Abstract
In this graceful, intelligent, and humane book, Claire Stacey examines the work experience of home care aides, whose labor is becoming more central to an aging society in which the break-up of extended families means that the process of care for the older adults (and infirm) is increasingly socialized. Home care work is defined as care and support work undertaken in clients’ houses outside of that undertaken by medically trained professional staff. Occupational statistics confirm the rising importance of home care work, with the Bureau of Labor Statistics estimating that home care aides belong to one of the fastest growing occupational groups. The book shows that despite the importance of this occupation, both numerically and as a touchstone for the texture of care within an aging society, we know too little about the work experience of home care aides. In addressing this gap in our knowledge, the author draws on rich quasiethnographic research on home care aides in California and Ohio. For 6 months, the author spent 10 hours per week in shadowing aides, going with them on their daily rounds of caregiving. In addition, she conducted in-depth interviews with 33 aides, 11 coworkers, and 6 managers. Using these bottom-up methods, the author is able to present a vivid and vital picture of home care work in which the voices of the aides themselves ring loudly.
The book offers a carefully balanced examination of the costs and the rewards of being a home care aide. The significant costs involve the low wages attached to this occupation, predominantly occupied by women, often from racial and ethnic minorities, whose labor market positions tend to be highly constrained. In addition, the author shows that other conditions of work, notably negative aspects of the often intense emotional labor rendered to clients, financial insecurity, on-the-job injury, lack of training, and bureaucratic constraints on care, also produce distress and fatigue for aides. The most significant contribution that the book makes is to show that there is also much that is deeply rewarding in their jobs for home care aides. Central to this is how home care aides create an identity of “the caring self.” The book argues that aides create a sense of the caring self through three types of “identity talk.” Aides profess that care is natural and innate to them; they emphasize the ethic of care and service to others; and they mark boundaries between themselves and “non-caring” others. It is through the process of creating the sense of the caring self that aides are able to find dignity and meaning in their work. The process of creating dignity is also supported by the degree of autonomy that home care aides have in their mobile work, and by their ability to create meaningful relationships with clients. The book gives a moving and acute portrayal of the deep, socially embedded, quasikinship relationships that aides frequently form with clients. The final substantive section of the book considers the way in which aides perceive labor unions—a topic of some importance, given the notable organizing success regarding home care aides in California at the end of the last century.
In an otherwise impressive book, one important question was left hanging for this reader. Methodologically, the author gives primacy to the role of “talk” in how aides create the caring self, but there is some ambiguity about the status of the evidence regarding this talk. The talk that the author focuses on was gathered primarily in the process of interviewing, and so this talk may exist as an unusual product created by the research process itself, rather than existing as an everyday part of aides’ lived experience at work. Indeed, given the relatively isolated work roles of aides, the reader is left wondering to whom this talk could be directed in aides’ everyday working lives.
Overall, the book offers much for sociologists of work to consider. It not only addresses an important empirical research gap in a penetrating and insightful way but also offers new concepts—particularly that of the caring self—that should stimulate important theoretical and policy-related debates. The Caring Self is another fine addition to the already impressive ILR Press imprint of Cornell University Press.