My parents in the late 1970s.
Like many people my age (45), I am now having to figure out how to best care for aging parents. In 2006 my father had a debilitating stroke. He is now almost 80 and my mother is 80 and no longer able to care for him at home. In January of this year my father entered an assisted living center in Pittsboro, North Carolina, and my mother moved into an independent living center nearby about a month ago. Until these moves they lived self-sufficient lives on a seventy-acre farm that is still home to twenty cows. 
       Both of the facilities my parents live in are pleasant, clean places staffed for the most part by approachable, kind people. Considering the costs of care and living space in the Northeast, my brothers and I realize the monthly costs at the two homes are quite reasonable. However, during a visit to Pittsboro over Fourth of July week I realized how fragile the state of my parents' care is, and the economic realities behind senior care. Many of the people taking care of the older generation can barely make it financially. 
       Caregiving is still "women's work". In my parents' homes, men usually work in maintenance, the kitchens, or occasionally they are the physical therapists who have the strength to push and pull damaged bodies. While their husbands work as electricians or TV cable installers, or sometimes even manage to work at two jobs at once, women have turned to caregiving to supplement family incomes.
       There are all kinds of workers at the type of assisted living homes that my parents are in, from highly-educated visiting doctors to employees who gather around the central "nurses' station," waiting for buzzes from residents who need something, and who help bathe, feed, and push residents to daily activities. In addition, there are administrators, activities coordinators, drivers, and various maintenance staff. The qualifying barriers to many of these jobs are low, so women who, for various reasons, did not get college degrees or had children or simply need money can get work in senior care and healthcare — and often these are the best jobs available to them in small towns. Drive around or shop in an American town at the end of the day and you'll see many women dressed in the colorful print blouses of nurses and caregivers, getting off of work and picking up dinner at McDonalds. 
       While most of these women are friendly and good at their jobs and even feel a calling to work with the elderly, talk to them a little and you hear stories of struggle and endless work for low wages. My sister-in-law works as activities coordinator at the home my father lives in and she tells of being asked by coworkers for loans and bringing extra food so that she can share with coworkers who can't afford lunch. Many jobs are hourly with no benefits, and wages range from only about eight to twelve dollars an hour. On holidays like July Fourth there is no overtime or extra pay added to the hourly wages. 
       My brothers and I have hired caregivers to assist and drive my mother during the day. These women are contracted through a company called Home Instead, which helps families care for the elderly who want to remain somewhat independent. One of them helps my mother on Sundays and also has a full-time job in a hospital, is getting a college degree in business from the online University of Phoenix, and is raising two boys. Her husband works two jobs. She doesn't have any particular medical training and doesn't need it because in effect she is selling her services as a kind of servant / maid / domestic. 
       One day I went shopping for items for my father, including sweatpants, difficult to find during the hottest days on record in the area. My sister-in-law and I went into many of the cheap-goods stores surrounding Siler City, a worn, former mill and chicken-processing town where the actress who played Aunt Bee on The Andy Griffith Show retired. Walmart, Dollar General, Maxway: these are the kinds of stores where many Americans shop now, strip-mall boxes inelegantly crammed full of shelves of inexpensive, often remaindered, random products and junk food, what feels like the detritus of better times and better places.
       My parents have gone into senior care at a time when many Americans are struggling to get by, working very hard for little money, so busy they barely have time to wonder what their standard of living is, or is supposed to be. In a place like Pittsboro, the current standard of living often appears better than that of older generations: people have big shiny cars and loads of cheap goods from Walmart. But they also don't have health insurance and take antidepressants and work all the time. There is a fancy new restaurant in Pittsboro, a startling change in this small town that got by for years with only a Hardees, but most residents can't afford to eat at the new place, which is meant for the local rich and visiting sophisticates from Chapel Hill. 
       My Fourth of July was tinged with a bewildering combination of small-town desperation, wonder, and consternation at American life now. It became clear to me that the care my parents receive depends on the almost mysterious good will of workers who are underpaid, often undertrained, and overworked. If anything made me proud of America this Fourth it was the sense of community and dedication that causes many people to be very kind to my parents.