Caught Between Love and Money: The Experiences of Paid Family Caregivers

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.

Challenges to the provision of community aged care services across rural Australia: perceptions of service managers

“…Australian contributions describe how community aged care services are encouraged to keep wages low to increase profit margins or, in the case of charitable organisations, to crosssubsidise other organisational activities 5,8 . This work emphasises the impact of tightly calculated government subsidies to these organisations and the wider political economy.…”

“…A substantial body of work depicts aged care work as hidden and gendered, and workers as poorly remunerated [4][5][6][7][8][9] . The 'lot' of workers is linked to the often casual and insecure terms of employment and industrial powerlessness 5 .…”

Walking the Line: Navigating Market and Gift Economies of Care in a Consumer‐Directed Home‐Based Care Program for Older Adults

“…In a market economy, compensation is expected for each hour of care or service provided. Paid caregivers, including non‐related caregivers, often describe their motivations and care activities as rooted in a context of close emotional ties to the consumer of care and as a sense of moral obligation to the individual or the population of older adults with disabilities more generally . But they do so in a context of financial strain, particularly given the low wages for caregivers’ work.…”

“…We also expect caregivers’ decisions related to the care they provide to change and respond to policy changes over time, a point that has not yet emerged from cross‐sectional studies of paid home‐based caregivers . For example, nonrelated paid caregivers who assume a caregiving role with the intention of defining it as a market transaction may nonetheless form emotional bonds over time with consumers that draw them into the world of the gift, in which they go beyond a market exchange to provide extra, unpaid care, or care that is not deemed reimbursable by the IHSS .…”

“…Finally, because the consumers’ perspective is often missing from studies of home‐based caregivers’ experiences and burdens, we consider their perspective of care as they describe their own role in shaping caregivers’ experience of “walking the line.” Consumer‐directed care assumes that consumers of care have the ability to decide who will provide their care. In some cases, consumers prefer caregivers that remain at a distance, offering less intimate care, and care that follows the rules of what is acceptable for compensation.…”