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Caretakers

Chris Clarke has an interesting post at Pandagon about how several quality-of-life movements depend on unpaid female labor. Even the “enlightened” ones, because what else is new?

Yes, death has been increasingly medicalized, but McKown isn’t exactly advocating de-medicalizing the process, just changing the venue. The problem isn’t that death has been medicalized — no one seriously advocates getting rid of doctors and nurses for aid during the process — but that it has been corporatized, like so many other facets of life. We get sick enough to die, and then the course of what’s left of our lives is lived out in impersonal surroundings, our needs attended to by strangers — skilled strangers, true, but dispassionate nonetheless, our decisions circumscribed by HMO policy and procedures driven by monetary concerns of either the cost-cutting or ass-covering varieties.

But when parts of our lives get corporatized, it’s generally the case that the associated relationships get monetized. In English: suddenly we find ourselves paying someone for labor we once got for free.

Or, as Ron Sullivan put it a couple years back, reminiscing about the good ol’ days:

Remember how it felt when you realized those nice gentle brothers still thought you were a household appliance? The only household appliance they weren’t ready to give up when they went all wholegrain and groovily off-the-grid?

Well I do.

I have to say, this hit home for me.

My father dropped dead in August 1995 (a day before Jerry Garcia, which became an issue a month later at my brother’s wedding, when my family was admonished not to upset the bride’s sister because she was in mourning. From a family who didn’t even so much as mention my father’s passing less than a month before). So, you know, long-term care issues weren’t on the radar.

But then, my mother had a heart attack in 2002 (one she didn’t recognize as such, not being the classic male-identified symptoms). And, well, while we didn’t really know what was going on, there was discussion amongst my siblings about What To Do.

And, you know? My brothers (all four of them) acted as if the choice was between my sister and I to take care of her. My sister was actually in a better place than any of us to take care of her given that her husband was in the Marines, they were about to get sent from Hawaii to Virginia anyhow, and Mom could become a dependent and get all the attendant benefits. Plus, she had the grandchildren around for Mom.

Yet, somehow, because I was the other daughter, and because I was the closest geographically (Mom lived in a subdivision in North Jersey off I-80 with an express bus to NYC), the talk turned to me as caretaker. Because of course a single woman with a full-time job and crushing student debts and a one-bedroom apartment is the PERFECT fucking choice as caretaker to a woman with a damaged heart.

This was pushed, incidentally, by the sister-in-law who had spent a lot of time positioning herself as Mary Ann’s Best Daughter in order to get her hands on at least some of the good china.

Of course, this is nothing new. Time was, the youngest daughter remained unmarried and essentially became a domestic servant. Happened to my Aunt Martha (she did try to join the convent like her twin sister, but she just didn’t feel the calling), and my Great-Aunt Julia, and my friend Terri’s mother’s sister (whose name I don’t remember, but who was not only brought over from the Philippines to raise Terri and her siblings, but once they were grown, to help raise Terri’s kids).

Chris also mentions the Slow Food movement as yet another way to guilt women into providing unpaid labor in the name of authenticity. Can’t say I disagree.


22 thoughts on Caretakers

  1. It always confounds me how the same “family and community” types who’d like to see care administered privately (as opposed to bureaucratically) end up being the same crowd who want everyone to “pull themselves up by their bootstraps”. From chidlhood to late adulthood, it seems that the aid of near entirely female caregivers is a crucial part of that.

    On the one hand, I like the idea of taking the shame out of “dependency”. On the other, I wish that could be done without shaming and pressuring women into putting their own life plans second as soon as their aid is called upon.

  2. I already ranted at Pandagon about my ugly family situation, but “who’s the closest” is definitely a major factor in who gets stuck doing the work. (And this is why my aunt practically never had to do a thing for my grandparents. She lived an hour and a half away from them/my mother, incidentally.)

    I’m reminded of Like Water For Chocolate, where the youngest daughter was forced to remain her mother’s servant forever.

  3. This is interesting for me because my 94-year-old grandmother lives in London. She’s not good health, but has been in the same house since the Blitz. My aunt’s in England (although in Cambridge, so it’s a haul) and my dad’s in the U.S. While my dad goes over there as often as possible, geography is definitely what decides it.

    I do wonder what it would be like if my parents were living in England, because I know that neither my father nor my aunt were keen on taking care of my grandparents. (To that end, the NHS was phenomenal. Visiting nurses, meals on wheels, and modifications to their house to make it handicapped accessible with no out of pocket costs.) Not sure what would have happened otherwise.

