The cost of caring: The social reproductive labor of Filipina live-in home health caregivers

Frontiers

Volumn 21, Issue 1-2, 2000, Pages 61-82

  Tung, Charlene ^a  

^a NONE

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EID: 0034366926     PISSN: 01609009     EISSN: None     Source Type: Journal    
DOI: 10.2307/3347032     Document Type: Review

References (49)

1. Though perhaps uncommon and cumbersome to those not used to the spelling, the usage of Filipina/o is used in order to most clearly introduce and ensure gender inclusiveness.
2. The arrival of these Filipinas to the United States as mothers attempting to provide for their families back in the Philippines comes about through the confluence of numerous political economic factors. The increasing demands for U.S. health care for the elderly, coupled with encouragement by IMF-led and Philippine national policies, has encouraged Filipina women to pursue outmigration as the best available option. See, for example, Rosalinda Pir eda-Ofreneo, The Philippine Debt and Poverty (Oxford: Oxfam, 1991), for a more detailed examination of the debt crisis in the Philippines and Philippine government's response.
3. I use the term "elderly caregivers" to refer to those with little or no offical health care training. When the women had certificatic n as nursing assistants, they used the term CNAs (certified nursing assistants). For the purpose of this paper, I use the term "home health care worker" interchangeably with "elderly caregiver." Although I do not use it in this manner, "home health care workers" may typically encompass a full range of workers from registered nurses (RNs) down to CNAs. For more detailed explanations of the nursing industry hierarchy, see Evelyn Nakano Glenn, "From Servitude to Service Work: Historical Continuities in the Racial Division of Paid Reproductive Labor," Signs: Journal of Women in Culture and Society 18:1 (1992): 1-43; Nona Glazer, Women's Paid and Unpaid Labor: The Work Transfer in Health Care and Retailing (Philadelphia: Temple University Press, 1993); and Timothy Diamond, Making Gray Gold: Narratives of Nursing Home Care (Chicago: University of Chicago Press, 1992).
4. I use the term "elderly caregivers" to refer to those with little or no offical health care training. When the women had certificatic n as nursing assistants, they used the term CNAs (certified nursing assistants). For the purpose of this paper, I use the term "home health care worker" interchangeably with "elderly caregiver." Although I do not use it in this manner, "home health care workers" may typically encompass a full range of workers from registered nurses (RNs) down to CNAs. For more detailed explanations of the nursing industry hierarchy, see Evelyn Nakano Glenn, "From Servitude to Service Work: Historical Continuities in the Racial Division of Paid Reproductive Labor," Signs: Journal of Women in Culture and Society 18:1 (1992): 1-43; Nona Glazer, Women's Paid and Unpaid Labor: The Work Transfer in Health Care and Retailing (Philadelphia: Temple University Press, 1993); and Timothy Diamond, Making Gray Gold: Narratives of Nursing Home Care (Chicago: University of Chicago Press, 1992).
5. I use the term "elderly caregivers" to refer to those with little or no offical health care training. When the women had certificatic n as nursing assistants, they used the term CNAs (certified nursing assistants). For the purpose of this paper, I use the term "home health care worker" interchangeably with "elderly caregiver." Although I do not use it in this manner, "home health care workers" may typically encompass a full range of workers from registered nurses (RNs) down to CNAs. For more detailed explanations of the nursing industry hierarchy, see Evelyn Nakano Glenn, "From Servitude to Service Work: Historical Continuities in the Racial Division of Paid Reproductive Labor," Signs: Journal of Women in Culture and Society 18:1 (1992): 1-43; Nona Glazer, Women's Paid and Unpaid Labor: The Work Transfer in Health Care and Retailing (Philadelphia: Temple University Press, 1993); and Timothy Diamond, Making Gray Gold: Narratives of Nursing Home Care (Chicago: University of Chicago Press, 1992).
