Caregivers for Older People in Latin America and the Caribbean: Overburdened and Underpaid 

In Latin America and the Caribbean, there are currently 8 million older people with care needs, and due to rapid population aging, this figure is projected to triple by 2050. To cater to the needs of older people, there is a workforce of 3 million paid caregivers, and at least 8 million unpaid caregivers in the region.  

Yet, the people who provide care for older people—face a range of challenges, from low wages to poor working conditions. These caregivers, mostly women, play a critical role in supporting older people, but their own needs and conditions are frequently overlooked. 

The IDB recently launched an online self-administered survey to listen to their voices. This survey, available in English, Spanish and Portuguese across 25 countries of the region, was distributed among paid and unpaid caregivers.  

Our first report analyzing the results titled “Caregivers for Older People: Overburdened and Underpaid“, shows that paid caregivers face four major challenges: (i) lack of training, (ii) inadequate pay, (iii) limited access to social security and social protections and, (iv) insecure working environments. 

The Four Major Challenges of Paid Caregivers 

Lack of Training 

One in three paid caregivers work without any training, and only three in ten have completed an extended course of 150 hours or more. The Ibero-American protocol for training in caregiving recommends a course duration of at least 260 hours. Courses of less than 150 hours may fall short in adequately preparing caregivers for the complexities of their role. This lack of training not only impacts the quality of care provided to older people but also limits caregivers’ opportunities for professional development and upward mobility within the sector. 

Low Pay, High Responsibility 

Despite the high levels of responsibility they bear, 7 out of 10 caregivers earn the minimum wage or less. These workers provide essential support for older people—helping them with daily tasks like eating, bathing, and taking medications—yet their compensation does not match the importance of their labor. Moreover, the long hours they work exacerbate their financial difficulties, as many of them are required to work between 11 and 12 hours a day over 5 days a week. 

Limited Access to Social Security and Social Protections 

Only 37% of paid caregivers contribute to social security, which limits their access to benefits like health insurance, paid leave, or pensions. These uncertain conditions are even worse for those working inside care recipients’ homes: they are half as likely to have a written work contract (28% compared to 59% of caregivers working in institutional settings), or contribute to social security (23% versus 42%). Despite this challenging environment, 64% of paid caregivers believe they will remain in this occupation.  

Insecure work environments  

Caregivers often face the threat of violence from clients, co-workers, or management. A striking 39% of paid caregivers indicate that they have experienced verbal abuse in the course of their work, while 15% report instances of physical abuse. The threat of violence adds another layer of hardship to a challenging profession, exacerbating emotional burden and contributing to caregiver burnout. 

The added hardships of being an unpaid caregiver 

Unpaid caregiving comes with extra emotional, financial, and social burdens.  In response to our survey, 48% of unpaid caregivers reported stopping work due to caregiving duties. This insight reflects important gender equality implications: the majority of respondents were women. Additionally, 8 out of 10 unpaid caregivers have no formal training, which leaves them unprepared for the complex medical and emotional tasks they face. 

What Can Be Done? 

Addressing the challenges faced by paid caregivers is urgent. Governments, employers, and societies must join forces to ensure that caregivers receive fair wages, access to social security and social protections, and opportunities for professional development. 

These are some of our recommendations: 

• Investing in training is a crucial first step. Evidence from the IDB survey shows that training is positively linked to higher earnings, lower levels of stress and fewer symptoms of depression. Any type of training – whether self-study or an extended course – can improve caregivers’ working conditions and well-being, ultimately enhancing the quality of care provided to people of old age. Training is key to comprehensive care systems, which require courses tailored to different populations and types of services. 

• Promoting the professionalization of long-term care work. Many caregivers contend with long working hours, low wages, and limited social security and social protection benefits. These conditions are unlikely to attract the human capital required to meet the demand for care in the near future. To develop the care economy and attract and retain workers, countries need policies that promote higher wages, formal employment contracts, continuous education and opportunities for career advancement. 

• Encouraging work-life balance allows caregivers to manage their responsibilities while preserving financial stability and fostering career development. Flexible working hours and part-time opportunities are key for caregivers, as they help them to juggle demanding workloads. Access to respite care is also vital in preventing burnout and improving caregivers’ ability to provide quality care. 

• Driving cultural change is fundamental to transforming how societies regard caregiving. Care work is often undervalued and seen as a private, domestic responsibility rather than a critical component of the social infrastructure. Greater recognition of caregiving as an essential service that sustains the well-being of societies and economies is key. This requires, first, improving the working conditions of the many women already involved in caregiving and, second, encouraging men to participate in caregiving roles. 

Caring for Caregivers 

Caregivers are essential to ensure the quality of long-term care in Latin America and the Caribbean. Yet their work remains underpaid, undervalued, and unsupported. Investing in better working conditions for caregivers is an investment in the future of care across the region. It is time to ensure that those who care for others are, in turn, cared for themselves.