Labors of Love: Nursing Homes and the Structures of Care Work

by Jason Rodriquez

Every day for the next twenty years, more than 10,000 people in the United States will turn 65. With life expectancies increasing as well, many of these Americans will eventually require round-the-clock attention—and we have only begun to prepare for the challenge of caring for them. In Labors of Love, Jason Rodriquez examines the world of the fast-growing elder care industry, providing a nuanced and balanced portrait of the day-to-day lives of the people and organizations that devote their time to supporting America’s aging population.

Through extensive ethnographic research, interviews with staff and management, and analysis of internal documents, Rodriquez explores the inner workings of two different nursing homes—one for-profit and one non-profit—to understand the connections among the administrative regulations, the professional requirements, and the type of care provided in both types of facilities. He reveals a variety of challenges that nursing home care workers face day to battles over the budget; the administrative hurdles of Medicaid and Medicare; the employees’ struggle to balance financial stability and compassionate care for residents. Yet, Rodriquez argues, nursing home workers give meaning and dignity to their work by building emotional attachments to residents and their care. An unprecedented study, Labors of Love brings new insight into the underlying structures of a crucial and expanding sector of the American health care system.

256 pages, Hardcover

First published October 24, 2014

Reviews

[Edwin Goh Wei Qian · Rating 4 out of 5]

A comparison of non-profit and for-profit nursing homes shows how bureaucratic, systemic, institutional, and reimbursement barriers affect care. These issues force care providers to prioritise volume over quality. The book concludes by calling for a long-term care insurance and more to address these them.

[Laura · Rating 4 out of 5]

Really looking forward to teaching this this fall. Does a good job showing how nursing home care is shaped by irrational regulatory and reimbursement frameworks that dehumanize the residents and devalue the workers. I wish the author had included more from the perspective of nursing home residents (either in his own interviews or even just as context/lit review), although I recognize that doing so would have made the book a lot longer. He does, however, give a lot of really helpful history explaining how the regulatory and reimbursement frameworks that are currently in place came into being--it's a real case study in perverse incentives.