6. Glenn, "From Servitude to Service Work," 1.
7. This paper arises out of my dissertation work in which I collected data over a period of a year and a half, through twenty oral histories, in-depth interviews, and participant-observation. Participant-observation involved living and working with half of the caregivers for several days. I did not go through any nurse's aide/caregiver training and become an elderly caregiver myself. The early stages of fieldwork involved working in Los Angeles, California, with various immigrant rights community organizations, eventually helping to found a Filipina/o nonprofit workers' center.
8. Grace Kovar, Gerry Hendershot, and Evelyn Mathis, "Older People in the United States who Receive Help with Basic Activities of Daily Living," American Journal of Public Health 79:6 (1989): 778-79.
9. California Department of Finance figures, population projections, 1993, available on-line at www.aging.state.ca.us/Internet/stats/Default.htm.
10. For example, 92 percent of Filipinas/os in Los Angeles County are foreign born. Filipinas/os make up 67 percent of the city of Carson, 44 percent of Covina, and 24 percent of Cerritos (Paul Ong and Tania Azores, "Asian Immigrants in Los Angeles: Diversity and Divisions," in The New Asian Immigration in Los Angeles and Global Restructuring, ed. Paul Ong, Edna Bonacich, and Lucie Cheng [Philadelphia: Temple University Press, 1994], 121).
11. Some estimates on the amount of money sent back to the Philippines by Filipina elderly caregiverrs range as high as seven million dollars. See, for example, Dean Alegado, "The Labor Export Industry and Post-1986 Philippine Economic Development," paper presented at the Third European Conference on Philippine Studies, Institute for Research on Southeast Asia of the National Centre for Scientific Research, University of Provence, April 27-29, 1997.
12. Elizabeth C. Eviota, The Political Economy of Gender: Women and the Sexual Division of Labour in the Philippines (London: Zed Books, 1992), 142-44.
13. The other most common route is through job placement agencies that specialize in domestic help or home health care.
14. Emily K. Abel and Margaret K. Nelson, "Circles of Care: An Introductory Essay," in Circles of Care: Work and Identity in Women's Lives, ed. Emily K. Abel and Margaret K. Nelson (Albany: State University of New York Press, 1990), 17.
15. Abel and Nelson, "Circles of Care," 17.
16. In this case, Myra Bradwell, a married Illinois woman, sued the state for the right to admission to the bar. She was denied this right in an opinion that presented a "separate spheres" argument, relegating women to the home while maintaining that men's rightful sphere was in the public (Bradwell v. Illinois, 83 U.S. 130 [1872]).
17. See, for example, Arlie Hochschild with Anne Machung, The Second Shift (New York: Avon Books, 1989). For an in-depth study of daughters who serve as caregivers for their mothers and fathers, see Emily Abel's Who Cares for the Elderly?: Public Policy and the Experiences of Adult Daughters (Philadelphia: Temple University Press, 1991).
18. See, for example, Arlie Hochschild with Anne Machung, The Second Shift (New York: Avon Books, 1989). For an in-depth study of daughters who serve as caregivers for their mothers and fathers, see Emily Abel's Who Cares for the Elderly?: Public Policy and the Experiences of Adult Daughters (Philadelphia: Temple University Press, 1991).
19. Shellee Colen, "'Just a Little Respect': West Indian Domestic Workers in New York City," in Muchachas No More: Household Workers in Latin America and the Caribbean, ed. Elsa Chancy and Mary Garcia Castro (Philadelphia: Temple University Press, 1988), 171-96.
20. See, for example, Mary Romero's extensive work on Chicana/Latina domestic workers in Colorado, Maid in the U.S.A. (New York: Routledge, 1992); Colen's work on West Indian domestics in New York City, "'Just a Little Respect'"; and Evelyn Nakano Glenn's work on Japanese American women domestic workers, Issei, Nisei, War Bride: Three Generations of Japanese American Women in Domestic Service (Philadelphia: Temple University Press, 1986).
