International Handbook on Ageing and Public Policy
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International Handbook on Ageing and Public Policy

Sarah Harper, Kate Hamblin, Jaco Hoffman, Kenneth Howse and George Leeson

The International Handbook on Ageing and Public Policy explores the challenges arising from the ageing of populations across the globe for government, policy makers, the private sector and civil society. It examines various national state approaches to welfare provisions for older people, and highlights alternatives based around the voluntary and third-party sector, families and private initiatives. The Handbook is highly relevant for academics interested in this critical issue, and offers important messages for policy makers and practitioners.
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Chapter 27: Ageing and caregiving in America: the immigrant workforce

B. Lindsay Lowell


Ageing populations, decreasing care by families and increasing non-familial care in informal care settings are some of the factors driving growing demand for caregivers for the elderly. During the first decade of this century the number of caregivers grew faster than comparable occupations. And since 2011, the retirement wave of America’s baby-boomers will generate yet more demand for caregivers, although the impact of ageing is lessened in the USA compared with other nations due to past fertility and generous levels of immigration. Immigrants and their children are projected to account for 82 percent of population growth by 2050 (Livingston and Cohn 2012). Without immigration the US working-age population would be stable or decline slightly. Nevertheless, a wealthy society with a growing number of retirees living longer lives will demand an increased supply of labor for their care. Immigrants supplied close to 30 percent of the growing workforce caring for the elderly in the 2000s, and that raises many questions; some of the most important include: what roles do immigrant play, what do projections tell us about future demand, and how does the immigration system address demand? This chapter distinguishes professional care workers – physicians, dentists, nurses and therapists, who are highly trained and deliver medical care – from direct care providers. The latter workers – home health aides and lower-skilled providers – receive less training and assist the elderly with the challenges of daily living.

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