Care Falls Apart

2018 ◽  
pp. 176-200
Author(s):  
Elana D. Buch
Keyword(s):  
United States ◽  
Older Adults ◽  
Public Policy ◽  
Home Care ◽  
Job Loss ◽  
Family Care ◽  
The United States ◽  
High Turnover ◽  
Care Workers

Across the United States, home care faces perpetual worker shortages and endemically high turnover levels estimated at between 60% and 90% per year. This chapter examines cases of turnover in rich ethnographic detail, arguing that the inability of agency and public policy to recognize the interdependence of older adults, workers, and their families contributes to this startling statistic. In observed cases of turnover; job loss stemmed from workers’ inabilities to sustain both their own households and those of their older adults without blurring the boundaries between them. Workers lost jobs because of conflicts with family care and because they engaged in unsanctioned reciprocities with clients. Current attempts to protect vulnerable older adults from possible exploitation actually exacerbate the exploitation of care workers and increase instability in home care.

Inequalities of Aging

2018 ◽  
Author(s):  
Elana D. Buch
Keyword(s):  
Older Adults ◽  
Home Care ◽  
Population Policy ◽  
Quality Care ◽  
The United States ◽  
Turnover Rates ◽  
High Turnover ◽  
Social Challenges ◽  
Care Workers ◽  
Institutional Contexts

Paid home care sits at the nexus of two of the United States’ biggest social challenges: rising inequality and an aging population. Policy and advocacy initiatives typically treat poverty and care of the aged as distinct forms of vulnerability. They are seen as having separate social causes that require different solutions. Using rich ethnographic narrative based on fieldwork in Chicago, this book examines the diverse relationships generated by care and their connections to longer national histories, policies, and institutional contexts. The vulnerabilities of older adults and care workers are commingled: low wages and poor working conditions render workers’ lives precarious. In turn, high turnover rates and endemic worker shortages translate into wait lists and lower quality care for older adults. In home care, the fate of older adults and the working poor are bound together, entangled by the broader indifference of a society that devalues both aging and care.

A Lack of Reciprocity

2019 ◽  
pp. 203-238
Author(s):  
Cati Coe
Keyword(s):  
United States ◽  
Health Insurance ◽  
Home Care ◽  
The United States ◽  
Domestic Service ◽  
National Belonging ◽  
Workplace Conditions ◽  
Care Workers ◽  
State Of Affairs ◽  
Service Agencies

This chapter examines how workplace conditions and benefits shape care workers’ national belonging. It discusses the home care field, including its historically unregulated character due to its categorization as domestic service. Agencies are currently responding to new regulations regarding overtime and health insurance, which have had contradictory effects on workers. It also discusses the amount of profit agencies are making from care workers. Care workers feel that they are denied reciprocities to which they are entitled through their labor. This is thus a complicated sense of belonging, in which they belong enough to feel entitled to reward, but not enough belonging to feel that they can work in unison against this system. Many, instead, decide that this state of affairs confirms that they belong in their home countries rather than in the United States. It is there that they imagine that they will reap the rewards of their labor and attain a dignity that is denied in the United States.

scholarly journals Filipino Home Care Workers: Invisible Frontline Workers in the COVID-19 Crisis in the United States

2021 ◽  
pp. 000276422110004
Author(s):  
Katherine Nasol ◽  
Valerie Francisco-Menchavez
Keyword(s):  
United States ◽  
Home Care ◽  
Assisted Living ◽  
Elder Care ◽  
Health And Safety ◽  
The Elderly ◽  
The United States ◽  
State Regulation ◽  
Care Workers ◽  
Home Care Workers