  4. What do you think the best way to approach the situation is? I mean, I do live with someone disabled and there’s no way to pretend I don’t do a lot of the caretaking and heavy lifting because of it, and we’ve already had the “When mom gets old” talk in regards to his mom. I don’t know a way of supporting either of them in any sense without it being based around my unpaid labour, anymore than I’d know how to support women who are unpaid labourers in terms of raising their children.

  5. We looked at it as a family- yes, I ended up being the “unpaid” labourer but I also took control of the family finances. We had to balance alot of factors in our choices based on family circumstances- age of senior, just starting a family, costs of home care versus a ‘home’, wish to give son and grandfather as much time together as possible and long term viability. We ended up with me at home due to circumstances. The family is now having to look at the “what ifs” of my side of the family- four daughters/one son=odds are on a daughter.
    The best way to approach the situation is to send the message that not everything is about the money and that includes feminism. The hard fact is that the more competent you are the more jobs, paid and unpaid, you will acquire and that includes family care. Remove the stigma and find a way to balance out the injustice of the valuations on labour and we have a chance of finding a solution- don’t make it about the work because it needs to be done one way or the other.

  6. This was what happened to my mother when my grandmother got sick. She and her living brother lived about equidistant from my grandmother, but there was never any real question that my grandmother would be coming to live with us, not him. Indeed, when my grandma took a turn for the worse, pretty much all of the end-of-life decisions were left up to my mom to make, with really no support from anyone else.

    My sister and I live in the same metro area as my parents, and I promised myself back then that I wouldn’t force her into the same situation when the time comes. It’s not fair to force that on one person. As for my daughter–since she’s an only child, and is likely to remain so, I guess she’s stuck, which is why I’m buying LTC insurance the day I turn 40.

  7. Well, of course it should be you zuzu, you don’t have any responsibilities, no kids, no husband, it’s not like you have anything else to do.
    /sarcasm

  8. I have such mixed feelings about this, as someone who I think is about equally likely to end up a caretaker or a caretakee in the foreseeable future. On the one hand, I absolutely agree that the overwhelming majority of the burden ends up falling on women. (Actually, in my extended family, it’s fallen hugely on one gay man, who finished taking care of his friends who were dying of AIDS just in time to take care of his aging parents and their siblings.) On the other hand, I feel like these discussions somehow end up casting the people who need the care *only* as burdens, not as rights-bearing individuals who deserve some consideration, too. And I have a really hard time figuring out what I think a workable, humane caregiving system would look like.

  9. My mom is in a situation where it became pressingly obvious that her mother needed care. There are 4 sisters (including her) and a brother. Weirdly enough, since daughters who are unmarried and/or don’t have children usually get pressured into taking on most of the work, the message my mom is getting from one of her sisters is that “Poor [brother’s name]. He has no wife or children, let’s not burden him with another thing. We can deal with this on our own.” (unrelatedly, the proposition has been put forth that since he has no wife or children, he must be in a worse economic state than his sisters (you know, the ones who’ve put children through college), so they should try to make things easier for him and make sure he gets a larger share of the inheritance). My mom, good for her, isn’t standing for this and is making sure that he’s present on conference call during their conference about what should happen about their mother (there was pressure to “not bother him about the details”) and their mother is going to live with him for the summer, during which time he’ll hopefully realize that she needs paid care.

  10. I knock my dad for a lot of things. But in the seven months that it took for cancer to eat my mother, he did it all. She wanted to die at home. She was in pain even through the morphine, she was delusional and psychotic some of the time from very heavy steriods to control the brain mets. Her children all had jobs in the big city, and made a grim Metro North pilgrimage every Friday, but my father stayed. He shaved the hair that fell out in clumps. With only a little help (and a lot of friction) from one of her sisters, he emptied the bedpans and gave the spongebaths and watched her die.

  11. this reminds me of a woman i used to work with – promising career in field archaeology, parents (retired) living in the countryside in the irish republic, mother diagnosed with parkinsons disease. despite two brothers living nearby, both married and settled in the area, and one brother living AT HOME with her frail father and sick mother, guess who gave up her job and future prospects to live at home as a full-time unpaid carer when her mother’s parkinsons worsened?

    her brothers never even gave a passing thought to the idea they could help out with day to day care as far as i could tell – she made the choice to move home after finding that the at-home brother was doing virtually nothing to help because that’s not what boys DO.

    good old-fashioned irish values there. it enrages me every time i think about it – she is worth ten of her brothers. and they could have supported their parents WITHOUT giving up their careers. but hey, what’s a single daughter’s future worth? the lads might have been inconvenienced. can’t have that.

  12. In my family, I’m the one who needs the care. I’ve got fibromyalgia syndrome, and it’s been getting progressively worse over the past ten years. It always seems like there’s less and less I can do (we fully expect that eventually I’ll need a wheelchair) and I hate it. We have a very small apartment, and I just don’t have the energy to keep it as clean as I’d like it to be.

