Caring here, caring there: Boston-based black Immigrant caregivers as agents of the globalization of eldercare
O'Leary, Megan Elizabeth
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This dissertation explores the transnational care perspectives and practices of black immigrants working on the frontlines of eldercare in Greater Boston. Responding to the critical shortage of caregivers for the burgeoning aging population, first-generation immigrants from African and Caribbean countries find work in this field, performing physically and emotionally grueling work as Home Health Aides and Certified Nursing Assistants for low pay and few benefits. At the same time that these caregivers provide the most intimate care for older Americans and adults with disabilities, they often take on caring responsibilities for their aging relatives abroad. Evidence from fifty in-depth interviews with African and Caribbean caregivers reveals that these immigrants are changing the climate of eldercare in the U.S. as well as in their countries of origin by providing eldercare-specific economic and social remittances to their families abroad and fictive kinship through creative emotion work for their clients in the United States. These practices are informed by their transnational social location and work experiences which expose these caregivers to different state systems and care cultures. A dual evaluation of the perceived strengths and weaknesses of national eldercare systems produces for them a general definition of compassionate eldercare as the delivery of life saving medical care and skillful emotion work that ensure elders feel dignity in body and mind. Along with perceived cultural differences, these caregivers identify income inequality and weak welfare regimes as producing atmospheres of resource deficit and emotional deficit in the countries of origin and country of settlement, respectively. These perceptions provoke these caregivers to attend to the observed deficit and provide well-balanced compassionate care for their dependents, whether family member or client. These immigrant caregivers derive a sense of agency and pride from "filling the voids" in care for their clients and family members, arming them with a positive transnational caring identity strategy that helps guard against racism and marginalization they often experience on the job. Taken together, these findings reveal new ways of thinking about eldercare best practices and illustrate how actors at the micro level can inform institutional change at the global level.