The Arts and Crafts of Compassion

As I sit down to write about Clare L. Stacey’s timely discussion of the daily grind of home caregivers, and the elderly or disabled people placed in their charge, my ninety-year-old mother-in-law’s face rises before me. An overweight, severely arthritic retired union retail clerk, she’s just been released from the hospital and moved to a rehab center. She survived an eight-hour bowel obstruction/perforation/resection surgery, and now she must attempt to regain enough strength to return to her own home. A wheel of plans must be formulated to help her maintain what seems to be a very teetering independence. Mother to twin girls and two sons, she has outlived both daughters. Not a day passes without her telling me, “I wish Darlene were here. She always said she’d take care of me.” This is the newest chapter of my mother-in-law’s life’s narrative, and it’s waiting for all of us. As I sigh and push her wild gray hair back from her forehead, I wonder who will bathe me, feed me, diaper me, and, if I’m really lucky, play a hand of rummy before waving me goodbye?

Long-term care in the United States is a cloudy question and a crisis we’d rather not discuss. And what will become of the growing legions of disabled and elderly poor? If they are not in our own family, we may not pay attention to who provides care, how those caregivers are paid, how they are trained, and the agencies ultimately responsible for their actions. A medical sociologist, Stacey invested ten years in studying the experiences of home health care workers and their clients in California and Ohio. In this book, she presents their poignant, disturbing, and thought-provoking narratives as evidence to call us to think about work we would often prefer to ignore.

Stacey divides The Caring Self into four main areas: the costs of caring (real dollars, ratios of clients to caregivers and emotional currency), the physical and emotional labor of home care, the rewards of caring, and organizing home care. Instead of graphs, charts, and congressional debates, the book explores these issues through the voices of seasoned home care aides. Stacey provides a brief biography of each of the people she interviewed, followed by an honest account that presents the day-to-day work of caregiving in powerfully concrete terms. Here’s how one Ohio home health worker described her experience:

I had a client over in Middletown. The lady had Alzheimer’s, which I dealt with. It was no problem. People were filthy, nasty, they had animals all in their house, feces. The son, which was lazy, he was a bum. Lived off of his parents. Cats, dogs, all through the house. Urine all through the home. Feces everywhere from the animals. Just filth. And the guy that lived there, the son, had a gun laid on the table. I put up with that for a year

(p. 49).

There’s a real immediacy in these narratives, which put us beside the caregivers and clients throughout the book. Through the interviews, Stacey demonstrates the emotional investment of this work, which she examines as a “resource” and “capital” for home caregivers. Drawing on feminist studies, Stacey shows the theory of circular emotional capital, tracing how girls are taught to be caregivers early in childhood and then carry that behavior pattern into the workplace. She gives us a snapshot of social psychologists’ theory that our work identities are rooted in race, class, and gender. Childhood plants the seeds for our life’s work, and Stacey points out that this “produces identity” while also “reinforcing inequality” (p. 36). It’s not surprising that all but five of the thirty-three workers Stacey interviewed are women. She reminds us that if the current trends continue, when I wonder about who will bathe and feed me when I’m old, I should imagine a poor immigrant or...