Abstract
This paper considers the experiences of family home care providers, paid an hourly wage by California’s In Home Supportive Services program to care for disabled or elderly relatives. These caregivers are unique in that they provide care in what Arlie Hochschild calls the “third sector” of social life, where norms and responsibilities tied to work and family intersect. Drawing on in-depth interviews and ethnographic observations of family home care providers, we find that providers perceive their paid caregiving as deviant behavior that violates social norms surrounding family care, i.e. that people should not be paid for the care of kin. Family caregivers manage the norm violation associated with their carework by offering “accounts” that 1) emphasize the tasks and skill associated with caregiving and 2) by framing their carework as a public good that benefits the larger community. These accounts allow family providers to distance themselves from the norm violation of receiving a wage for care and to reconstruct their actions in a positive light.
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Notes
Medicaid, in tandem with state monies, often funds home care for low-income elderly or disabled individuals through programs like IHSS, thereby “waiving” the need for institutional care. Several states use Medicaid dollars to provide community-based long-term care to low-income disabled and/or elderly individuals. In California, Medi -Cal and the so-called “Residual Program” also provides reimbursement for IHSS services if clients meet their respective criteria.
As Hochschild (2003a) reminds us, our society places a great deal of ideological importance on care, “as part of an intense and hazy quest to create a kinder, gentler family and nation” (2003a, 2). The trouble is that while we profess an ideological commitment to care, we do not (as a nation) afford honor or monetary reward to those who actually do the work. This leads Hochschild (2003a) to assert “Ideologically, care went to heaven. Practically, it’s gone to hell.”
It is worth noting that non-family aides interviewed for the first author’s broader study on home care also construct accounts that at times resemble those of family providers. Many home care aides, for example, speak of altruistic motivations for working with elderly or disabled clients (Stacey 2011). The similarities end there, however, as the majority of home care workers are not caring for family, and therefore do not challenge the boundary between love and money in the way that their family counterparts do. If anything, non-family caregivers believe themselves morally superior to others, since they often fill in the “care gaps” left by people who cannot or will not care for their own relatives. We mention this to underscore the fact that the context of work and the nature of a given norm violation (in this case, receiving pay for care of family) appears to noticeably affect the accounts caregivers offer for the work that they do.
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The authors wish to thank Tiffany Taylor, Michelle Jacobs and the anonymous reviewers of Qualitative Sociology for their thoughtful and constructive feedback on the manuscript.
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Stacey, C.L., Ayers, L.L. Caught Between Love and Money: The Experiences of Paid Family Caregivers. Qual Sociol 35, 47–64 (2012). https://doi.org/10.1007/s11133-011-9210-4
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DOI: https://doi.org/10.1007/s11133-011-9210-4