Adding Value Through Direct Care Work

My work empowers on multiple levels. It allows me to support myself and my children and is a key part of my identity. As a Direct Support Professional, or DSP, my work also makes it possible for others to contribute their skills and talents to the American workforce. It has an amplifying effect. It has value.

Direct care work is, and always has been, essential to America’s workforce and economy. Yet, historically, direct care provision has not been given the respect it deserves. Many direct care providers live in poverty and rely on public assistance. Adjusted for inflation, we’ve received little to no gains in real wages since 2000. This lies in longstanding inequities based on gender and race. Eighty-seven percent of DSPs are women, and 53% are women of color.A photo of Aleathea and Russell.

In this context, consider just the first half of my workday. I provide direct care for a man named Russell, who has limited mobility due to cerebral palsy. I’m an in-home DSP, meaning I live with Russell in Sacramento. I wake up around 4:30 a.m. I then help Russell get up, take his medication and shower. After that, I help him put on his catheter and leg bag and get dressed and ready to work. He’s currently working remotely, so this includes setting up his workstation.

I’m a single mom, so on school days, I do all this while juggling the morning routine for my children, one of whom has disabilities. I’m incredibly grateful for the flexibility to take care of my kids’ needs while also working, but it’s both a perk and stressor of the job. Once school starts, I run errands, tidy the house and ensure Russell has lunch. There is no “typical day”—much of my job entails responding to unanticipated needs, from minor to more significant and very personal tasks that require mutual trust and respect.

The job takes grit, and on tougher days, I remind myself that, without my assistance, Russell would not be able to do his job, which is equally important. His work as Statewide Community Organizer at California Foundation for Independent Living Centers helps others with disabilities get the supports and services they need to live and work. In this way, I’m the beginning of a chain of interdependent relationships supporting many.

But here’s the thing—while I’m proud of my work, I’m not unique. An estimated 4.6 million people are direct care workers in the U.S., and demand for our services has increased. We must recognize the vital contributions DSPs make to our society and to our economy.  

This starts by providing appropriate compensation and opportunities for advancement. The U.S. Department of Labor’s Office of Disability Employment Policy and its LEAD Center recently convened national experts to discuss potential policy solutions for achieving these aims. The conversation focused on four areas ripe for action:

  • Expanding and improving training and career pathways.

  • Elevating the field’s professional standing by tracking national trends.

  • Setting and raising standards for job quality, pay and benefits.

  • Supporting people with disabilities themselves to become DSPs.

Addressing each area will attract more people to join the profession and, by extension, help ensure more people who need direct care support, including working Americans like Russell, can access it. It’s a positive chain reaction, and I’m proud to be a critical link.

Aleathea Simmons is a direct support professional who lives in Sacramento, California.