Forced to Care

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Over the years, M has gotten used to going without childcare. She moved from the UK years ago, got married, and settled down in the same state in the South as her in-laws. But unlike the millions of people in the United States who rely on relatives for regular or backup childcare, M’s in-laws weren’t physically able to provide care on their own, and M’s own parents were an ocean away.

Eventually, M found a small, home-run daycare center for coverage during the day. But they had no options for anything close to affordable overnight care. When she and her husband were invited to weddings, one would attend while the other stayed home. When one of them was in the wedding party, they managed to fly M’s cousins out from the UK to watch the kids. It was the only time in 13 years that they were able to be away from their kids overnight. She felt jealous of her sister, who lives close to her parents in the UK, and all the other parents in town who seemed to have grandparents available for on-demand care.

But then K and her family moved to a new town, and everything changed. They became friends with another couple who were in a similar situation — marooned, for lack of a better phrase, on an island without unpaid care options. And they effectively became each other’s extended families: they watch each other’s children during emergencies, they handle drop-offs and general shuttling if the parents are at work. Since moving, M and her husband have relied on this family during emergency room visits, for funerals, and for weddings that they can finally attend as a couple. They created an infrastructure of care for one another.

“It has changed my outlook so much to finally have someone who cares to help us,” she said. “Finally, I have someone to put as an emergency contact on school forms.” M’s kids are older now, which makes this sort of care much easier than if, say, her kids were toddlers. But has dramatically changed her family’s life.

Over the last week, I’ve heard so many iterations of M’s story. Mostly, I’ve heard from people who are trying to find care for their children, but I’ve also talked to people desperate to find help caring for their aging parents, with no immediate family to fill the need. In many ways, these people are the exception, not the rule: as sociologist Jessica Calarco pointed out in last week’s interview, the average American adult lives only 18 miles away from their mother, and a stunning 80% of adults live within a two hour drive. (The more education you have, the more likely you are to live farther away).

But those stats don’t quite account for the vagaries of familial care: whether people are physically able, like M’s in-laws; whether the emotional tax of having that person around and levying judgment is too much to bear; whether you trust the family member to provide care; whether that family member is actually willing to provide care, even in a pinch. (Several moms, for example, told me that their own parents have plainly communicated that they don’t plan to spend their retired years as a babysitting service). Just because you live within two hours of your mom doesn’t mean that you have access to regular or reliable caregiving options, whether for a chance weekend away, an emergency room visit, or backup/interstitial care when other care options fall through or are too expensive.

What we have, then, is a caregiving paradigm — not just for kids, but for elders and other adults — that relies heavily on proximity to family and presumed willingness. For those without those things, there are two options: 1) pay a lot of money for help, or 2) figure it out your damn self.

Now, you might say: these options should be rough! We should be more reliant on families! People should try to live closer to home! This is how care works! It takes a village! And yes, this is indeed how care has historically worked in many societies: people in the larger familial unit take on roles as secondary caregivers, thus weaving together an entire safety net of care for those who need it, either because they’re children or aging or disabled or recovering from illness.

But many societies — and American society in particular — is no longer arranged this way. Even if 80% of adults still live within two hours of their parents, as of 2016, only one in five American families has a “stay-at-home” parent (an increasingly antiquated word to describe not working for pay). An estimated 16.8 percent of the population — 41.8 million people — currently provides care for an adult over 50, a number that will only continue to grow as boomers continue to age. Twelve percent of parents are part of the so-called sandwich generation: simultaneously providing care for an aging parent and a child under 18.

Childcare costs have gone up a staggering 41% over the course of the pandemic; families now spend an average of $14,117 a year per child on care. In Indiana, the average family with children under five is now spending 20% of their income on childcare. Eldercare costs are similarly ridiculous — and similarly difficult to come by, particularly if your parent isn’t eligible for Medicare. But you’ve likely heard these numbers before, and if you’ve had to figure out care, you also know the American solution: just deal with it.

So you find the money. You stop saving. You reduce your hours. You put it on credit cards. Or, for many mothers in particularly, you quit your job to provide the care your children or elders require, because that’s a lot easier than trying to cobble together the assistance you need. In her excellent book Forced to Care, Evelyn Nakano Glenn refers to this ongoing scenario as a care crisis. It’s not just that there isn’t enough care — it’s that those who end up providing it are coerced, in some form, to do so.

Coercion, in Nakano Glenn’s conception, develops in three primary forms. There’s coercion through kinship ties — aka, the person in need of care is my father, or my Aunt, or my kid, and it is my responsibility to provide it for them, even if I don’t particularly want to or am even able to. There’s coercion by gender identity — the daughter, the grandmother, or the sister who becomes the de facto caregiver simply because she is a woman, and whatever other labor they’re doing, they’re getting paid less (or not at all) so they should do this work instead. And there’s coercion through race and citizenship — the people who do the poorly compensated care work when family refuses or is not available to do it for free, not necessarily because they are drawn to the work itself, but because it is the only work available to them.

Nakano Glenn argues that the overarching care crisis is the result of a stubborn adherence to public/private conceptions of labor: that there are certain types of labor that take place in the public sphere — and primarily performed by men — that are valuable, and compensated as such, and certain types of labor that take place within the private sphere — and primarily performed by women — which aren’t considered labor at all, but what one should “naturally” feel called to do, and thus poorly compensated, if compensated at all.

This line of thinking is a pretty obvious patriarchal tent pole — but it also does a lot of work upholding the American cult of the individual (family). If someone needs help, if someone’s in crisis, if someone’s struggling, the solution to their struggle should always be to turn inward, not outward. This might seem contrary to the whole barnraising American ethos, but it has emerged as the prevailing ethic: our most venerated heroes are those who (ostensibly) “did it themselves,” even if they absolutely did it, whatever it is, with the invisibilized labor of women, or exploitative and racialized labor practices, or the benefits of familial wealth.

