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Ep 73 - They Think Caregiving Means Grocery Shopping

  • May 18
  • 4 min read

Caregiving in America has a public-relations problem. The people doing it know exactly how serious, exhausting, emotionally brutal, and socially necessary the work really is. The people talking about it politically often sound like they think it mostly involves picking up canned soup and balancing a checkbook.


America tells seniors to age with dignity while quietly dismantling the systems that make dignity possible.
America tells seniors to age with dignity while quietly dismantling the systems that make dignity possible.

That disconnect matters. Because the way a society talks about caregiving eventually shapes the way it funds it, regulates it, and values it. And right now, too many powerful people seem to view elder care less as essential infrastructure and more as a suspicious expense category waiting to be audited.


Recently, RFK Jr. described home-care work in terms of things like grocery shopping, bookkeeping, and tasks family members “used to do for free.” Technically, yes, those tasks can be part of caregiving. But presenting home care primarily through that lens is like describing firefighters as “people who occasionally hold hoses.” It strips away the reality of the labor itself.


Because actual caregiving often means helping somebody bathe. Helping somebody use the bathroom. Monitoring medications. Managing confusion, paranoia, memory loss, falls, mobility problems, and dementia-related behaviors. It means trying to preserve a person’s dignity while their body or mind slowly betrays them. It means emotionally stabilizing frightened people who increasingly no longer understand what is happening to them.


And a huge amount of that labor is performed quietly, invisibly, and underpaid by women. Daughters. Wives. Sisters. Family members who reduce work hours, drain savings, sacrifice careers, and absorb enormous emotional pressure because the alternative is letting somebody they love fall apart alone. When politicians nostalgically talk about families handling elder care “the old-fashioned way,” what they often mean is women quietly carrying impossible burdens without support.


America has built enormous portions of its elder-care system around the assumption that caregiving labor will simply materialize inside families forever, free of charge and free of consequence. But caregiving is not free. Someone always pays for it. If not through taxes or public investment, then through exhaustion, lost income, deteriorating mental health, burnout, and family collapse.


And now, in the middle of an already strained elder-care system, the federal government has announced freezes tied to fraud concerns in home-health and hospice enrollment. To be clear: fraud exists. Any system involving large amounts of money will attract scammers. Fraud should absolutely be investigated and prosecuted. But the political framing around this issue reveals something ugly about American priorities.


Notice how quickly the conversation shifts from “How do we support vulnerable people?” to “How do we stop people from cheating?” Notice how rapidly suspicion becomes the emotional center of the discussion. The exhausted home aide suddenly becomes more politically suspicious than industries and elites that drain vastly larger amounts of money from the public every year.


That imbalance is difficult to ignore. America often seems dramatically more energized about fraud involving public assistance than ethically murky behavior involving wealthy or politically connected people. A struggling caregiver receiving reimbursement triggers outrage. Billionaires navigating morally radioactive financial ecosystems somehow becomes “complex.”


And underneath all of this is another uncomfortable reality: many of the people shaping elder-care policy do not personally experience aging the way ordinary Americans do. Wealth changes everything. If somebody in a wealthy political family develops dementia or serious physical decline, there are private nurses, concierge doctors, legal resources, financial flexibility, and backup plans. For ordinary families, elder care can become an all-consuming crisis capable of financially and emotionally wrecking entire households.


Most Americans do not understand how fragile the elder-care system really is until somebody they love needs it. That is when the illusion collapses. Families discover there are not enough workers, not enough providers, not enough support systems, and not enough margin for error. They discover that “aging in place” often depends on exhausted workers and family members holding everything together through sheer force of will.


And maybe that is the part that angers me most. America constantly celebrates independence, productivity, and self-sufficiency, but aging eventually exposes the limits of all three. If we live long enough, every one of us eventually becomes vulnerable. Every one of us eventually depends on somebody else for help in some form. Dependency is not failure. It is part of being human.


Caregiving is not secondary labor. It is not decorative labor. It is not optional labor. It is foundational to a functioning society. And the way America treats caregivers and elderly people says something deeply unsettling about what this country believes human beings are worth once productivity fades.


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