Labor of Love

How one caregiver makes ends meet in an often unforgiving industry.

Photos and text by Arvin Temkar
The Atlanta Journal-Constitution

Juliet Pingul was exhausted. For years she’d toiled for minimum wage in nursing homes and assisted care facilities, hectic environments that required her to be on her feet for up to 12 hours a day pushing wheelchairs, cleaning messes and feeding and bathing dozens of patients.

So in 2012 she enrolled in evening classes at Gwinnett Technical College with an eye toward a more comfortable and well-paying job as a medical administrative assistant. By the end of the year-long program she had a job offer at a doctor’s office. But she didn’t accept it.

At the time Pingul had spent 10 months caring for a client in Atlanta with dementia. She worked privately for her client as a home care aide and earned more money than she had at any institution. The hours were better and the work, though physical, was less demanding. She found that she’d grown attached to the person she’d looked after, joked with, and took swimming and other activities.

“I told her family, ‘As long as you need me, I will not leave,” says Pingul. She would serve as her caretaker until the client died six years later.

Pingul, 47, is still a caregiver has added her own business, connecting other caregivers to private clients. She’s a single mother, who also cares for her 7-year-old daughter and her own 81-year-old mother. The Filipino immigrant considers herself lucky to have found a way to make a living looking after others.

“I’m blessed enough to meet the right people in the right path that lets me do what I’m doing now,” she says.

The Pingul family — Juliet (right), her daughter Tala and her mother Josie — poses for a portrait in Snellville. (Arvin Temkar / arvin.temkar@ajc.com)

But other home care professionals aren’t as fortunate. Many work for minimum wage for agencies and other institutions.

Nationally, home care workers earn a median annual income of $19,100, according to PHI, a research and advocacy group that aims to enhance working conditions for care workers. About two in five home care workers work part time, more than half have not completed an education beyond high school and more than half are on some form of public assistance.

There are roughly 2.6 million home care workers in the nation and 36,000 in Georgia, according to 2021 data collected by PHI. That’s a “very conservative” estimate of the workforce size, since people who are privately employed, like Pingul, aren’t included in the data, says Kezia Scales, senior director of policy research at PHI.

Meanwhile, as the elderly population expands, the need for home health care work is rapidly rising. From 2020 to 2030, there will be nearly 5 million job openings for these workers – including 1 million new jobs created by demand, according to PHI.

The pandemic hasn’t made hiring easier.

“We’re seeing employers struggling more than ever to recruit and retain home care workers in these difficult jobs,” says Scales. “Those who might consider home care jobs may instead choose jobs in retail or fast food or other industries that are able to offer, in most cases, a higher wage.”

Pingul sees what’s coming and hopes to open a day center for aging adults. “I am good at this,” she says. “This is my calling.”

We documented Pingul as an example of the ups and downs of being a caregiver both professionally and to her own family. It’s clear that for Pingul, caregiving — a profession that is both essential and overlooked — is a labor of love.

Pingul’s days started at 9 a.m. and ended at 8 p.m. four days a week. Though the hours were long, the pace and pay were far preferable to work inside a nursing home, she says.

Pingul spent four years caring for Rekha Shah, 65, who has frontotemporal dementia (FTD). The disease typically affects people in their 40s to 60s. Rekha is unable to speak or walk, and she often appears vacant. The TV show “60 Minutes” called FTD “the cruelest disease you’ve never heard of” because it’s the most common form of dementia for Americans under the age of 60, although not many people know about.

Pingul says the Shah residence became her “second home” and she developed a deep connection to Rekha. “I can feel when she’s in discomfort — I just look at her and I know how she feels,” she says.

Raj Shah first noticed something different with his wife in 2010. At first he thought it was depression. Then her personality really changed — a tell-tale sign of FTD. “She would shout at you. Wear the same outfit every day,” he recalls. Typically reserved, Rekha would sometimes dance in front of company. The disease “robs your personality,” he says. “A person loses insight to who they are. She never thought anything was wrong with her.”

Caregiving is physically demanding. “If a patient falls, we fall first,” says Pingul. “We catch them.” Earlier this year Pingul developed back pain and left the Shah family after four years of working for them. She now works with clients who are more mobile, while growing her business.

Rekah was diagnosed with FTD in 2012. She lost her ability to speak in 2019 and became wheelchair bound in 2021. Raj thinks her disease would have progressed even quicker if not for the level of attention and interaction given by Pingul and others. It also makes a difference that Rekah has been able to stay at home, rather than go to a facility, he says.

Long hours means time away from home. Pingul says she missed out on Tala’s baby days and only saw her one hour in the morning before work. Now that Tala is in second grade Pingul tries to leave work earlier so she can help her with her homework in the evening. Pingul doesn’t think of her work commitment as a sacrifice, rather as a necessity. “It’s our life, we have to do it this way.”

After starting her caregiving staffing business in 2017, Pingul was able to buy a home in Snellville.

Tala once told Pingul that she wants to be a caregiver like her mom. Pingul responded, “You can do better than me.” “I don’t want her to do the hard work,” Pingul says. “It is a satisfying job but I want her to do more for herself. She can be a nurse or doctor.”

Tala, now 7, has declared Thursday to be “mommy day.” “I like to have some fun, cook with mommy, get some ice cream, get McDonalds. And then we can play games,” she says.

With the help of her mother Josie, Pingul makes kalamay, sticky rice with coconut and sugar wrapped in banana leaves. Josie makes life easier by taking care of Tala and helping cook. But Pingul knows that it’s only a matter of time before she’ll have to take care of her mother too.

FTD can be very difficult to diagnose. Raj says before his wife was diagnosed, “I was told by two different doctors that there was nothing wrong.”

Over time, Rekha has needed more than one home care worker to support her. Jingky Yarnell, 47, (right) worked an evening job as a factory machine operator before arriving in the morning to work a few extra hours as a caregiver. After Pingul left, Jingky became the main caregiver and no longer works at the factory.

Pingul ate her meals at the Shah’s house. At first she brought her own lunch, but Raj insisted that she eat with them. It took her some time to get used to Indian vegetarian cooking, but now she says, ”I miss it.”

Pingul arrived home at 9:30 p.m. after a particularly long day.

Since taking on a lighter schedule, Pingul now has more time to spend with daughter Tala. “We get to eat dinner together, which we haven’t done in the first six years of her life,” she says. “I’m not as ragged and tired on my days off. The other day we went to the pumpkin patch.” But there’s always the chance that a future client will have more demanding needs. “I like this job,” says Pingul. “I like seeing my patients smile. Maybe I’ll do this for the rest of my life. Who knows?”

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