Improving the Conditions of Paid Caregiving
This chapter brings together central claims about identity and inequality in home care and suggests ways that the empirical findings about aides' work experiences might enrich ongoing discussions about maintaining a robust direct care workforce. It summarizes ways that the caring self reinforces aides' commitments to their clients, at the same time that it essentializes women's roles as “natural” caregivers and obscures home care as a form of waged labor. The chapter concludes with a discussion of policy changes that would improve working conditions for aides and ensure higher quality of care for clients. Specifically, it discusses in detail the “companionship exemption” of the Fair Labor Standards Act (FLSA), which excludes personal and home care aides from wage and overtime protections, largely due to the informal nature of the work they provide. It suggests that reforms to the FLSA must be accompanied by empirically grounded and theoretically engaged discussions of the meaning of companionship, so that fair value is given to the emotional and relational work of caregiving.
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