    My wife does a lot to help me, but she still feels resentful sometimes when she’s (say) doing laundry and I’m curled up in bed. If things got so bad I couldn’t work, I would so like to have professional help, to keep our marriage from imploding. Housekeeping and caring for someone with a disability is not easy work, and I can totally understand how someone would resent having to do it for free.

  13. My mother’s one of seven children. When my grandmother started failing to take care of herself and her schizophrenia worsened, she and the other four women were the ones to take care of Grandma. My two uncles, as far as I know, never lifted a finger.

    Actually, I take that back. I think one uncle mowed her grass once in a while, and the other occasionally bought her something. The men only did the ‘masculine’ work, though – as far as I know they never ever did any of the weekly care like taking her to the grocery store.

  14. Anectodally, the two people I knew who took care of elderly/dying relatives were both men. But they got a suspicious amount of praise for it — I suspect because it seemed so out of the normal gender role. Nevertheless, they were both awesome people to do that.

  15. A huge part of this problem is, of course, our stupid-ass broken health insurance system. Ideally, people with disabled or elderly dependents could get respite care at a minimum, if not actual in-home nursing care.

    My grandmother was able to live in her own condo up until a couple of months before she died because my aunts and father had the resources to hire a wonderful in-home care nurse (and it took a couple of tries to find her, too). But they were able to do this because of the real estate business my grandfather founded back in the 1940s, not because of any magical ability to get blood from a stone.

    Me, my (step)mother made me pledge years ago that I would not put her in a home unless she was so demented she didn’t know what was going on. But she used to volunteer at the state nursing home, and she’s terrified of ending up as neglected as those people were.

    Why is it my job? It just is, I guess. But at least my dad has been able to make plans and buy sufficient insurance that it won’t completely drain our resources. But, again, that’s more because I picked the right grandparents, not because I have any illusions that it’s not a problem.

  16. Oh, and Moira, I may have mentioned this before, but if you guys can swing the budget for a twice-monthly or even once-a-month cleaning person, it will be worth every penny to the both of you. Let them do the heavy lifting so all you guys have to do is the everyday maintenance.

    It will be at least $100 a month, but it will REALLY help with the resentment issue if it doesn’t dent the budget too much.

  17. Hiring someone to come and clean the apartment regularly is something I’d definitely like to do. We just bought a car, so that’s going to make money tight for a while, but it’s on the list.

  18. Matt C mentions

    the same crowd who want everyone to “pull themselves up by their bootstraps”. From chidlhood to late adulthood, it seems that the aid of near entirely female caregivers is a crucial part of that.

    Yeah. Remember Clarence Thomas’ dissing his “shiftless” sister who’d stayed home to take care of their mother?

    As for whatdowedo?: The problems mostly boil down to the fact that (mostly) women are essentially a/drafted for and b/uncompensated for this work. If it’s happening within your own family, you can be conscious of both of those, and think about how to spread the burden and compensate anyone who voluntarily (or otherwise) takes on a disproportionate share of it.

    I’m still mulling over whether I did enough within my own family in those regards when our mother was in a nursing home after her second stroke. Money and geography were severe constraints… That’s one of those things I still need to talk about with my remaining sisters and brother.

    Why yes the personal is political.

  19. Ron Sullivan Says:

    It’s really Ron Sullivan! Surprising to see an “old” Usenetter in the blogosphere.

  20. zuzu: Apologies for being off topic AND giving unasked for advice, but…it sounds like both your mother and father died young. You don’t mention what your father died of but that he dropped dead suddenly suggests to me vascular disease (ie stroke or heart attack.) PLEASE take care of yourself. Make sure your blood pressue and cholesterol are in the good range, use meds if you have to to keep them there, get some exercise on a regular basis, and if you have symptoms that might be a heart attack, call 911. Don’t worry about looking silly in a false alarm–if your call is the silliest any of the medical personnel involved has ever dealt with then they are very inexperienced indeed. And remember that you might have non-traditional syptoms such as unexplained fatigue, breathlessness, or abdominal pain instead of the classic chest pain.

    Sorry to rant at you like that. I also had a relative die from a heart attack that wasn’t recognized quickly because it presented with unusual symptoms (my grandfather, ironically, since the “classic” symptoms of heart disease are the typically male ones).

  21. Thanks for the concern, Dianne. I’m already way ahead of my parents, health-wise, because both of them were chainsmokers for forty years and my father drank over a liter of whiskey every night for at least 20 years. I’ve also got very low cholesterol and am in the lowest risk category for heart disease. Really, the only issues I have are my weight and my knees, and both of those can be remedied one way or the other.

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