There are approximately 4.4 million direct-care workers in the United States. Comprising the labor of nurses, home health aides, certified nursing assistants, personal attendants, and companions to the elderly, direct-care work constitutes one of the fastest-growing labor niches in the United States. Within the commodified caregiving sector, cost-cutting imperatives to subdivide care labor introduce insalubrious complications for patients by cleaving – or attempting to do so – their physical needs from their emotional and relational needs, a process that I label ‘rationalized aging’. In this essay, I reflect on my experiences as a paid elder companion in New York City to argue that this process of subdivision combines earlier nineteenth-century rationalization strategies with neoliberal regimes of flexible accumulation and to highlight the consequences of subdivision in this sector both for care workers and for the patients in their care.
Rationalized aging