21. See, for example, Mary Romero's extensive work on Chicana/Latina domestic workers in Colorado, Maid in the U.S.A. (New York: Routledge, 1992); Colen's work on West Indian domestics in New York City, "'Just a Little Respect'"; and Evelyn Nakano Glenn's work on Japanese American women domestic workers, Issei, Nisei, War Bride: Three Generations of Japanese American Women in Domestic Service (Philadelphia: Temple University Press, 1986).
22. See, for example, Mary Romero's extensive work on Chicana/Latina domestic workers in Colorado, Maid in the U.S.A. (New York: Routledge, 1992); Colen's work on West Indian domestics in New York City, "'Just a Little Respect'"; and Evelyn Nakano Glenn's work on Japanese American women domestic workers, Issei, Nisei, War Bride: Three Generations of Japanese American Women in Domestic Service (Philadelphia: Temple University Press, 1986).
23. See, for example, Bonnie Thornton Dill, "'Making Your Job Good Yourself': Do-mestic Service and the Construction of Personal Dignity," in Women and the Politics of Empowrment, ed. Sandra Morgen and Ann Bookman (Philadelphia: Temple University Press, 1987); Glenn's Issei, Nisei, War Bride; and Romero's Maid in the U.S.A. Research also includes discussions on white (largely Irish immigrant women from the late 1800s to the early 1900s in the Northeast) and black domestic workers, particularly between the Civil War and World War II. See, for example, David M. Katzman's Seven Days a Week: Women and Domestic Service in Industrializing America (New York: Oxford University Press, 1978), which notably utilizes the available writings of domestic workers of the period. Quite a few of the women who wrote about their experiences had some college experience and thus were not, as he notes, typical; however, their "middle-class sensibilities . . . shed brilliant light upon the shadows which hid much of servants' lives" (6). Live-in domestics, most prevalent before WWII, were usually single African American and Japanese Americans (with the exception of Chinese men from the late 1800s until approximately the 1920s). For the Nisei (second-generation Japanese Americans), the position was considered the middle stage between a woman's fathers home and that of her husband's - a training stage to prepare for running a household.
24. See, for example, Bonnie Thornton Dill, "'Making Your Job Good Yourself': Do-mestic Service and the Construction of Personal Dignity," in Women and the Politics of Empowrment, ed. Sandra Morgen and Ann Bookman (Philadelphia: Temple University Press, 1987); Glenn's Issei, Nisei, War Bride; and Romero's Maid in the U.S.A. Research also includes discussions on white (largely Irish immigrant women from the late 1800s to the early 1900s in the Northeast) and black domestic workers, particularly between the Civil War and World War II. See, for example, David M. Katzman's Seven Days a Week: Women and Domestic Service in Industrializing America (New York: Oxford University Press, 1978), which notably utilizes the available writings of domestic workers of the period. Quite a few of the women who wrote about their experiences had some college experience and thus were not, as he notes, typical; however, their "middle-class sensibilities . . . shed brilliant light upon the shadows which hid much of servants' lives" (6). Live-in domestics, most prevalent before WWII, were usually single African American and Japanese Americans (with the exception of Chinese men from the late 1800s until approximately the 1920s). For the Nisei (second-generation Japanese Americans), the position was considered the middle stage between a woman's fathers home and that of her husband's - a training stage to prepare for running a household.
25. See, for example, Bonnie Thornton Dill, "'Making Your Job Good Yourself': Do-mestic Service and the Construction of Personal Dignity," in Women and the Politics of Empowrment, ed. Sandra Morgen and Ann Bookman (Philadelphia: Temple University Press, 1987); Glenn's Issei, Nisei, War Bride; and Romero's Maid in the U.S.A. Research also includes discussions on white (largely Irish immigrant women from the late 1800s to the early 1900s in the Northeast) and black domestic workers, particularly between the Civil War and World War II. See, for example, David M. Katzman's Seven Days a Week: Women and Domestic Service in Industrializing America (New York: Oxford University Press, 1978), which notably utilizes the available writings of domestic workers of the period. Quite a few of the women who wrote about their experiences had some college experience and thus were not, as he notes, typical; however, their "middle-class sensibilities . . . shed brilliant light upon the shadows which hid much of servants' lives" (6). Live-in domestics, most prevalent before WWII, were usually single African American and Japanese Americans (with the exception of Chinese men from the late 1800s until approximately the 1920s). For the Nisei (second-generation Japanese Americans), the position was considered the middle stage between a woman's fathers home and that of her husband's - a training stage to prepare for running a household.
