Spending 12 Hours at Home With a Healthcare Aide
Junior Cooper, a home healthcare aide, is a man with an austere face that immediately softens when he bends down to rub the face of his patient of two years, Joe Schorr, 89.
“Ma Nishma, Cookie?” Cooper asks. “Ma Nishma” is Hebrew for “How’s it going?” and “Cookie” is Schorr’s nickname that he got from a quacking noise he used to make for his grandchildren.
“Speaking to him like this brings back his memories,” Cooper, 53, explains.
Schorr, a former real estate developer, was diagnosed with early onset Alzheimer’s in 2000 at age 71. Eighteen years later, he is unable to walk and has difficulty seeing and speaking. For the next 12 hours, Schorr’s well-being is Cooper’s main responsibility.
Every day from Monday to Friday, Cooper wakes up at 6 a.m., leaves his house in the Bronx at 7 to take the 2 train from Gun Hill Road Station to 72nd Street. He then transfers to the 1 and gets off at Lincoln Center. By the time he arrives at the lobby of the Schorr’s apartment , it is around 7:45. He takes the next 15 minutes to himself, either reading the Bible or scrolling through his phone and texting his fiancée, before making it up to the fifth floor to start his shift at exactly 8 a.m.
Cooper is one of 166,800 home healthcare aides working in New York City. These aides are licensed by the state’s Department of Health to assist seniors and people with disabilities in their daily routines. This can range from meal preparation, feeding and bathing to housecleaning and handling of personal finance. In some cases, aides are required to work in 24-hour shifts. However, under current state laws, workers are compensated for only 13 of the 24 hours.
Last October, two state appellate courts ruled in favor of home health aides, requiring agencies to pay workers for all 24 hours of work. Since then, the state’s Department of Labor has used emergency ruling procedures to maintain the 13-hour pay policy. The department argues that the industry cannot afford to increase hours and wages, as it would burden agencies and their clients.
On Sept. 26, the state’s Supreme Court invalidated the department’s emergency rulemaking amendment.
Although Cooper is dividing up the 24-hour shifts with another aide who takes the night shifts, he has worked the full shifts for two of his past clients.
Approximately 8 percent of aides in the state work 24-hour shifts, according to the 1199SEIU United Healthcare Workers East.
The Department of Labor’s “definition of ‘residential employees’ excludes their regular sleep hours from the total hours worked. But the nature of job interrupts their breaks,” said Travis England, a lawyer for the National Center of Law and Economic Justice.
“It’s a mental thing. I may not be physically moving, but my mind is focused on my patient, all the time,” said Cooper. He continues, “As soon as I walk in the door, all my attention is directed towards Joe.”
Schorr is bedridden, and Cooper spends approximately nine of his 12 hour shift inside, sometimes watching him sleep the entire day. But because Schorr is unable to speak, Cooper checks in on him to to see if he needs water, or to use the restroom.
“I have to think for him. Be his eyes, his ears, all of his senses because he can’t speak for himself,” Cooper said.
When the weather permits, Cooper takes Schorr out for hour-long walks in Central Park at least once a day. Simply leaving the house is a task that requires at least 30 minutes of preparation.
First, Cooper helps Schorr onto the toilet where Cooper will leave him for approximately 15 to 20 minutes. During this time, Cooper shuttles between the kitchen and the bedroom, preparing water and snacks for Schorr and himself. He then cleans Schorr, goes into the closet and selects weather-appropriate attire. Schorr is never more than 10 feet away.
Finally, Cooper props Schorr up from the chair and they stand for a few minutes with Schorr in the front and Cooper right behind him, grabbing hold of his waist and wrists.
Cooper explains, “It’ll help get blood flowing through his legs. If I were sitting in a chair for 24 hours a day, I’d imagine that I’d like to exercise my legs occasionally.”
At 11:30, they are out the door; Schorr in a wheelchair, Cooper pushing from behind. He navigates through the crowds of tourists to his favorite parts of the park: the baseball field, the vendor near Strawberry Fields selling $3 bags of honey-roasted cashews, the bench in front of the skateboard park where a trumpeter serenades onlookers.
“Life with Joe is pretty good,” said Cooper, “But I’ve also had cases where the client was aggressive, the pay was not good but I was in a desperate situation when I was employed by an agency. … I wouldn’t go back unless I have to.”
Cooper is an independent contractor and is certified. He solicits clients and negotiates work contracts directly, rather than through a home healthcare agency.
According to a 2018 study conducted by the city’s Department of Consumer Affairs, the average yearly salary of aides is approximately $19,500, with an average hourly salary of $13 to $15. Cooper makes $19 an hour.
Schorr is covered by John Hancock Long Term Care, a private insurance company, according to Schorr’s wife Adina, 80. She estimates that they pay $7 to $8 per hour out of pocket for Schorr’s 24-hour care.
Most aides however, are contracted through agencies that are predominantly funded through Medicaid, according to LaDonna Lusher, an attorney representing aides in the case against the Labor Department’s 13-hour policy.
“Agencies may receive clients on private insurance who pay more ,but many patients are on Medicaid. Unless the state raises Medicaid funding, both patients and agencies won’t be able to pay aides more,” said Lusher.
According to the state Department of Health, home health care accounted for approximately $2.5 billion of the total budget of $7.7 billion. There are currently over 6 million people enrolled in Medicaid, approximately 31 percent of the state’s population.
For Adina Schorr, a healthy husband is worth the extra money.
“We can afford it, and I couldn’t do it alone anymore. I couldn’t take care of Joe physically and emotionally. That’s where Junior came in,” she said.
Cooper started with the Schorrs back in November 2016. His life might be stable for now, but Cooper knows that the nature of his job requires him to prepare for the worst.
“It’s this industry. You always have to be ready for anything. But for now it’s all about Joe. He is my patient, my responsibility,” Cooper said.
