Inequalities of Aging: Paradoxes of Independence in American Home Care

276 Pages·2018·2.027 MB·English

by  Elana D. Buch

Inequalities of Aging
Anthropologies of American Medicine:
Culture, Power, and Practice
General Editors: Paul Brodwin, Michele Rivkin- Fish, and Susan Shaw
Transnational Reproduction: Race, Kinship, and Commercial Surrogacy in India
Daisy Deomampo
Unequal Coverage: The Experience of Health Care Reform in the United States
Edited by Jessica Mulligan and Heide Castañeda
Inequalities of Aging: Paradoxes of Independence in American Home Care
Elana D. Buch
Inequalities of Aging
Paradoxes of Independence in American Home Care
Elana D. Buch
NEW YORK UNIVERSITY PRESS
New York
NEW YORK UNIVERSITY PRESS
New York
www.nyupress.org
© 2018 by New York University
All rights reserved
References to Internet websites (URLs) were accurate at the time of writing. Neither the
author nor New York University Press is responsible for URLs that may have expired or
changed since the manuscript was prepared.
Library of Congress Cataloging-in-Publication Data
Names: Buch, Elana D., author.
Title: Inequalities of aging : paradoxes of independence in American home care /
Elana D. Buch.
Description: New York : New York University Press, [2018] | Series: Anthropologies of
American medicine : culture, power, and practice | Includes bibliographical references
and index.
Identifiers: LCCN 2017044866 | ISBN 9781479810734 (cl : alk. paper) |
ISBN 9781479807178 (pb : alk. paper)
Subjects: LCSH: Home care services—United States. | Older people—Home care—
United States.
Classification: LCC RA645.35 .B83 2018 | DDC 362.14—dc23
LC record available at https://lccn.loc.gov/2017044866
New York University Press books are printed on acid- free paper, and their binding materials
are chosen for strength and durability. We strive to use environmentally responsible suppli-
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Manufactured in the United States of America
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Also available as an ebook
To my parents, Ray and Lindy Buch, who cared for me first,
and through it all.

Contents
List of Abbreviations ix
List of Key People xi
Introduction 1
1. Generating Independence: Older Adults’ Life Histories 33
2. Inheriting Care: Home Care Workers’ Lives 62
3. Making Care Work: Training and Supervision in Home
Care Agencies 88
4. Embodying Inequality: Empathy and Hierarchy in
Daily Care 126
5. Independent Living: Housekeeping as Personkeeping 151
6. Care Falls Apart: Turnover and the Limits of Independence 176
Conclusion 201
Acknowledgments 217
Notes 221
Bibliography 241
Index 257
About the Author 263
vii

List of Abbreviations
ADA— Americans with Disabilities Act
ADC— Aid to Dependent Children
ADLs— Activities of Daily Living
AFDC— Aid to Families with Dependent Children
CCP— Community Care Program
CHA— Chicago Housing Authority
CNA— Certified Nursing Assistant
DON— Determination of Need
FLSA— Fair Labor Standards Act
HCBS— Home and Community Based Services
HUD— Housing and Urban Development
IADLs— Instrumental Activities of Daily Living
NDWA— National Domestic Workers Alliance
PRWORA— Personal Responsibility and Work Opportunity
Reconciliation Act
SEIU— Service Employees International Union
TANF— Temporary Assistance for Needy Families
ix