in employment as elder care providers. I learned of this when I visited Rome in 2012 and ran into someone who had participated in my dissertation research on domestic workers 20 years earlier. Fe looked much older with her now gray and brittle hair but had still been quite recognizable, with her distinctively dark skin and impeccable English. She had been a grade school teacher in the Philippines before becoming a domestic worker in Italy. When I asked Fe and her friends why they did not return to the Philippines, reunite with their family, and retire, they all admitted that they could not afford to do so. Like Letty, they either did not have an adequate retirement pension or still needed to support family in the Philippines, or worse, they confronted both.
Older Domestic Workers
Domestic workers are aging, and continuing to work because they have to. A survey I conducted with Jennifer Nazareno of 100 Filipino domestic workers in Los Angeles indicated the average age of our respondents was 57.5 years old. Most were elder care providers, a job that domestic workers come to prefer as they age. In conversations with migrant domestic workers over 50 years old, many told me, “Ayaw ko ng bata,” meaning, “I do not want a child.” As 63-year-old Lilly explains, “At my age, I’d rather take care of old people, not kids. I could not run after them anymore.”
Older domestic workers prefer to care for the elderly because of the relatively lighter one-on-one workload. As Letty says, “It’s only you and the lady. If she sleeps, you sleep too.” Whereas younger domestic workers prefer child care and housecleaning, older migrants are also said to prefer elder care for its slower pace. In contrast, younger domestic workers are said to prefer child care, as they wish to avoid the slow, monotonous, and isolated routine of caring for the elderly; elder care is said to be “boring.”
Elder care, however, is not without its challenges. Elderly patients who suffer from Parkinson’s, Alzheimer’s, and other forms of dementia increase the demand and stress of the work. Letty for instance recalls the stress of being kicked out almost every morning by her patient with Alzheimer’s: “Oh my God … in the morning … when I would say, ‘Good morning,’ she would say, ‘How did you come here?!’ I would say, ‘I stay here with you.’ She would say, ‘No, no, no, you go out, you go out.’ Then you know what, I go to the bathroom. I stay there for a few minutes, and just pray there, and then I go out and say, ‘Good morning,’ and she would be nice already.” Additionally, elder care can bring physical challenges such as lifting nonambulatory patients. Those who can walk also impose their own set of physical challenges. Fighting elderly with Alzheimer’s in the bathtub has been described as a one-sided “boxing match” with water splashing everywhere.
Another challenge of elder care is said to be its 24-hour shift. The job requires most workers to wake up in the middle of the night to bring their patient a glass of water, take them to the toilet, respond to their crying and requests to sleep on the same bed, or check on any noise they make. The majority of our survey participants had to get up at least twice in the middle of the night. Add to this the usual duties of domestic work. The vast majority, about 70 percent, of survey participants reported their primary tasks to include cooking, laundry service, ambulation assistance, bathing, toileting, grooming, and feeding, with a slightly lesser percentage adding housework.
The challenge of retirement for migrant domestic workers invites us to examine their plight in old age.
Elder care also demands unrequited loyalty. According to Luz Ibarra, who writes on Latino elder care providers in Southern California, moral norms dictate that elder care providers commit to the job until their patient dies, and provide care as they would to their own parent. However, the experiences of domestic workers I have met indicate that this loyalty is rarely reciprocated; raises are infrequent, compensations upon the passing of a patient are likely not to be extended, and gifts, small tokens of appreciation, are frequently disappointing. “I made $80 a day when I started and I asked for a raise after five years,” one respondent told me, a complaint echoed by many others. Receiving inexpensive presents for their birthdays and holidays is another common occurrence. Shares one caregiver: “I took care of a 103-year-old, and she gave me earrings for Christmas, and she told me they were real, but they were fake.”
Despite its many challenges, elder care is a job that older-aged domestic workers much prefer. This is because this job allots them more rest time than other types of domestic work. Comparing child care and elder care, Letty explains, “It is better than if there are family around with children. It is hard because you would have to keep on working. You don’t have rest because you are ashamed also. But if you are only two … if they say, ‘I want to rest,’ then you can rest too.” Domestic workers such as Letty suggest the emergence of not only older-aged domestic workers but the rising case of elderly caring for elderly, or unretirable elderly caring for retired elderly.
