Helping Seniors—and the Women Who Care for Them
By Heather Madden
The need to care for aging loved ones is something that many of us, particularly women, face or will face. We want options that are compassionate, flexible, and affordable. Yet far too many families encounter regulatory hurdles that make it almost impossible to arrange the kind of live-in caregiving support necessary to allow seniors to remain in their homes, which is where they overwhelmingly want to be.
The U.S. Department of Labor has proposed a common-sense rule change that would help families and seniors. It would expand access to in-home care by lifting cumbersome regulations that currently hinder such arrangements. From now until September 2, the public has an opportunity to comment on this proposal.
Independent Women, an organization founded by women for women, recognizes the meaningful impact this proposal could have on families and caregivers, especially women, who often play a leading role in caregiving. We have been working to highlight these potential impacts to foster a broader understanding of the issue.
At the heart of the issue is the 2013 Home Care Rule, an Obama-era regulation that placed new restrictions on families seeking live-in caregiving support. Specifically, the rule narrowed the scope of the “companionship exemption,” a provision that had previously protected certain caregiving arrangements from rigid overtime requirements. As a result, many families have faced increased regulatory hurdles when trying to secure in-home care. The Trump administration is reassessing this policy in order to address these challenges.
Under the rule, if a caregiver devotes over 20% of their time to essential care tasks such as meal preparation, assistance with dressing, or transportation to medical appointments, the arrangement can no longer qualify for a companionship exemption. Additionally, caregivers employed through third-party agencies are entirely ineligible for this exemption.
As a result, care has become harder to find and afford. Families are boxed out of the ability to craft flexible, live-in solutions tailored to their needs. Seniors may be pushed toward institutional care, forced into isolation, or feel like a burden to their already strained loved ones.
Most seniors wish to age in place. Remaining in their homes helps preserve independence, dignity, and social connection, all of which are essential to healthy aging. However, the current in-home care system is overly rigid and medicalized, often overlooking those who do not require intensive, specialized, or constant care.
The reality is that many seniors don’t need round-the-clock nursing care. They need help with daily life. Many seniors even have a spare room and would be thrilled to welcome a live-in caregiver in exchange for room, board, and fair compensation, creating mutually beneficial arrangements that current misguided labor policies often discourage. A more flexible and realistic system is necessary to provide accessible support for seniors with diverse needs, enabling them to age in place successfully.
Meanwhile, the cost of full-time, in-home care has skyrocketed. On average, it runs about $80,000 per year, and in some regions, it’s much higher, which is simply out of reach for most families. This disproportionately affects women, who are more likely to serve as both family caregivers and home care workers. It's imperative that we expand, not limit, the available options.
The Department of Labor's proposed rule change rescinds the 2013 Home Care Rule, which has caused difficulties for families and caregivers for over 10 years. By restoring the pre-2013 definition of companionship services, the proposed rule would once again make many in-home caregivers eligible for a companionship exemption from overtime. This exemption would also extend to caregivers employed through third-party entities like home care agencies or staffing firms.
This would restore flexibility to the caregiving market. It would make it easier for families to legally and affordably hire in-home help. And, at the same time, it would generate new employment opportunities for caregivers. This is a win-win: for families in need of support, for caregivers who want options, and for seniors who deserve the dignity of staying in the place they call home.
The Department of Labor is accepting public comments on the proposal through September 2. For those who have cared for an aging loved one, or anticipate needing to in the future, this is an opportunity to share personal experiences or perspectives that could help inform the policy discussion.
Women understand the intimate realities of caregiving. We know the demands, the logistical challenges, and the emotional burden. We also recognize the profound joy of helping someone we love remain safe and connected in their own home. To truly support our loved ones and one another, we need smart policies that reflect the realities of caregiving—making it easier for families to access care and for caregivers to provide it effectively.
Let’s shape a system where aging in place isn’t a luxury but a choice that’s within reach for all seniors.
Heather Madden is the policy staff director at Independent Women. To contribute your thoughts on this Trump administration policy, visit Independent Women’s comment drive: Support Aging in Place: Expand Access to In-Home Care.