February 9, 2024, Lower Manhattan
Bundled inside a purple quilted jacket and wearing an orange hood cut from a fleece, Wei Na Liang wheels a red cart to the M15 bus stop outside the Staten Island Ferry. In one arm, she cradles a reusable grocery bag packed with enough food for three days. Liang boards the bus and rides to a stop near the Seaport Museum in lower Manhattan, where she gets off and slowly makes her way to St. Margaret’s House, a brown brick apartment community that houses the elderly and disabled. It’s over an hour-and-a-half-long commute to her job as a home care aide to a married elderly couple. They are more than one hundred years old. They cannot walk. Liang is in her sixties. She will be lifting. Toileting. Waking up in the middle of the night to help them go to the bathroom. She will work for the next 72 hours: three consecutive 24-hour shifts. In all likelihood, she’ll hardly sleep. If she does, it will be a few hours here and there, on a couch in the couple’s apartment.
She peers through the sliding glass doors of the building’s entrance. Red lanterns hang from strings: The Chinese New Year begins tomorrow. Liang, who is from Taishan, China, came to the United States in 2012 and will miss all the celebrations among her family on Staten Island.
She pauses outside the building, surrounded by her provisions, as if summoning strength for an arduous hike. She glances inside and then steps through the building’s sliding doors, not to emerge until the following week.
January 24, 2024, City Hall
On a gray and foggy afternoon, Liang stands with a crowd of home care aides in front of City Hall. The workers pace in a long oval chain, holding up cardboard signs with handwritten slogans: “24 Hour = Violence”; “Adrienne Adams Stop Killing Women”; “I am owed $700,000 for 9 years working 24 hours”; “Years of 24-Hour Workdays Have Caused: heart attacks, nerve damage, miscarriages, neurasthenia, pass INT-175 Now To Stop This Violence.” The protesters want the city council to buck a state law that makes it legal to hire someone for a 24-hour shift but only compensate them for 13 hours if they have also been scheduled for an 8-hour sleep break. Workers like Liang report being frequently awakened during that rest period by patients who require near-constant care. They blame Council Speaker Adrienne Adams for failing to pass Bill 175 (now 615), which would restrict the maximum working hours for home care aides.
In New York State, the number of home health aide jobs is expected to rise from 440,000 in 2018 to over 700,000 by 2028, according to a City University of New York study. That adds up to a lot more people needing care, and an increasing demand for workers like Liang. Over a 10-year period, it will mean almost a million job positions need to be filled to meet the demand.
Today, the winding line of workers consists mainly of women, middle-aged or older. New York City’s home care workforce is 90 percent women, 82 percent people of color, and 67 percent foreign-born. About 10 percent are 65 years old or older.
Wei Na Liang steps up to a small wooden stage. Around her neck hangs a cardboard sign that reads “Adrienne Adams Stop the Violence.” She speaks into the microphone and an organizer, Vincent Chao, translates. “I’m here today to say to Adrienne Adams, if you’re still not here to bring INT-175, you are helping the sweatshops, you are helping the insurance companies, homecare agencies. We need to end the 24-hour workday now.”
Not long after this protest, the group will stage a hunger strike, which will last a few days. The workers will eat nothing and drink only coconut water.
December 1, 2023, Lower East Side
Wei Na Liang sits in the basement of the Chinese Staff and Workers Association offices in the Lower East Side. Her hair is shiny and falls short around her face. She wears a blue mask and gesticulates as she speaks, the skin on her hands pale and cracked. The large basement room is dark except for some dim overhead lights. A ping-pong table takes up most of the space, and a dry-erase board on the wall is scribbled over with dates for future rallies. From a small school desk chair, accompanied by a translator, Liang explains how since March 2013, she has worked 24-hour shifts for a company called Premier Home Health Care Services. Every week she takes care of different patients. One patient she visited a few years ago had diabetes, high blood pressure, one leg, and used a walker.