According to the Administration for Community Living, the nearly 50 million individuals who comprise the older population—those who are 65 years and older—make up more than 16 percent of the U.S. population, about one in every six Americans. Their population is expected to almost double to 98 million by 2060. Due to the rise of the aging population, elder care is one of the fastest-growing occupations in the United States. With its designation as low-wage employment, those who are most likely to respond to this demand are migrant workers.
The Elder Care Chain
The phenomenon of elderly caring for elderly indicates the emergence of an elder care chain. Aging baby boomers—individuals born between 1946 and 1964—are paying elder care workers to care for their parents, who are in their eighties and nineties. The Filipino elder care providers I have met include a 62-year-old who cares for a 96-year-old, a 60-year-old caring for an 89-year-old, and a 71-year-old caring for a 78-year-old. These care providers give the baby-boomer children of their elderly parents the freedom to retire. This suggests that the inability of domestic workers to retire works to the advantage of aging baby boomers in their early years of retirement; to give themselves greater freedom during retirement, they hire a crop of workers who tend to be former nannies and housekeepers.
One such elder care provider is 63-year-old Lilly, who cares for an 85-year-old woman 60 minutes south of Los Angeles in Orange County. The woman has mild symptoms of dementia and Parkinson’s, and she had become increasingly forgetful in the months prior to when I met Lilly. Living close to Lilly’s elderly patient is her 65-year-old daughter Mary, who remains active in her mother’s life. Mary handles the grocery shopping for her mother and Lilly. Because Lilly does not know how to drive, Mary also takes her mother to her weekly therapy appointments. Mary leaves it to Lilly, however, to see to the day-to-day needs of her mother. Bearing the brunt of managing Mary’s mother’s dementia, Lilly also has to provide emotional support, including constant reassurances against the frustrations and insecurities caused by memory loss and diminished comprehension.
Without question, Lilly relieves Mary, a retired schoolteacher, of the time-consuming burden of watching someone with dementia. Mary’s freedom hinges on the work of Lilly. Despite the friendship Lilly has cultivated with Mary’s mother, she knows better than to romanticize their relationship. As she told me, “You just care but [do] not emotionally get involved … You care; you do your job. It is my job. If someone asks, ‘Lilly, how can you do this?’ It is my job.” Lilly knows to keep her emotional distance because she is aware that she lacks job security, or as another caregiver put it, “security of tenure.” If the mother dies, then her job ends.
From experience, Lilly also knows she is unlikely to receive any form of compensation for her long-term service to Mary and her mother. Other elder care providers I have met agree, as only two had ever been included in the will of their patients but neither one received “enough to retire.” Most others complained that they were not materially compensated for their loyalty: “Nowadays, even if you work for someone for 20 years, because of economic pressures, Medicare, taxes, and the children are there too … So, they don’t really give.” After the passing of an elderly patient, workers usually receive no more than what is equivalent to a week’s salary, which is not enough to cover their living expenses while they transition from one employer to another. Expecting any more, they say, would be similar to “waiting for nothing.”
“Can I Ever Retire?”
The aging of domestic workers is an issue ignored in policy discussions. The question of retirement is absent in the International Labour Organization’s Convention on Decent Work for Domestic Workers. Adopted in 2011, this convention signals a significant advancement toward the formal recognition of domestic work and the implementation of employment standards. It calls for the use of written contracts in accordance with national laws, regulations, or collective agreements in domestic work; safe and humane working conditions; freedom of movement; and, among other things, regular pay. Missing, however, is the question of retirement and the insecurities of aging among domestic workers.
In the survey Nazareno and I conducted with domestic workers in Los Angeles, the challenge of accumulating retirement funds along with job security and access to health care were the three biggest concerns identified by participants. They struggled to acquire funds sufficient for retirement because first, wages are often too low; and second, the informal arrangement of their occupation allows employers to avoid paying their share of taxes mandated by the Federal Insurance Contributions Act, namely, Social Security and Medicare taxes.
