Paid Care Work Research Articles

Emotional Labor and the Problem of Exploitation in Roboticized Care Practices: Enriching the Framework of Care Centred Value Sensitive Design

Care ethics has been advanced as a suitable framework for evaluating the ethical significance of assistive robotics. One of the most prominent care ethical contributions to the ethical assessment of assistive robots comes through the work of Aimee Van Wynsberghe, who has developed the Care-Centred Value-Sensitive Design framework (CCVSD) in order to incorporate care values into the design of assistive robots. Building upon the care ethics work of Joan Tronto, CCVSD has been able to highlight a number of ways in which care practices can undergo significant ethical transformations upon the introduction of assistive robots. In this paper, we too build upon the work of Tronto in an effort to enrich the CCVSD framework. Combining insights from Tronto’s work with the sociological concept of emotional labor, we argue that CCVSD remains underdeveloped with respect to the impact robots may have on the emotional labor required by paid care workers. Emotional labor consists of the managing of emotions and of emotional bonding, both of which signify a demanding yet potentially fulfilling dimension of paid care work. Because of the conditions in which care labor is performed nowadays, emotional labor is also susceptible to exploitation. While CCVSD can acknowledge some manifestations of unrecognized emotional labor in care delivery, it remains limited in capturing the structural conditions that fuel this vulnerability to exploitation. We propose that the idea of privileged irresponsibility, coined by Tronto, helps to understand how the exploitation of emotional labor can be prone to happen in roboticized care practices.

The Automated Heart: Digital Domesticity and Emotional Labour Saving

This article considers the relevance of domestic labour saving devices to emotional labour. Starting with an account of the ways in which household technologies failed to relieve the burdens of domestic drudgery in the twentieth century, it proceeds to consider the labour saving potential of the ‘smart home’, as well as the gendered ideologies it represents. By looking at social robots designed for use in the smart home, we see that, while manual housework is beyond the scope of today’s smart technologies, emotional labour is not. Thinking about the different forms that domestic automation can take allows us to recognise that there are qualitative as well as quantitative factors to consider when it comes to critically assessing domestic labour saving ambitions. The article concludes by exploring continuities with paid care work, and by developing a tri-partite approach to reproductive labour as high touch, high tech, and high talk.

Unravelling the tensions: exploring the interplay of paid care work, family obligations, and transnational care among Zimbabwean migrant care workers in the UK

ABSTRACT An increasing number of studies have examined the impact of migration on reconciling familial care obligations with demanding paid care work. However, much of this research focuses on women who employ migrant care workers and ignores the experiences of migrant care workers balancing their jobs with their own familial responsibilities. As a result, little is known about how migrant care workers navigate local contexts, form families, and manage work and childcare in destination countries while maintaining commitments at home. This paper explores the family dynamics and transnational lives of Zimbabwean migrant care workers in the UK. It draws on qualitative interviews with 10 participants to elaborate on the additional challenges they face in reconciling paid care work with localized and transnational family care. The analysis highlights that migrant workers must simultaneously respond to the care demands of their families and employers, often causing tensions as gendered care expectations are challenged. To manage these difficulties in balancing work and family, Zimbabwean care workers employ various strategies that sometimes strain familial relationships. This study provides insight into the intersection of migrant care workers’ paid labour and familial care obligations across borders.

The good, the bad and the grey areas of care: a review of the anthropology of care in health care

Current societal transformations in health care and other fields of care have led to an enormous increase in the number of publications in the anthropology of care. Yet, the field turns out to be fragmented and complex. To provide some orientation, we present results of a scoping review on empirical research on paid care work in health-care settings. We structure our findings according to whether the authors tend to focus on ‘good’, ‘bad’ or ‘grey’ areas of care. Anthropology might contribute to the field of care studies by making aspects of care visible that often remain concealed otherwise.

‘Extra hands’ or the ‘icing on the cake’? The boundaries of the volunteer role in formal care settings in England

The adult social care sector in England has been encouraged to increase the role of volunteers in service delivery. To understand the volunteer role in care delivery and its impact upon paid care work, we undertook 94 qualitative interviews in seven care settings for older people in England. While the boundaries between care worker and volunteer were clearly established in some organisations, they were more indistinguishable in others. We discuss how both clear and murky boundary making, especially regarding ‘emotional’ and ‘bodily’ aspects of care, can contribute towards paid care work’s invisibility, lack of recognition and poor remuneration.

