107 Notes Introduction 1. Like Code, I recognize liabilities that might stem from my embrace of the discourse of ecology, but opt for it anyway, finding its resources irresistible . 2. Code refers to the work of Cornelius Castoriadis on “the instituted social imaginary,” which “carries within it the normative social meanings , customs, expectations, assumptions, values, prohibitions, and permissions —the habitus and ethos—into which human beings are nurtured . . . and which they internalize, affirm, challenge, or contest as they make sense of their place, options, responsibilities within a world, both social and physical, whose ‘nature’ and meaning are also instituted in these imaginary significations. A social imaginary is social in the broadest sense: it is not merely about principles of conduct, although it is about these too; but it is about how such principles claim and maintain salience; about the scope and limits of human knowledge and the place of knowledge in the world; about the structural ordering of institutions of knowledge production ; about intellectual and moral character ideals, subjectivity, and agency; about the kinds of habitat and living conditions that are within reach and/or worth striving for; about social-political-economic organization and just distribution of goods, privileges, power, and authority. In this complex sense, the social imaginary of mastery extends across the ethos and expectations of the affluent white western world that sees no limits to human possibilities of mastering and controlling the world’s resources . . . and human Others as well” (Code 2006, 30–32). 3. I make use of the terms caregiving and care work after reflection on other possibilities. I use these terms synonymously for the most part, though most often caregiving is used to describe the activities of family members, not paid care workers. 108 Notes to Pages 10–26 4. While there are important distinctions to be made between nurses and direct care workers, and among direct care workers (for instance, hospital-based nurse aides tend to earn more than those working in home care), I will discuss them largely as a group, in part because their concerns overlap to such a great extent and because “down-skilling” of nurses educated abroad is not uncommon. Chapter One: The Plight of the Dependent Elderly and Their Families 1. For further discussion and analysis of the debate, see Institute of Medicine 2008. 2. For a history of long-term care in the United States, see Holstein and Cole 1996. 3. Important advances are being made by some companies, including geriatric care managers, to support employees, referral services, and education on how to better care for oneself as a caregiver (Dobkin 2007; Galinski, Bond, Sakai, et al., 2008). Larger nonprofits that are unionized and have more women and minorities in leadership positions tend to be the most supportive. An estimated one-fifth of companies in the United States now offer telephone resources and referral services on elder care, an increase from 15 percent in 1998. Nevertheless, some employees maintain that “they’re not seeing the true picture” (Gross 2006b). Companies tend to favor strategies that cost them little or nothing; hence referral services and unpaid leaves are preferred. Meeting child care needs tends to be the prototype for many employers, reflecting a misunderstanding of long-term care needs. And for many small businesses and nonprofits, elder care bene fits “seem a luxury.” 4. Notably, tax law requires that consumer-directed care assistants be treated as employees rather than as self-employed and also subject to federal and state laws regarding work hours and wages, as well as workers’ compensation (OECD 2005, 58). 5. Since then, Congress and the states have seen a steady flow of bills introduced for initiatives such as expansion of the FMLA to offer specific assistance to caregivers of injured as well as deployed servicemen, caregiver assessment, training, and education, care coordination, and respite care. Only a few measures have been enacted (Family Caregiver Alliance, n.d.a). Efforts to expand the population of employees eligible for the FMLA, to [18.208.203.36] Project MUSE (2024-03-19 04:36 GMT) Notes to Pages 32–59 109 pay caregivers during leave—save for those caring for veterans—have so far been unsuccessful. Chapter Two: The Plight of Paid Workers in Long-term Care 1. Reasons for the difficulty include inconsistency over definitions of particular kinds of health workers and the fact that some migrant care workers leave under tourist or student visas and...