Eldercare in the United States: Inadequate, Inequitable, but Not a Lost Cause

Abstract

Eldercare, like other forms of care work, is often taken for granted and undervalued. The burdens as well as the failures of providing care for the elderly are often borne disproportionately by women. This paper documents inequality of access and low quality of care for the elderly in the United States. It argues that public funds used to subsidize nursing homes are poorly spent and that profit-maximizing competition in the nursing home industry adversely affects the quality of care provided. In seeking to address these problems, policy-makers can learn important lessons from several different sources. The experiences of several European countries, current regulatory efforts in the state of Massachusetts, and more decentralized volunteer efforts to promote humane visions of eldercare all offer some hope for the future.