Abstract
There are approximately 4.4 million direct-care workers in the United States. Comprising the labor of nurses, home health aides, certified nursing assistants, personal attendants, and companions to the elderly, direct-care work constitutes one of the fastest-growing labor niches in the United States. Within the commodified caregiving sector, cost-cutting imperatives to subdivide care labor introduce insalubrious complications for patients by cleaving – or attempting to do so – their physical needs from their emotional and relational needs, a process that I label ‘rationalized aging’. In this essay, I reflect on my experiences as a paid elder companion in New York City to argue that this process of subdivision combines earlier nineteenth-century rationalization strategies with neoliberal regimes of flexible accumulation and to highlight the consequences of subdivision in this sector both for care workers and for the patients in their care.
Highlights
There are approximately 4.4 million direct-care workers in the United States
As Gene’s remonstration made clear, elderly patients are harmed when their physical needs are separated from their relational needs, as it jeopardizes their comfort and care
I reflect on my experiences as a paid elder companion in New York City to trace the changing contours of low-waged care work in the United States and to highlight the consequences of subdivision in this sector, both for care workers and the patients in their care who, I argue, are subject to a novel process of rationalized aging
Summary
This essay draws on my experiences working as a companion to the elderly throughout graduate school between 2009 and 2012. The specific narrative I recount here only came into analytical focus after I conducted several months of fieldwork among care work activists. Since this paid experience was outside of my formal research activities, I ground my narrative description in personal memories and perceptions. While using personal narrative in this manner prevents me from fully addressing the function of ‘racial capital’ in structuring this racially segmented, low-waged labor niche or attending to women caregivers of color’s lived experiences of discrimination on the job (Robinson 1983), I offer a firsthand perspective on the effects of capitalist restructuring on elderly patients as well as those who care for them
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