Who’s minding the labor law protection of the thousands of caregivers who are working behind closed doors under circumstances that may be “standard” for that industry, but illegal everywhere else. In California , the home care industry can work their folks 24 hours a day, 3, 4 or even 5 days a week without a break for food, showers or a nap? They can do it because of the belief that they are exempt from current labor laws because they are “taking care of vulnerable seniors who cannot be left alone.”

Let’s take a closer look at this.

These caregivers are earning low wages, are often marginally employed (when this case is over, they don’t know when they’ll be called in on another), and at the mercy of their employer who hires them “at will” for each particular case. A caregiver may be working for five or six agencies at a time in order to keep their hours to a liveable rate. In other words, they might be working at XYZ agency on one case, and then when it ends, get called by ABC agency to work another. Home care agencies often share caregivers because no one can guarantee a 40 hour work week.

It came as a surprise to me when a home care agency I recently hired to care for a family member brought in a caregiver who worked five days, four nights, without sleeping. She kept telling me that she was “okay.” For me not to worry, that she’s “used to not sleeping for days at a time in this type of work.”

What? How can a sleep deprived caregiver be held responsible for measuring medications, monitoring vital signs or even getting along with family members? Needless to say, as the days wore on, (and they did wear on everyone, this particular caregiver became increasingly sharp, opinionated and interfering. She was unable to gauge changes in circumstance, and was adamant that she was in control and all was in order.

Whatever came to pass, I could tell that this caregiver didn’t want to lose this job, or be replaced, because she desperately needed the money.

Of course she wants to earn a living, and these low wages mean that she has to pack in as many hours as possible in order to make enough to live on until the next job comes along.

And, when I worked as a caregiver, I too tried to pack in as many hours as possible because I had no idea where the next job would be coming from.

But, these are not fair or equitable working conditions.

Home care agencies charge a premium for their services. What they publish as the going rate of $25 an hour, may not be what’s actually charged. There are caveats for overtime, holiday pay, minimum number of hours and shift work. If an agency has to bring in 3 different people to cover a 24 hour shift (8 hours each), they’ll charge a premium as well.

An agency can charge overtime and holiday fees, but I’m wondering how many actually pass this on to the caregiver. I just received a phone call from a disgruntled consumer who asked me why the home care agency charged them for the two hour “break” that the caregiver was supposed to have each day.

Of course, the agency’s moan about the worker’s compensation and employer benefits that must be paid. And, they also talk about overhead expenses, nonpayment, lagging insurance payments, etc.

Everyone’s got their side.

But, the truth is that caregivers are the lowest paid folks on the totem pole and right now, they’re working without third party oversight. And, it’s all done behind closed doors.

No vacation or sick days. No benefits. No guarantee of work.

And, these are folks delivering the most personal of care in often the most vulnerable times of anyone’s life.

There’s gotta be a better way.