Caregiving Professionals Talk About Challenges and Hopes

 

At a time of upheaval and hate, care for one another is essential. In a recent PBS documentary, Caregiving, activist Ai-Jen Poo is quoted as saying that caregivers are part of “this invisible army who are essentially holding us all up.”

Caregiving is also a discipline — a practice that employs the language and lens of social work. With federal budget cuts and worker shortages, caregiving is in short supply for elderly and children, people with disabilities or mental illness, as well as newcomers and other vulnerable populations. We talked with three caregiving professionals around Minnesota to share their challenges, their hopes, and their stories.

On the Ground

“Lord, have mercy!” Melissa Almer whoops with laughter when asked to describe the scope of her responsibilities. “I roll up my sleeves and do what needs to be done,” she says. “I help with paperwork a lot. Managing money. I’ve stood at the kitchen sink and done dishes.”

For 17 years, Almer has been a senior and caregiver advocate at Semcac, a community action agency serving up to 12 counties in southeastern Minnesota. Almer’s focus is Dodge and Steele counties, where most of her clients “live in poverty,” she says.

She encounters addiction issues, mainly alcohol, often affecting family caregivers rather than the patients themselves. Most of her clients, of whatever age, are frail. “They struggle with getting their basic needs met, with transportation, with how to get groceries into their home,” Almer explains.

Managers have called her a troublemaker for going above and beyond. Though Almer does no hands-on care — her focus is “finding resources, making referrals, connecting with the appropriate people” — she credits her roll-up-the-sleeves approach with not being a trained social worker. “They have rules and boundaries and guidelines. I don’t have those guidelines,” she explains. “I won’t complain about how messy someone’s house is if I’m not going to help them clean it.”

What would make her job easier? There was no hesitation when she replied: “I wish I had money.” Almer praises the support from her agency and her social worker colleagues. But money would provide at least a temporary answer to the question she hears so often: “Do I eat this week, or do I take my medications?”

“If I could do anything,” she says, “I’d have a checkbook and write people checks.”

More money would ease worries about loss of Medicaid funding too. Almer says the Trump administration fails to realize how many elderly people are on both Medicare and Medicaid, which is “most of the people I work with,” she says. “We are causing a humanitarian crisis in so many ways.”

Multigenerational Healing

For Comfort Dondo, a native of Zimbabwe and a survivor of domestic abuse, caregiving means “being a steward on behalf of community.” She considers herself a bridge and a relationship builder for women in the African immigrant community navigating the white-centric Twin Cities culture.

Survivors of civil war in Monrovia, Liberia, have congregated in Brooklyn Park, just as immigrants from Mogadishu, Somalia, tend to live in Minneapolis. “Those communities have been ravaged by civil war,” Dondo explains, “and their families are still recovering.”

As founder of Phumulani, a nonprofit whose values include “grit” and “grace,” she aims to provide healing services to African immigrants and refugees, as well as to mentor youth. “I created the organization because I saw the gap,” Dondo says. “I wanted to provide what I needed.”

The injuries and indignities of physical and verbal abuse from a once-trusted partner can be multigenerational and multilayered, she says. “No one is thinking about how the trauma is transferring to the children — the ones witnessing and seeing.”

Elders who are “left back on the continent” are also depending on immigrants to send money — what she notes is referred to as the “Black tax.”

Dondo herself received caregiving “in ways that may not look typical,” and she tries to replicate that at Phumulani. An African American elder — a person “who didn’t come from my community” — helped her assess whether a potential workplace was racist, navigate the child protection system, find a pro bono lawyer, and even buy a bus pass.

“I think I have subconsciously been creating programs that are ingrained in that holistic approach,” Dondo says. The healing circles she organizes, “African in nature,” are direct caregiving.

Like others in social service and caregiving, Dondo spends a growing amount of time finding resources to do the work. “As an African immigrant woman in the anti-violence movement that was started way before I came here, I encounter ‘old boys’ club’ rules that go back to the default of the white supremacist system.”

Growing Diversity

Bemidji is sometimes called a border town due to proximity to the Leech Lake, Red Lake, and White Earth Nations. Although the student population of Bemidji State University (BSU) remains largely white, at 78 percent, the diversity of the region’s Indigenous population is starting to influence BSU’s social work program.

Ashley Charwood, an assistant professor of social work at BSU, says the university had the highest number of Indigenous graduates in 2025. Ten percent of them were in the social work program. The program offers a curriculum that includes a focus on Indigenous child welfare and what Charwood calls “disparities” around adoption or foster care placement.

A Black American, and descendant of people from Nigeria and Ghana, Charwood says the social work program has evolved in ways that the demographics of its student population may not suggest. Employing an anti-oppressive practice model is one change Charwood has seen in the profession since she graduated from college in 2007.

That means “acknowledging bias and privilege,” and making time and space for “the history and the harm, how the past informs the present.” Day to day, an anti-oppressive approach means that Charwood tries to consider students’ challenges and outside responsibilities when she schedules assignments. She models the practice of empathy by sharing stories of her own life struggles.

She encourages self-care while teaching through a trauma-informed lens, aimed to help students empathize with their clients’ challenges.

“We’re interacting with people facing abuse, domestic violence, poverty, potentially the end of Medicaid, systemic oppression. We embed that awareness into all our classes now,” Charwood says.

Her social work students include veterans, parents, midlife professionals who earn their degrees largely online (“a huge trend”), and those who disclose as nonbinary or LGBTQ+. “I find hope in the students,” says Charwood. “Students who are eager to learn, interested in policy and running for office. They want to learn how to dismantle and change systems.”