Challenges Facing Home Care for Seniors
Right now, many seniors are finding it hard to afford care at home. They often need help with daily tasks and companionship but don’t necessarily require skilled nursing. The situation might improve, though, as a suggestion from the Ministry of Labor could help ease the burdens imposed by regulations established during the Obama administration. With the aging U.S. population, a more practical and cost-effective approach to home care is increasingly necessary.
Home care has historically been complicated from an administrative perspective. Back in 1974, Congress amended the Fair Labor Standards Act to cover minimum wage and overtime for many domestic workers. However, they created exemptions for those providing companionship or care to seniors and individuals with disabilities. In 1975, the Ministry of Labor identified these services as involving “fellowship, care, and protection.” This essentially means engaging in activities that boost someone’s daily well-being. These exemptions also apply to workers hired through agencies.
However, things changed in 2013 when the Department of Labor, under the Obama administration, tightened the definition of companionship services. They removed “care” as a necessary task, meaning that if a companion spent over 20% of their time on non-exempt duties—like meal prep or helping with dressing—they lost that exemption. Plus, third-party organizations were no longer able to fully utilize the exemptions.
This has created a lot of legal complications. Families looking to hire help now face the challenge of keeping meticulous daily records and dealing with wage calculations, especially for live-in caregivers who may have room and board included in their pay. Consequently, many families are opting out of formal assistance entirely or are forced into “off-the-books” arrangements that escape regulation.
Adding to the struggle, the costs of home support can exceed $80,000 a year, which places a massive financial strain on families. Medicare doesn’t cover this kind of care, leaving families to shoulder the entire expense, often making it unattainable for those on fixed or limited incomes.
Additionally, the 2013 regulations contributed to a smaller workforce of available companions. This shortage doesn’t just impact seniors who need basic support—it also limits job opportunities for low-income individuals, students, or retirees who might be looking for work. The Labor Department under the Trump Administration proposed a more workable structure that could maintain necessary oversight while lowering these barriers.
Public input on the department’s proposal is open until September 2, 2025. Feedback is expected to reveal how the 2013 regulations have affected access, affordability, and availability of support services. If those rules are overturned, caregivers through third-party agencies could once again qualify for exemptions, opening up more options for older Americans.
The current system is failing to provide adequate support for the aging population who wish to remain home with companions for basic assistance, friendship, and reassurance. Fortunately, we can address this issue by clarifying definitions around companionship services. By distinguishing between intensive medical care and just being present to support someone, we can meet the diverse needs of older adults, helping them age with the dignity they deserve.