26. See, for example, Bonnie Thornton Dill, "'Making Your Job Good Yourself': Do-mestic Service and the Construction of Personal Dignity," in Women and the Politics of Empowrment, ed. Sandra Morgen and Ann Bookman (Philadelphia: Temple University Press, 1987); Glenn's Issei, Nisei, War Bride; and Romero's Maid in the U.S.A. Research also includes discussions on white (largely Irish immigrant women from the late 1800s to the early 1900s in the Northeast) and black domestic workers, particularly between the Civil War and World War II. See, for example, David M. Katzman's Seven Days a Week: Women and Domestic Service in Industrializing America (New York: Oxford University Press, 1978), which notably utilizes the available writings of domestic workers of the period. Quite a few of the women who wrote about their experiences had some college experience and thus were not, as he notes, typical; however, their "middle-class sensibilities . . . shed brilliant light upon the shadows which hid much of servants' lives" (6). Live-in domestics, most prevalent before WWII, were usually single African American and Japanese Americans (with the exception of Chinese men from the late 1800s until approximately the 1920s). For the Nisei (second-generation Japanese Americans), the position was considered the middle stage between a woman's fathers home and that of her husband's - a training stage to prepare for running a household.
27. Today geography often determines which women of color are to be found within domestic work. For housekeeping in the West and Southwest, the field is dominated by Chicanas/Latinas. For child care and he use care in the East, West Caribbean women predominate. For elderly care in California, especially live-in work, Filipinas predominate.
28. Evelyn Nakano Glenn, "Social Constructions of Mothering: A Thematic Overview," in Mothering: Ideology, Experience, and Agency, ed. Evelyn Nakano Glenn, Grace Chang, and Linda Rennie Forcey (New York: Routledge, 1993), 5-6.
29. Two points are worth following up. First, this class and racial division is most predominantly the case with live-in home health care workers. It it is less often the situation, for example, for county home health care workers who work predominantly within low-income communities. Second, this debate highlights ongoing discussions in feminism, illustrating that middle-class women's increased opportunities and choices directly impact working-class women. The hiring of housekeepers, child care workers, and elderly care workers is a result of other more privileged women being able to afford this kind of service. This occurs not only in private household work, but also in our corporate and professio ial offices. The successful woman professor, lawyer, or administrator also relies on mostly (if not entirely) female clerical support. That being said, however, feminist scholars entrenched in debates on equality/ difference among women might note who is once again absent: Men rarely enter into the picture or discussions. We tend to look at the racial/class division and the consequent impact upon women, overlooking the lack of contribution by husbands or sons. Research on elderly care in particular shows this gender division of labor to be acute. So while the racial division among women exists and deserves attention, a more productive public and academic discussion might be to consider the gender division in service and caring work as a whole.
30. Glenn, "Social Construction of Mothering," 7, emphasis added.
31. Glenn, "From Servitude to Service Work," 1, emphasis added.
32. Correspondence from caregiver to researcher September 7, 1997; and personal interview with caregiver.
33. Colen, "'Just a Little Respect'"; Romero, Maid in the U.S.A.; Denise Segura, "Working at Motherhood: Chicana and Mexicana Immigrant Mothers and Employment," in Glenn, Chang, and Forcey, Mothering, 211-36; Pierrette Hondagneu-Sotelo and Ernestine Avila, "'I'm Here, but I'm There': The Meanings of Latina Transnational Motherhood," Gender & Society 11:5 (1997): 548-70.