Filipino home care workers are at the frontlines of assisted living facilities and residential care facilities for the elderly (RCFEs), yet their work has largely been unseen. We attribute this invisibility to the existing elder care crisis in the United States, further exacerbated by COVID-19. Based on quantitative and qualitative data with Filipino workers before and during the COVID-19 crisis, we find that RCFEs have failed to comply with labor standards long before the pandemic where the lack of state regulation denied health and safety protections for home care workers. The racial inequities under COVID-19 via the neoliberal approach to the crisis puts home care workers at more risk. We come to this analysis through Critical Immigration Studies framing Filipino labor migration as it is produced by neoliberalism and Racial Capitalist constructs. Last, while the experiences of Filipino home care workers during the pandemic expose the elder care industry’s exploitation, we find that they are also creating strategies to take care of one another.

scholarly journals Diverse, Culturally Rich Approaches to Family Care in the United States

2021 ◽  
Vol 5 (Supplement_1) ◽  
pp. 269-269
Author(s):  
Lauren Parker ◽  
Manka Nkimbeng
Keyword(s):  
United States ◽  
Older Adults ◽  
Family Care ◽  
The United States ◽  
Minority Populations ◽  
Culturally Tailored ◽  
The Us ◽  
Ethnic Minority Populations ◽  
Definition Of ◽  
Racial Ethnic

Abstract Despite the projected rise in the diversity of caregivers and caregiving in the US, the health system is not prepared to accommodate this growth. Interventions and supports often are not adequately tailored to meet the cultural needs of older adults. Additionally, the limited interventions available for racial/ethnic minority populations frequently fail to capture and report culturally tailored perspectives. Therefore, the purpose of this presentation is to describe how culture influences caregiving in the US. Specifically, it will: (1) provide a contemporary definition of culture; (2) identify cultural domains that impact caregiving; (3) offer examples of how caregiving is influenced by different cultural/demographic backgrounds; (4) provide examples of culturally tailored caregiving programs, and (5) discuss how to approach cultural needs that may not be addressed by current interventions.

An Emerging Model of Primary Care for Older Adults: The House Call–Home Care Practice

2009 ◽  
Vol 10 (3) ◽  
pp. 110-114 ◽  
Author(s):  
Steven H. Landers ◽  
Paul W. Gunn ◽  
Kurt C. Stange
Keyword(s):  
United States ◽  
Older Adults ◽  
Primary Care ◽  
Home Care ◽  
Nurse Practitioners ◽  
The United States ◽  
Care Practice ◽  
House Calls ◽  
House Call ◽  
Care Practices

House calls to older adults have become more common, in part related to the emergence of medical practices that either emphasize or exclusively provide house calls. In this article we seek to describe organizational, clinician, and patient characteristics of house call–home medical care practices in the United States. We conducted telephone interviews with clinicians representing 36 randomly selected practices from across the United States. This study found that house call–home care practices typically are recently formed small groups of physicians and nurse practitioners that provide in-home primary care, especially chronic disease care, to Medicare beneficiaries. Clinicians are motivated by the opportunity to improve care and to maintain autonomy. This emerging model may represent a mutually beneficial trend for older adults and physicians.

“Anyone Who Is Not African”

2019 ◽  
pp. 41-80
Author(s):  
Cati Coe
Keyword(s):  
United States ◽  
Labor Market ◽  
Home Care ◽  
Cultural Capital ◽  
The United States ◽  
Immigrant Status ◽  
Agency Staff ◽  
African Migrants ◽  
Care Workers ◽  
American Economy

Home care is a portal to the American economy for African migrants, but it is one in which they are racialized as African and Black. When Africans come to the United States, they encounter a racialized employment market, in which their Blackness and immigrant status plays a major role in how they are perceived. Because they are desperate for work to support their families, they are valued by agency staff as dedicated and hard-working, patient and respectful. Africans also highlight these qualities when they seek employment. However, their cultural capital as “African” is not considered valuable by patients, who often express a preference for “white” or “American” care workers. This chapter analyzes the ways that care workers are recognized and positioned within the care labor market, and how this recognition makes African care workers vulnerable to exploitation and humiliation.

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