In a focus group discussion with 30 elder care providers, many participants reported inadequate savings because their daily expenses, including the money they have to send to family in the Philippines, eats up most of their earnings. They also mentioned that the informal arrangement of domestic work puts the onus on them as the worker, and not the employer, to secure their retirement. Employers are legally mandated to pay 7.65 percent of their employees’ wages to cover Social Security and Medicare taxes, but most do not. Of 100 survey participants, only 14 had employers who did so. This pattern fits historical trends. Luisa Grillo-Chope and Carlos Ramos, writing for the National Council of La Raza, found that, according to the U.S. General Accounting Office, nearly 96 percent of private household workers lacked pension coverage in the 1990s.
Enabling the poor remuneration of elder care providers is the assumption of their natural affinity for this labor, which is a claim that Filipino domestic workers seem to embrace. Says an elder care provider in Los Angeles: “I think the role of Filipinos is as natural-born caregivers. And so, in a country that needs assistance specifically for the aging population, first and foremost, we Filipinos are the ones in the front lines of it … We are being the ambassadors of our own country to do this work.”
Mirroring these comments, another elder care provider, Thelma, asserts that Filipinos have a “sixth sense” when it comes to providing elder care. Lilly agrees: “I think Filipinos are like the most caring people … It is inherent in us, I think.” What are we to make of the insistence of Filipino elder care providers that they have a “care gene”? Why do they pride themselves on having a genetic disposition to provide care? It is actually to their advantage to do so as it establishes their indispensability as domestic workers—yet this pride in their work also facilitates their exploitation.
Elder care providers frequently spoke with pride about the deep loyalty they held for their elderly patients. This includes Betty, who says, “My heart and my life are dedicated to taking care of the elderly because, if you put it in your heart, you will do everything to take care of them.” Betty, an undocumented worker who is in and out of the hospital as she fights cancer, forgoes caring for herself to care for others. Her deep commitment is not one materially reciprocated by her employers; Betty is without medical insurance.
Claims of Filipino workers having a natural affinity for elder care, one that supposedly results not only in their “deep loyalty” but also their emotional and spiritual fulfilment, often come at the cost of their material compensation. However, this need not be the case. Believing that material motivations would taint one’s emotional and spiritual motivations, and diminish one’s job performance, assumes they inhabit separate spheres. Sociologist Viviana Zelizer criticizes this “hostile worlds” view, the belief that money must be kept separate from the intimate and sacred for the latter two to retain their value, as it ignores the ceaseless interplay between love and money that defines many of our social relationships. Churchgoers donate money to their pastor, parents send their children to school, and so on. In contrast, employers often do not reciprocate for the allegiance of care workers. However, the emotional and spiritual fulfilment of doing elder care should not justify the monetary devaluation of this work.
Domestic workers provide a necessary service to maintaining society. Recognizing their labor—the work of caring, feeding, bathing, and clothing the population—requires that we acknowledge their reproductive rights. This refers not just to their right to a family life but also their right to retirement. The inability of domestic workers to retire signals the emergence of new kinds of inequality in American society. Perhaps an apt description of their situation is one of modern-day servitude, as their dismal compensation as informal, low-wage workers turns domestic work into compulsory labor. The situation of Lilly suggests as much. The security of her labor demands her loyalty to Mary and her mother. They in turn ensure her dependence by minimizing her payment and refusing to cover her taxes, thereby disqualifying her from unemployment, pensions, and health insurance. The work of older-aged domestic workers such as Lilly—most of whom are elder care providers—also signals an elder care chain that links unretirable elderly with retired elderly. We see Lilly, an unretirable elderly woman, allow Mary, a retired elderly woman, to enjoy her retirement.
The inability of domestic workers to retire poses a challenge to global advocacy efforts for the recognition of domestic work. How do we remedy the elusiveness of retirement? Imposing heavy penalties on employers who fail to contribute to Social Security and Medicare taxes seems to be a worthwhile first step. Pressuring employers to financially reciprocate for the loyalty elicited by the emotional and spiritual fulfillment of elder care is another. For elderly people who need care but cannot afford to pay, we need social subsidies so that care workers can receive decent pay for their labors. Finally, placing retirement in the forefront of domestic work advocacy and policy efforts highlights the struggles of workers such as Fe, Letty, and Lilly, making it a necessary step to standardizing their occupation.