“I Only Tell Them the Good Parts:” How Relational Others Influence Paid Careworkers’ Descriptions of Their Work as Meaningful

The occupational images associated with paid care work for older adults range from a job carried out by earthly angels to a form of stigmatized dirty work: This ambiguity makes maintaining a committed long-term care workforce challenging. Encouraging careworkers to view their work as meaningful has been touted as a potential solution. Moving beyond a purely subjective approach to meaningfulness, we explore how careworkers construe their work as meaningful and how relational others influence careworkers’ ability to speak about meaningfulness. Others’ messages matter, although their importance depends on relational others’ knowledge of care tasks and involvement in the care relationship. By documenting how others’ accounts both enhance and compromise careworkers’ ability to speak about meaningfulness and moments of meaninglessness, our study identifies sources of meaningfulness for careworkers, a socially essential workforce under-examined by meaningful work research, and extends meaningful work research in contexts where relationships are central to occupational identity.

Valuing the Contributions of Family Caregivers to the Care Economy

The purpose of this paper is to estimate the monetary value of Canadians’ family care work, to highlight inequalities within the family care sector and place this work within the care economy. Using Statistics Canada’s 2018 General Social Survey, we estimated the replacement cost of the 5.7 billion hours of respondents’ care work at between $97.1 billion and $112.7 billion. We used descriptive, backward stepwise regression and dominance analyses to examine the distribution of care responsibilities among caregivers. Caregivers comprised 22.1% of the sample (6.8 million Canadians). Living arrangement explained most (81-83%) of the variance in the value of unpaid care work, followed by generation (14-15%), income (2%) and gender (1-2%). These findings provide powerful evidence of the economic value of family care work and of the inequalities among family caregivers in the magnitude of their contributions. Monetizing the value of family care makes it more visible, locates it in the context of the broader care economy and establishes its relationship to the much more visible and valued realm of paid care work. This contextualization also responds to global action plans and resolutions urging governments to create systems of long-term and continuing care for people with chronic conditions and disabilities rather than imposing sole responsibility on unpaid caregivers.

Cleaning guest rooms as care work? Politicization of hotel housekeeping in the Las Kellys movement

ABSTRACT The literature on labour conflict in the field of paid care work deals primarily with highly feminized occupations that fit in with the International Labour Organization’s (ILO) characterization of the care workforce, such as nurses, domestic workers and childcare providers. We focus instead on room attendants: a highly feminized occupational group that lies beyond the scope of the care economy defined by the ILO. Our analysis draws upon Briskin’s ‘politicization of caring’ through which care workers demand professional recognition, decent working conditions and fair wages, as well as call for the acknowledgement of caring as a collective responsibility. Following this thread, we look into the politicization of hotel housekeeping by Las Kellys, a Spanish movement of room attendants that frames hotel housekeeping as care work with the aim of subverting low social standing and improving precarious working conditions. Such a framing relies on two axes of meaning-making: (1) room attendant as provider of customer well-being, and (2) (hotel) cleaning as undervalued feminized basic care. This article expands the scope of the ‘politicization of caring’ beyond the limits of the care economy.

Taking Care Seriously: Gendering Honneth’s The Working Sovereign – A Normative Theory of work

Axel Honneth’s latest work The Working Sovereign. A Normative Theory of Work states that the democratization of work and employees’ experience of democracy at work are important prerequisites for creating and promoting democracy as well as social and political participation. According to Honneth, various aspects of ‘good work’ are essential for such a democratization of work. Undoubtedly working conditions must be improved and it is an inestimable merit of Axel Honneth’s book to demand this so clearly. Beyond this fundamental agreement, I would, however, take a broader view of some details and draw some conclusions differently. First, it is difficult to derive the improvements needed in the world of work from a theory of democracy alone as its limited scope hides other urgent problems. Second, any approach might prove short-sighted if the democratization of work thesis only refers to wage labour or, at best, to paid care work. Rather, a comprehensive concept of care/work must be the starting point. On a surface level, Honneth’s conception of work is broad and gender-sensitive. However, Honneth does not follow this to its logical conclusion and fails to provide a systematic role to his conception of work when deriving his claims in the final chapters of his book. Rather, this broad conception of work is lost more or less inconspicuously behind a latent androcentrism. This has far-reaching consequences: from a comprehensive, gender-theoretical perspective, it would have been necessary to demand the ‘democratization of care/work’ such that gender and specifically women, who are the main care providers and perform this work largely unpaid and invisibly, finally are also included. What is more, in Honneth’s analysis the same elision applies to other intersectional categories, as race, migration, citizenship and ability are all lost from view in Honneth’s nation-state-based, homogeneous and harmonious concept of democratization. In sum, in my critical engagement with Honneth’s new text I will show that while he very clearly points out the indispensable need for better working conditions, he is blind to gender and care work.

