BRIDPORT, Vt. — The yellow squash has an ugly rotten spot. “Mommy’s little secret,” Amanda Sheppard says as she surveys mounds of produce at the local food pantry. She’ll take the hand-out, knife away the rot and her family will never know.

Sheppard’s survival tricks are finely-tuned after seven years as a personal care aide, the fastest growing job in America. Selecting a box of Cheerios, she spies a six-pound can of tomatoes; she’ll divvy it into glass jars and it’ll last weeks. Between what she’s picked up today, free school lunches for her 8-year-old and suppers at the Congregational Church off the common in Middlebury, Vt., her family won’t go hungry.

Supermarket shopping can be a luxury because of what she does for a living, making $9.78 an hour, with no benefits or guaranteed hours. She’s one of more than 900,000 personal care aides, caregivers who provide comfort and companionship for the elderly and disabled and perform daily chores so they can remain in their homes. It’s a signature occupation of a post-recession economy creating mostly low-wage jobs.

The number of PCAs, as they’re called, will increase 70 percent between 2010 and 2020, making it the fastest-growing job in the country, according to the Department of Labor. The trade is exploding as the country ages and Medicaid focuses on keeping people out of nursing homes and other facilities. That saves money, and requires an army of caregivers like Sheppard who are helping fill the growing ranks of the working poor.


Five-feet-four with blond hair, Sheppard, 31, is a combination groomer, cook, housekeeper, guardian and friend. Her schedule is typical for a PCA: spotty and unpredictable. She has one full-fledged client, and two who can’t pay her at the moment. She tends to them anyway. It’s a generosity Kent State University sociologist Clare Stacey found was common among the home-care workers she studied for her 2011 book, “The Caring Self.” They spend extra hours with their charges knowing they won’t be reimbursed because, as Sheppard says, “What am I supposed to do, just leave them?”

As an independent contractor, not on the payroll of a home- care company, Sheppard isn’t in the Bureau of Labor Statistics tally. While the government counted 985,230 PCAs in 2012 – a 44 percent increase from 2010 – there were an additional 800,000 like Sheppard who weren’t included in the category, “and that’s a very conservative estimate,” says Abby Marquand, an associate director at the New York-based Paraprofessional Healthcare Institute, an advocacy group for direct-care workers, 90 percent of whom are women.

The average hourly pay for the PCAs the government tracked in 2012 was $10.01, according to the BLS. Adjusted for inflation, their wages fell 5 percent over a decade. Sheppard has earned the same state-set rate since she started in 2006, and inflation means her real wage has dropped 14 percent. Vermont will give some PCAs a raise this month to $11 an hour.


That’s in the lower-wage category of most of the jobs produced in the labor market recovery after the 2007-2009 recession, according to a study by the National Employment Law Project in New York, which receives funding from foundations and unions. The study found 58 percent of those created between 2010 and 2012 paid $13.83 an hour or less.

Two years after the recession was over, 32 percent of working families didn’t earn enough to cover basic necessities, up from 28 percent in 2007, according to a report by the nonprofit Working Poor Families Project that analyzed 2011 U.S. Census data. In the home-care sector, workers make so little that 50 percent depend on some form of government assistance, according to Dorie Seavey, PHI’s policy research director.

Sheppard’s four-member family receives help with utility bills and gasoline from Addison County social services agencies and qualifies for the U.S. Department of Agriculture’s Women, Infants and Children program, which sends a shipment of milk and cheese twice a month because of four-month-old Gabriel.

Last year, before her partner, Greg Sands, found a full- time job, they managed on the $14,790 she made and qualified for food stamps. Now Sands, 29, earns $12.30 an hour at the Goodwill Industries store in Williston, 42 miles away. This year, the family could cross the federal poverty guideline of $23,550 that’s used to determine eligibility for assistance. Sheppard won’t be turned away by the food bank; its doors are open to households whose gross income is less than 185 percent of the U.S. poverty level.

Still, the budget is tight for Sheppard and Sands. There’s $199 in a fund for winter tires that will cost $500, and they owe the electric company $500. The 8-year-old, Kaleb, Sheppard’s son from a previous relationship, is allowed to pick one sport, which this fall was soccer. “He’s a fish, he loves to swim,” his mother says, but they can’t swing the $30 monthly pool fee.

The day starts when Sheppard packs Gabriel into the back seat of her 218,000-mile Subaru at their rental off a dirt road in Bridport, bordering the college town of Middlebury, beneath the dark silhouettes of the Green Mountains. They can’t afford day care, so where she goes the baby goes.

She can cover 200 miles on a busy day. Twice a week she drives to Weybridge, to Judy Trudeau’s house. Trudeau, 54, has emphysema and chronic bronchitis, and answers the door in her black wheelchair. She reaches out. “My sweet pea!”

Sheppard supplements the round-the-clock care provided by Trudeau’s daughter, Eva. She does light housekeeping, washes Trudeau’s hair and holds her hand.

For a year, Sheppard says she came several times a week even though Trudeau’s Medicaid benefits covered only about two of those months. Starting two weeks ago, she says, Medicaid began paying for PCA care for at least six hours weekly. “It’s only going to get worse for me, not better,” Trudeau says, and she wants Sheppard to be there.


Sheppard’s often not compensated for the work she does, usually because funding for her mostly low-income clients has fallen through. More than half of direct-care workers in Vermont are paid by Medicaid, the joint state and federal insurance program for the poor and disabled. The rest are paid out-of- pocket by clients or by Medicare or long-term care insurance.

So there’s no telling what she’ll earn month to month, and the uncertainty creates tension at home.

Sands says that while he fell in love with Sheppard because of her compassion, there are times “I can’t handle it.”