Gender, Time, and Money in Caregiving

By Ward, Debbie Rn, PhD | Scholarly Inquiry for Nursing Practice, January 1, 1990 | Go to article overview

Gender, Time, and Money in Caregiving


Ward, Debbie Rn, PhD, Scholarly Inquiry for Nursing Practice


Nurses and scholars in other disciplines have examined the consequences of caregiving on the caregiver in behavioral and attitudinal terms, under the general rubric of "burden." This paper considers caregiver burden in less commonly used labor and economic terms. In addition to expanding nursing's conception of caregiver burden, this approach highlights issues gender-specific to the majority of caregivers, women. Housework is used as a model for women's unpaid work. Based on this model, studies are reviewed in which hours and dollars are measures of caregiving burden. Some specific calculations of the value of elder kin care are given. It is urged that the economic consequences of caregiving be routinely considered and evaluated when nurses in practice and/or research address the needs of caregivers.

This paper reviews an area in which nurses are deeply involved-care provided at home by family members and friends-in terms many nurses do not readily employ-time and money. Time and money are widely comprehensible measures by which work is analyzed and illuminated. The value of women's work in general and caregiving in particular, however, is poorly understood; one part of a clarifying analysis is measurement in time and money. This paper examines housework as the prototypical unpaid work of women and as part of the caregiving responsibilities of women. Studies of the time devoted to housework and the calculated values of the work are reviewed. These valuation methods are then adapted and applied as measures of unpaid caregiving work. Implications for nurses are addressed.

CAREGIVING AS LABOR

The care provided to the noninstitutionalized chronically ill, especially dependent elderly, by family members and friends has most often been examined in behavioral and attitudinal terms. Horowitz's (1985) comprehensive review of the elder caregiving literature reveals that researchers concentrated almost exclusively on the emotional strain of providing care. Current researchers continue the tradition of employing primarily psychological and occasionally physiologic measures in studies of caregiving ( Robinson, 1988). The concept of caregiver burden formed by this approach shapes the work of nurses involved in long-term care who worry about caregivers and think of ways to assist them. Nurses informed only by psychosocial studies of caregiving will also view its effects and devise remedies only in psychosocial terms.

But caregiving has economic and labor dimensions. Since most caregivers are women, analyses of caregiving using a workload/economic approach are especially important. Women are widely recognized to be systematically underpaid for their work in the marketplace (Women's Research and Education Institute, 1988). The extent of women's unpaid, family-maintaining work, however, is largely unrecognized, and the economic valueof the work often ignored. As nurses contemplate the worth of their own caring work (Aiken, Blendon, & Rogers, 1981; Aiken & Mullinix, 1987; Friss, 1988), they have a special stake in illuminating all the dimensions of women's work in a man's world.

McPherson (1983), Allen (1987), and others have suggested that socialist feminism provides a helpful theoretical perspective from which to discuss nursing as a form of work in a male-dominated, capitalist economy. As a theoretical framework, socialist feminism is useful because it addresses the intersection of gender inequality and labor issues (Jaggar & Rothenberg, 1984). Consequently it will be used to organize this discussion of women's caregiving work.

Caregiving is a quintessential piece of women's unpaid work. The terms used for care given by relatives and friends, such as "family" or "free" care, are themselves evidence that the central role of women in caregiving and the nature of caregiving as work are largely disregarded. To call care of the elderly "family care" implies that all members of families share equally in the work. …

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