“It's your Liangxin that tells you what to do”: Interpreting workplace-induced emotions in a Chinese nursing home

How Direct Care Workers (DCWs) interpret their work and perform care activities undeniably impacts the well-being of institutionalized older adults. Despite the emotionally charged nature of paid care work, little is known about how Chinese DCWs talk about their work and construct meaning within China's unique social context of a burgeoning institutional care market and changing cultural expectations for long-term care. This study qualitatively explored Chinese DCWs' emotion work as they navigate among institutional pressures and low social recognition in an urban government-sponsored nursing home in central China. Results revealed that DCWs used Liangxin (the good heart/mind) – a ubiquitous Chinese moral notion emphasizing the unity of feeling, thought, and action – as an interpretive framework, including its four dimensions (ceyin, xiue, cirang, and shifei), to inform care practice, manage emotions, and find dignity within what can be personally demeaning and socially devalued work. Our study delineated the processes through which DCWs sympathized with the pain and struggles of the older adults in their care (ceyin xin), shamed unjust attitudes and behaviors embedded in institutional care (xiue xin), delivered family-like relational care (cirang xin), and formed and reinforced principles of good (versus bad) care (shifei xin). We also revealed the nuanced role that the cultural value of xiao (filial piety), working in tandem with liangxin, both shaped the emotional terrain of the institutional care setting and impacted how DCWs engaged in emotion work. While recognizing the effect of liangxin for incentivizing DCWs to provide relational care and renegotiate their role status, we were also alerted to the risks of overburdening and exploiting DCWs who relied solely on their liangxin to meet complex care needs.

Individualising Risk: Paid Care Work in the New Gig Economy by Fiona Macdonald (2021)

Individualising Risk: Paid Care Work in the New Gig Economy by Fiona Macdonald (2021)

Dimensions of job precariousness and associations with workers’ health and well-being in Swedish homecare

Although international research has shown an increase in precarious work in recent decades, few of these studies have been devoted to paid care work. This article joins feminist research on care work with work–life oriented research on precarious work to study the work situation of Swedish homecare workers. The results show a high prevalence of multidimensional precariousness among the care workers and reveal how several indicators of job precariousness are associated with physical and mental strain, poor work–life balance, and intentions to quit the job, including time pressure, lack of job control and limited possibilities to develop and use skills, as well as to create and keep relations with users.

Gendered austerity and embodied debt in Ecuador: channels through which women absorb and resist the shocks of public budget cuts

ABSTRACT This paper examines the dynamics and implications of gendered austerity in Ecuador in the context of the fiscal consolidation framework recommended in the country's International Monetary Fund (IMF) loan programme, through three channels. First, that of the public health sector and the experiences of women public health workers. Second, that of unpaid care work and significant augmentations in home-based health care of family members as well as education support. And third, increases in consumer debt incurred by women through extractive short-term lenders. To illustrate the lived experiences of women, interviews were conducted with a leader of a nurses' union in the capital city of Quito and results collected from external published focus group surveys with women engaged in unpaid and paid care work as well as in community savings organizations. Two key theoretical frameworks are employed within feminist political economy. First, the social provisioning approach, where economic activity encompasses unpaid and paid work, human well-being is the yardstick of economic success, and power inequities, agency and economic outcomes are shaped by gender. Second, the literature on gender, care work and macroeconomics which articulates a reorientation of fiscal policy from expenditure control to investment in publicly funded social services in order to achieve gender equality, protect women's human rights as well as create fiscal space.

