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Photo by Paul Joseph Brown for Marguerite Casey Foundation's Equal Voice News

Equal Voice

The Dignity of Living: America’s Home Care Aides

June 9, 2015

In this Equal Voice News storytelling report from Marguerite Casey Foundation, meet Christal Boutte, a Seattle woman who is among 3.5 million home caregivers. Learn about her compassion, her clients and the movement for dignity in living.

There are only four kinds of people in the world: those who have been caregivers, those who are currently caregivers, those who will be caregivers, and those who need caregiving.” – Rosalynn Carter

Each morning, Christal Boutte takes a moment to relax before her workday fills up. She might engage in yoga at home, if she has time, or pull out an alternative newspaper to read during her bus commute. One thing is certain–it is going to be another long day.

The Mount Holyoke College graduate is a home caregiver in Seattle, one of about 3.5 million such professionals in the country. She assists people in doing something that many take for granted. Boutte, 30, helps four people lead dignified lives, regardless of circumstances, in their homes.

Boutte is working in a fast-growing segment of the U.S. economy. The country’s population is aging rapidly, and according to surveys, a high majority of people want to stay in their homes as they age. By 2020, one in six people in America will be over the age of 65, according to some projections.

Home caregivers help the disabled, the sick and the elderly with daily tasks, including dressing, bathing, managing medication, cleaning and cooking. They also provide emotional support and companionship.

In the U.S., nine out of 10 home care aides are women. A third are Black. About 16 percent of the workforce are Latino. Of all home caregivers, 25 percent were born outside the U.S.

The work has its rewards. Boutte enjoys a rapport with the people she helps. Smiles brighten long days. The work can be challenging, too, both physically and emotionally. There is a high rate of workplace injuries. Health insurance is not a given. Only 25 percent of all home caregivers have health care.

On average, wages are below $11 an hour. A quarter of home health workers live in poverty.

Boutte works full-time for Full Life Care, a nonprofit agency, to help clients stay in their homes. She earns $11.50 an hour. She also has health care. To save money, she shares a one-bedroom basement apartment with an uncle, sleeping on the floor in a walk-in closet.

Some workdays start before dawn. Others end at midnight. The people she helps have a variety of diagnoses, including cognitive disabilities, paralysis and multiple sclerosis.

“I can help people who are isolated, who really need help with the tasks of daily living, to stay in their homes and keep their independence and to feel respected and valued,” Boutte says.

Rhonda, one of her clients, says that Boutte is doing more than that—more, in fact, than most people ever achieve. Boutte is saving lives, Rhonda says, one long day after another.


Paul Joseph Brown is a photojournalist based in Bellingham, Washington. He contributed images, video footage and reporting. He is a former photographer for the Seattle Post-Intelligencer. He specializes in global health and environmental issues. Valerie Vozza, a Seattle-based videographer, helped with editing. Reporting for this project came from various sources, including the U.S. Bureau of Labor Statistics, “The Age of Dignity” by Ai-jen Poo and PHI. Equal Voice is Marguerite Casey Foundation’s publication featuring stories of America’s families creating social change. With Equal Voice, we challenge how people think and talk about poverty in America. All original and contracted Equal Voice content – articles, photos and videos – can be reproduced for free, as long as proper credit and a link to our homepage are included.

2015 © Equal Voice for America’s Families Newspaper

The Dignity of Living: America’s Home Care Aides