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The Caring Self

The Caring Self: The Work Experiences of Home Care Aides

Clare L. Stacey
Copyright Date: 2011
Edition: 1
Published by: Cornell University Press,
Pages: 216
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  • Book Info
    The Caring Self
    Book Description:

    According to the Bureau of Labor Statistics, there were approximately 1.7 million home health aides and personal and home care aides in the United States as of 2008. These home care aides are rapidly becoming the backbone of America's system of long-term care, and their numbers continue to grow. Often referred to as frontline care providers or direct care workers, home care aides-disproportionately women of color-bathe, feed, and offer companionship to the elderly and disabled in the context of the home. In The Caring Self, Clare L. Stacey draws on observations of and interviews with aides working in Ohio and California to explore the physical and emotional labor associated with the care of others.

    Aides experience material hardships-most work for minimum wage, and the services they provide are denigrated as unskilled labor-and find themselves negotiating social norms and affective rules associated with both family and work. This has negative implications for workers who struggle to establish clear limits on their emotional labor in the intimate space of the home. Aides often find themselves giving more, staying longer, even paying out of pocket for patient medications or incidentals; in other words, they feel emotional obligations expected more often of family members than of employees. However, there are also positive outcomes: some aides form meaningful ties to elderly and disabled patients. This sense of connection allows them to establish a sense of dignity and social worth in a socially devalued job. The case of home care allows us to see the ways in which emotional labor can simultaneously have deleterious and empowering consequences for workers.

    eISBN: 978-0-8014-6331-0
    Subjects: Health Sciences

Table of Contents

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  1. Front Matter
    (pp. i-vi)
  2. Table of Contents
    (pp. vii-viii)
  3. Acknowledgments
    (pp. ix-xiv)
  4. Introduction: On the Front Lines of Care
    (pp. 1-23)

    On a warm spring day in April, I accompanied Christina, a white public health nurse, to the home of an elderly African American man who suffers from heart disease, renal failure, diabetes, and mild dementia. Mr. Jones is a seventy-six-year-old man who lives alone in a subsidized housing complex in a low-income suburb of Central City.¹ His only regular visitor is his caregiver Keisha, a young African American woman who is paid to cook, clean, and care for him daily. As we approach his apartment building, Christina is sanguine about Mr. Jones’s isolation, recalling that she’d seen much worse while...

  5. 1 The Costs of Caring
    (pp. 24-42)

    Lete came to the United States in 1992 from Sinaloa, Mexico, at the age of twenty-six, to join her sister and aunt living in California. Soon after emigrating, Lete found herself caring for her aunt, who had fallen ill with a terminal form of cancer. In addition to providing care at home, Lete secured a part-time job in a factory at night, assembling computers for $9.50 an hour. Lete eventually earned her GED from a local community college and then enrolled in a few night courses—mostly nursing and computer science related—to try to identify a new career path....

  6. 2 Doing the Dirty Work: The Physical and Emotional Labor of Home Care
    (pp. 43-84)

    For the last thirty years, Virginia has been taking care of other people for a wage. A white woman in her early sixties, Virginia is tall and appears very muscular, characteristics that are somewhat at odds with her gentle manner and tone of voice. Her work history includes the care of elderly adults with chronic illness (both in and out of nursing homes), children with autism, developmentally disabled adults, and middle-class children in need of a nanny. Some of her clients have been wealthy, or “gold coast,” as she puts it, but the vast majority have been poor and elderly....

  7. 3 The Rewards of Caring
    (pp. 85-136)

    While attending a series of on-the-job training courses for home care aides, I met Andrew, an aide living and working in Central City, California. Andrew was an eager participant in the training sessions and appeared, at times, to have more firsthand knowledge of the subject matter than the registered nurses leading the courses on “Universal Precautions” and “Personal Care for Your Client.” After I made an announcement during a break about my study and the need for interview subjects, Andrew approached me to express interest in the research. I asked whether he would like to meet at his place of...

  8. 4 Organizing Home Care
    (pp. 137-155)

    On a late-summer evening in 2003, approximately twenty-five home care aides gathered in a large meeting room of the IHSS main office in Central City, California. The aides, new to IHSS but not necessarily to home care, were there to attend a mandatory orientation session sponsored by the Public Authority for the county. The Public Authority is responsible for processing the wages of nearly ten thousand aides in Central City and maintaining a registry that helps match workers with clients; it serves as the official employer of record with whom aides may collectively bargain. The orientation sessions, run by Public...

  9. Conclusion: Improving the Conditions of Paid Caregiving
    (pp. 156-170)

    Sooner or later, most of us will confront the limitations of our system of long-term care firsthand, as we face illness or disability in our own lives or the lives of loved ones. For a very few, ample personal resources will mean high-quality care, in the comfort of a home or reputable facility, provided by a team of professional and paraprofessional caregivers. For another subset—the very poor—services will be pieced together with the help of family, friends, and the state. For the vast majority of us, there will be a series of tough decisions to make about the...

  10. Appendix: Methods
    (pp. 171-176)
  11. Notes
    (pp. 177-182)
  12. References
    (pp. 183-192)
  13. Index
    (pp. 193-200)