What do we know about the experiences of migrant care workers in Australia? A scoping study

AbstractMigrant workers comprise a significant and growing segment of Australia's non‐professional frontline care workforce. In this article, we offer a scoping study of existing research to investigate what is known about the experiences of migrant workers employed in non‐professional care occupations in Australia. Through a systematic approach, which includes six discrete stages (Arksey and O‘Malley, 2005), we find a growing and substantial literature on migrants working in non‐professional care occupations in Australia. However, we also find that only a small number of studies are concerned with the experiences of migrant workers themselves. This article thematically maps out existing knowledge about these workers—including pathways in and out of paid care work, (under)utilisation of skills, cultural meanings attached to paid care work, experiences at work such as racism and language barriers, and finally how care work is situated in relation to workers’ private lives. We conclude by identifying major gaps in the literature and outlining important avenues for future research.

For Love of Money: Rewards of Care for India’s Women Community Health Workers

Abstract What are the rewards of paid care work for frontline health workers? I focus on India’s women community health volunteers, the largest such workforce in the world. Appointed since 2007 and numbering one million, these women are paid per-case incentives to connect the poor and marginalized to government-run health services. Using 14 months of ethnographic fieldwork in Delhi and Punjab, including 80 interviews, I find that women community health volunteers (called Accredited Social Health Activists or ASHAs) experience extrinsic rewards in paid care work. ASHAs earn not only from their official wages, but also from two unofficial streams: a) a boost of income from non-ASHA work and b) commissions from private hospitals. I also find that the intrinsic rewards ASHAs report—emotional gratification, relative autonomy, and skill-building—are co-constituted with extrinsic rewards; that is, they are tied to their earnings. This calls into question the “Love versus Money” binary, used to frame much of the discussion on care work. I argue instead for a “Love of Money” framing—that is, money as a reward and money as begetting other rewards. My findings highlight the significance of globalizing the empirical research on paid care work.

‘Indispensable to All Working Women and to Mothers in the Home.’ Global Labor Standards and the Quest for Social Justice, 1919-2019

The binary productive and reproductive labor –what the International Labour Organization (ILO) has called work and family responsibilities– cordoned off care from employment. Until the 2000s, paid care work mostly stood outside of ILO deliberations, while unpaid family care became a concern as a means to enhance labor force participation and thus reinforce the valuing of care as a special kind of activity. This analysis traces the construction of the woman worker under global labor standards by focusing on ‘All Working Women’ and ‘Mothers in the Home’ to complicate feminist discussions of equality.

Transforming care work and care jobs for the future of decent work

The article is an edited version of a keynote speech given at the 2019 Global Carework Summit and highlights the findings of the International Labour Organization report Care Work and Care Jobs for the Future of Decent Work. It takes a comprehensive look at the nexus between unpaid care work, paid work and paid care work, and its contributions to the future of work debates and global policy work around the achievement of gender equality.

‘Personalised risk’ in paid care work and the impacts of ‘gig economy’ care platforms and other market-based organisations

Research has identified ‘personalised risks’ for workers due to changes in the public/private dimensions of care where workers are directly employed or engaged by care users in individualised care systems. Drawing on interviews with workers in Australia’s new individualised disability services market, the research explores personalised risk and the effects of involvement in personalised care relationships of market-based organisations, including online digital care platforms. It finds that rather than having a protective role, both digital platforms and employing organisations can increase risks for workers in individualised care relationships.

Intersections on the Class Escalator: Gender, Race, and Occupational Segregation in Paid Care Work

As U.S. manufacturing and production industries have declined, the growth of the care sector has increasingly become an important source of jobs for workers without a college degree. Often requiring some form of postsecondary credentialing, many care occupations can provide better wages, job stability, and possible upward mobility for less educated workers. However, employment patterns in paid care work are both gendered and racialized: women and workers of color are overrepresented in care occupations with fewer entry barriers, benefits, and lower pay. Although these patterns are well documented, the mechanisms producing them are less well understood. Using event history analysis and the National Longitudinal Survey of Youth (NLSY79), this study evaluates the explanatory power of neoclassical economic, status attainment, and social closure theories of occupational segregation for black women’s and men’s greater hazard or “risk” of entering care occupations, relative to white workers. Net of individual and closure mechanisms, significant residual effects suggest labor market discrimination remains a primary explanation for the over‐representation of black workers in less credentialed care jobs with fewer benefits.

Beyond Separate Spheres

Beyond Separate Spheres