The socially conscious, consumer-savvy baby boom generation is beginning to do business with one of the most dysfunctional institutions in our society--the elder-care system.

What boomers are finding is that the search for decent, affordable care for aging parents who can no longer care for themselves can be a financial and emotional nightmare. Good home care is expensive and Medicare, the federal health plan for the elderly, pays for very little of it. When families opt for a nursing home, they get another shock: Medicare and private insurance don't pay for much of that, either. And even after demanding about $30,000 a year, some nursing homes can't even manage to keep residents safe, clean, and comfortable.

The alternative: A family member--usually a woman--puts aside other callings to stay home and provide care. Most do it with a great deal of affection and no outside help. Many give up a much-needed source of family income.

Can't we do better than that for our families? Yes, but it will take nothing short of a consumer and human rights campaign to bring about change, says Deborah Stone, a fellow of the Open Society Institute. Writing in The Nation (March 13, 2000), Stone calls for a 'care movement' to change the way we treat millions of children, elderly people, disabled people, and their caregivers.

'We need a movement to demonstrate that caring is not a free resource, that caring is hard and skilled work, that it takes time and devotion, and that the people who do it are making sacrifices,' she writes. The first step will be to build a coalition of what Stone calls the care triangle: those who need care, stay-at-home caregivers, and paid care workers. But aren't families who want affordable care and workers who want a living wage fighting against each other? Stone argues that the two goals overlap more than they conflict. In Los Angeles and San Francisco, for example, unions representing home care workers joined with disability activists and the elderly to set up systems that allowed the caregivers to negotiate higher wages and benefits. As a result, clients are getting better service, Donna Calame, executive director of the San Francisco Public Authority, told Stone.

'I see a different kind of person coming in to be a health care worker,' Calame says. 'They seem more stable.'

The care movement could reclaim the concept of family values from conservatives, who embrace the stay-at-home mom only if she's not on welfare. When welfare moms do return to work, they find a culture of long hours and rigid schedules that is hostile to the needs of a normal family, Stone writes. And those so-called family-friendly companies with their flextime and on-site day care? Well, they're a lot more friendly to white-collar workers than they are to low-wage workers, writes Betty Holcomb in Ms. (April/May 2000). She profiles Lynnell Minkins, a food service worker at Marriott International, which made Working Mother magazine's list of the most family-friendly companies. Apparently, the company's flextime policies don't apply to workers like Minkins, who can't even arrange her schedule ahead of time so she can make doctor appointments for her kids.