Integrating Care Work with Life

This chapter discusses what it's like for caregivers to work at home in contrast to work done by nurses in the hospital. Homes, by their very nature, lack the resources and support of a hospital, and often geography — the physical separation between the home and the hospital — places obstacles in the coordination of care. Unlike bureaucratic settings, which have standard work shifts, care work at home takes place over a twenty-four-hour period and caregivers' schedules are completely different from the schedules of the organizations they depend on for resources, such as delivery companies, vendors, or pharmacies. As is evident from contrasting the bustle of a busy hospital with the atmosphere in many homes, the division of labor and the people who do it are entirely different. In the hospital, nurses work in shifts to provide patient care. At home, there are far fewer people available, and they are in deeply embedded, preestablished familial roles and relationships, as well as existing patterns of housework and childcare. Because home is oriented toward relationships, “private” activities, and provisioning, rather than toward bureaucratic standards, compliance with medical regimens can also be more difficult. Whether or not caregivers received training in the hospital or rehabilitation, most said they were still very anxious, sometimes even overwhelmed and frightened, the first time they had to perform procedures by themselves at home. Caregivers dealt not only with the medical procedures, however, but also with their feelings about the care recipient's overall health and prognosis, and whether the recipient would be able to adapt to new regimens.