(Sidenote: I find sociologists’ conception of wealth particularly useful here: wealth isn’t, like, Scrooge McDuck pools of gold; it’s the ability to move back home, or borrow what you need for first and last months’s rent, or co-sign on a lease or a loan, or cover the costs of coming home from college. Wealth can be a shallow pool of money if it makes it so that the next generation doesn’t go deep into debt to enter the adult world).

Within the individualist conception, there’s no such thing as a systemic issue: no eldercare crisis, no childcare crisis, just hard decisions and sacrifices that every family (read: every woman in that family) has to make on their own. If another family or individual can’t make similar decisions, that’s their problem, and no one else’s.

What if a single mom is struggling to find help when she gets sick? She should’ve thought of that before having a kid on her own. Can’t find affordable care in the city where your industry is centered? Shouldn’t have taken that career route. Live in a childcare desert? Someone’s gotta stay home. Parent can no longer live on their own, but there’s no open beds in a nursing home for hundreds of miles in any direction? Gotta move them in with you, you have no other choice.

For so many people, this lack of options — this coercion to care — breeds intense resentment of a role that, when chosen of one’s own volition, might feel incredibly satisfying. When I was reporting my eldercare piece for Vox, I talked to so many women who looked back on their time providing care for a parent with some amount of tenderness: it felt so important to spend those last years together. But that tenderness was darkened if not blotted out altogether with forced sacrifice, with very real caregiver burnout, with being forced into sophisticated levels of everyday medical care that they simply were not equipped to provide. They needed help, they needed rest, they needed options. Instead, they simply kept carrying the burden of care alone.

Coerced care works a bit differently, I think, when it comes to kids. There are certainly parents out there who resent caring for their kids in any capacity. But the vast majority of parents really just resent the lack of options: in infancy and in preschool, but also for after school care, for summer care, for emergency care, or even for the sort of care that allows parents the leeway to be away from their children for a weekend.

When you’re forced to move to a place you loathe, or a city that feels suffocating, or quit your job with the knowledge that it’ll be very difficult to rejoin the workforce, simply so that you can have care? That’s a form of coerced care. When you have to put your kids in situations that feel unsafe, or rely on a family member who shames your parenting style? Coerced care. When you rely on a daycare center that pays a poverty-level wage to its employees, many of whom are women of color? Yet another form of coerced care. And all of it, all of it, feels sour.

Most caregivers I know, past and present — they know the system is broken. Most of them didn’t really have any idea just how broken until they needed care, but they get it now. But I think there’s still a vague undercurrent of oh, we’ll figure it out: childcare sounds expensive, but we’ll find a way; my parents will some day need care, but we’ll cross that bridge when we come to it.

Maybe people don’t know many parents ahead of time; maybe they don’t realize just much money and family proximity have come to matter when it comes to managing care; maybe their primary understanding of what it takes is still rooted in what it took to raise them. And whew, I get it, there’s so much to try and know before you become a parent! And when it comes to eldercare, no one talks about it! Whatever the reason: a lot of people find themselves flailing in the deep end.

The experience is often so traumatic and exhausting that once they’re out of the thick of it, they don’t want anything to do with the ongoing struggle. There’s sympathy for others, but very little solidarity. I see people without kids telling parents that they “knew what they were getting into,” and deep resentment between parents with perceived “better” options, and general ignorance of the ways low wages affect those providing paid care work, and enduring silence about eldercare, like if we don’t speak it aloud no one’s parents will ever age or die. And so the care crisis keeps deepening — and will continue to do so, so long as we continue to treat a systemic problem as private responsibility.

So what’s the alternative? That’s the plea I heard from so many caregivers: we know this blows, but what choice do we have? It reminds me, in a sideways way, of historian Timothy Snyder’s articulation of the politics of inevitability: there’s a palpable feeling of resignation and a paucity of imagination when it comes to what care could look like.

But it doesn’t have to be this way. We can create infrastructures of care — on both a societal and community level. First and foremost, that means policy that acknowledges the crisis for what it is — not a problem, but a pressing crisis that effects every single person in this society, regardless of whether they are currently providing care for a child or adult — and works to create policy that provides caregivers with legitimate choices when it comes to care.

Sometimes we limit that thinking to “Pre-3 for All” (which is great, so long as a system’s in place so that it kneecaps centers that provide care for kids under three) or significantly expanding Area Agencies for Aging, which can simplify and facilitate the process of finding in-home care assistance, and expanding funding for afterschool and summer care, so that families don’t have to compete on the open market for a limited number of spots.

But it also looks like FMLA leave policies (some of which are already in place) that allow for care of those outside of immediate family, and decoupling healthcare from employment so that part-time employment is a more viable option for people who want to provide part-time care but don’t want to leave the workforce entirely, and strengthening labor protections so that home health care aids outside of a select handful of states can unionize and advocate for fair pay, and, also, GOOD GOD ALMIGHTY, further expanding our truly embarrassing national parental leave requirements.

Most essentially, it’s about treating child and elder care as infrastructure: absolutely essential to the health of society, and deserving of holistic reforms that treat it as such.

But an infrastructure of care is also about imagining — and enacting — more robust and informal communities of care. I’ve heard from a lot of struggling parents and eldercaregivers who wanted concrete examples of what this might look like — and in next week’s newsletter, I’ll share several specific stories.

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And if you’ve figured out an infrastructure of care in your own life — particularly when it comes to eldercare, but also childcare or just general care for one another — I’d love to hear about it. As always, you can email me at annehelenpetersen @ gmail dot com.

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