Juliet Pingul has spent the past two decades taking care of strangers. She started her caregiving career working multiple jobs and making minimum wage in nursing homes, but now works with private families. In addition to her professional caregiving work she is a single mother responsible for her 6-year-old daughter and 80-year-old mother.
While Juliet has found a way to make a stable living taking care of others, many home care professionals aren’t as fortunate.
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.
I documented Pingul in Atlanta, Georgia as she cares for her client Rekha Shah, 64, who has lived with frontotemporal dementia for the last 10 years.
I pitched, wrote, and photographed the article for the Atlanta Journal-Constitution.
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?”