Liang is among the thousands of workers in the city who have filed claims with the State Department of Labor against Premier and other similar companies. She recounts some of the incidents she included in her complaint: the time she knelt to change one patient’s catheter, only to realize that urine had leaked all over the floor. The time a patient suffering from dementia struck her with a ladle. The elderly woman who walked out of her apartment in the middle of the night so Liang had to run after her into the street. The patient who dumped the contents of a garbage bin over her while she slept. A particularly bad shift in 2021, where she slept for less than five hours and was able to eat for only five minutes at mealtimes.
Workers never get eight hours’ rest and are often victims of wage theft.
She and other aides are demanding that the 24-hour shift be split up into two, with more than one worker caring for the same patient. She maintains that she repeatedly raised concerns with her managers at Premier but was told that if she didn’t like the job, someone else would take it. When she asked her employer why she was paid so little, she says, they told her “You signed a form when you came to work.”
All Liang can recall about starting her job is that she arrived at Premier’s offices in New York to apply for a home attendant position that was advertised in the paper. She signed some documents but wasn’t sure what they meant. According to Chao, these employers often don’t explain the terms of the position before the workers sign on to the job. (Premier could not be reached for comment.)
The challenges of Liang’s job are as much emotional as they are physical and sometimes require her to make consequential decisions in an instant. When one patient suffered stomach pains, she avoided calling an ambulance because of the expense and walked the patient to the hospital herself. She wants more humane working hours and split shifts. But she wants to honor her patients’ needs, too.
Monday, February 12, 2024, Lower Manhattan
Liang emerges from St. Margaret’s House around 8:30 a.m., through the two sliding doors. She stands outside the building with her belongings, her hair straight, oily, and matted down against her head. She pulls the red-wheeled cart behind her as she makes her way back to the M15. Her grocery bag is empty, with just a couple of plastic bags left inside.
She limps a bit, her purse slung around her body. She’s wrapped in the same purple puffer. Liang boards the bus, choosing the same seat she did days before, the front seat closest to the door, on the right side. She is anxious to reach Bensonhurst, where her son is waiting. She sinks into her seat, staring off to one side of the bus, blue mask covering her mouth. Her eyes seem to wilt as the bright sun creeps up the surface of Manhattan’s skyline.
She reaches the Grand Street subway station. When the train arrives, she slides into the subway car and pulls up her phone. A call comes in and she answers it on speaker. “Okay, okay,” she says to her son. As the subway car curves over the Brooklyn Bridge, she brings her hands up in prayer in front of her forehead. Directly above her seat is an ad for home care workers. “Earn $17-$21/Hour Caring for Your Relative, Friend, or Neighbor! Over 70,000 New Yorkers have put their trust in Caring Professionals for over 25 years.”
At 18th Avenue in Bensonhurst, she gets off and takes the four flights of stairs down to the street, one foot, then the other, hoisting the rolling cart behind her.
A young man stands next to his parallel-parked car. It is her son, who will take her out for dim sum. She smiles and he waves. Liang pulls the cart across the street to meet him.
October 21, 2024, Lower East Side
Liang sits at the ping-pong table in the basement of the Chinese Staff and Workers Association. She wears the same purple puffer and holds her hands neatly in her lap. She still does three 24-hour shifts weekly, walks up to the same two glass sliding doors, enters, and remains inside for 72 hours. Her hourly wage has gone up a bit from $10-$15 per hour, but she maintains that Premier still owes her back pay for the two elderly patients. On September 30, workers like Liang filed suit against a few homecare agencies that pay companies like hers for just 13 hours out of 24. They too, the suit alleges, are well aware that workers never get eight hours’ rest and are victims of wage theft.
The wife in the centenarian couple has just passed away. Lung cancer, Liang says. At the end of her life, Liang welcomed the patient back to her room in the brick building. Her children and doctor told Liang, “She’s already 100 years old, so just let her be.”
“After 24 hours she passed away,” Liang said. “I took care of her for a long time.” She nods and then looks down at her hands. Soon she’ll be back at work, to care for the old man. “Only one patient’s pay. It’s not enough.”
Amy Pedulla is a writer and radio producer. She’s written and reported stories or produced series for STAT, Defector, Still Alive Magazine, Serial Productions/ the New York Times, the Boston Globe, and Gimlet Media, among others. She holds an MFA in narrative nonfiction from the University of Georgia.
All photos courtesy of Amy Pedulla.
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