34. Colen, "'Just a Little Respect'"; Romero, Maid in the U.S.A.; Denise Segura, "Working at Motherhood: Chicana and Mexicana Immigrant Mothers and Employment," in Glenn, Chang, and Forcey, Mothering, 211-36; Pierrette Hondagneu-Sotelo and Ernestine Avila, "'I'm Here, but I'm There': The Meanings of Latina Transnational Motherhood," Gender & Society 11:5 (1997): 548-70.
35. Colen, "'Just a Little Respect'"; Romero, Maid in the U.S.A.; Denise Segura, "Working at Motherhood: Chicana and Mexicana Immigrant Mothers and Employment," in Glenn, Chang, and Forcey, Mothering, 211-36; Pierrette Hondagneu-Sotelo and Ernestine Avila, "'I'm Here, but I'm There': The Meanings of Latina Transnational Motherhood," Gender & Society 11:5 (1997): 548-70.
36. Colen, "'Just a Little Respect'"; Romero, Maid in the U.S.A.; Denise Segura, "Working at Motherhood: Chicana and Mexicana Immigrant Mothers and Employment," in Glenn, Chang, and Forcey, Mothering, 211-36; Pierrette Hondagneu-Sotelo and Ernestine Avila, "'I'm Here, but I'm There': The Meanings of Latina Transnational Motherhood," Gender & Society 11:5 (1997): 548-70.
37. The next most common explanation involved the desire to leave abusive or unfulfilling marriages - a topic for another paper.
38. See, for example, Arlie Russell Hochschild, The Managed Heart: Commercialization of Human Feeling (Berkeley: University of California Press, 1983); and Abel, Who Cares for the Elderly? Child care workers, like elderly care workers, expend much emotional labor. They are hired to care for or mother other individuals. Success on the job relies in large part on their ability to be compassionate and caring, yet maintain a degree of professional distance.
39. See, for example, Arlie Russell Hochschild, The Managed Heart: Commercialization of Human Feeling (Berkeley: University of California Press, 1983); and Abel, Who Cares for the Elderly? Child care workers, like elderly care workers, expend much emotional labor. They are hired to care for or mother other individuals. Success on the job relies in large part on their ability to be compassionate and caring, yet maintain a degree of professional distance.
40. Hochschild, The Managed Heart, 240.
41. See for example, Colen, "'Just a Little Respect'"; Glenn, Issei, Nisei, War Bride; and Mary Romero, "Sisterhood and Domestic Service: Race, Class, and Gender in the Mistress-Maid Relationship," Humanity and Society 12:4 (1988): 318-46.
42. See for example, Colen, "'Just a Little Respect'"; Glenn, Issei, Nisei, War Bride; and Mary Romero, "Sisterhood and Domestic Service: Race, Class, and Gender in the Mistress-Maid Relationship," Humanity and Society 12:4 (1988): 318-46.
43. See for example, Colen, "'Just a Little Respect'"; Glenn, Issei, Nisei, War Bride; and Mary Romero, "Sisterhood and Domestic Service: Race, Class, and Gender in the Mistress-Maid Relationship," Humanity and Society 12:4 (1988): 318-46.
44. Abel and Nelson, "Circles of Care," 4.
45. Leticia, however, also earned $7.50 per hour as a caregiver in her other day job.
46. These computations do not include taxes. Taxes were taken out for those working through agencies. Most women, even if employed directly by the employer, declared their own taxes at year end.
47. According to the agency, the trachea tube necessitates that an Licensed Professional Nurse be sent in Marie's stead - even though Marie, a CNA, learned to do it herself after she was hired. Note that the $31.50 hourly rate includes whatever percentage the agency takes. In addition, the agency that placed Marie over four years ago continues to charge her patients a twenty-dollar placement fee every day for as long as she is employed there.
48. However, despite hearing this often from the women in this study, only one out of twenty women I interviewed and worked with earned over ninety dollars a day.
49. The employers (patients) were financially stable, if not wealthy, in comparison to the caregivers. I want to acknowledge, however, that there still remained the possibility of the patient "outliving" his or her finances.