Thursday, June 8, 2023

"Caregiving is Women's Work"

I am a caregiver.   

I sort and organize medications.  I prepare food.  I go shopping, and purchase and deliver medical supplies. I take vitals...BP and Pulse Ox and weight to report to Dad's doctors.  I'm the primary contact for his caregiving team, the home aides and visiting nurses.  I take two of the fourteen home aide shifts weekly myself, because there's nothing more important for a caregiver than direct observation.  I handle filing insurance claims.  I need to see and hear how he's doing, first hand.  I get Dad out of bed, dressed, and ready.  I help him get to bed at night.  I can see how he's breathing, watch how he stands.  I'm there.  I check in almost every day that I am not physically with them.

This puts me in an unusual position, one that doesn't mesh with a particular set of cultural expectations.  

Every other human being I'm working with on his regular care team is a woman.  Every single one.

This we expect.  It is commensurate with the Way Things Are.  Also in line with expectations, not a single one of his other caregivers is of European heritage.  They are Filipina and Afrocaribbean on the home aide front line, eight hours a day, six days a week.  They dress him and clean him and prepare low sodium meals, as I do.  The cleaning crew for the house are a pair of efficient Latinas.  The visiting nurse who changes and dresses his wounds is Middle Eastern.  His complex care doctor is of Chinese heritage.

Caregiving is women's work.  For the white urban upper class, it's also work for immigrants or people of color.  It's an ingrained assumption, so deeply enculturated into us that though we notice it, there's little impetus to challenge it.

And I am a white man in his middle fifties, college educated, with two graduate degrees in my field, ignoring the herd-expectations of my "identity."  

As a middle aged white man with a still surprisingly full head of hair, were I to track with the career expectations of both our culture and Professional Christianity (tm), I should currently be the Senior Pastor of a large multistaff congregation.  I'd be working seventy hours a week, constantly on call to manage and lead and be the Face of the Church.  I'd be a name, a known quantity.  I'd have a network of connections among colleagues.   While I would still speak well of caregiving, I would pay women to do it.

Because caring for parents of advanced age and full-time careers do not mix.  Expecting them to do so is pure folly, the sort of foolishness that exhausts and depletes us.  You cannot do it all.  You must make a choice.

The choice I have made is to make space for caregiving.  It's a logical choice, a necessary choice.  I view this choice in terms of strength, duty, and honor.

I am still able and mentally competent, more or less.  This is vital, because caregiving requires strength.  Some of that is simply physical.  I have to be able to lift and move wheelchairs, to offer up a strong arm to my father.  When he gets into bed, he needs to be shifted into position, which requires both dexterity and physical strength.  I'm not as good at it as his more regular evening care provider, a sturdy Jamaican woman of remarkable capacity.  But I still get it done.  Being moderately handy, I can fix things, like installing grab handles in bathrooms.  I am useful.

Other forms of strength are required.  I am not squeamish.  I was with Dad recently when he had a sudden reaction to a new medication, and experiencing explosive, uncontrollable diarrhea.  I worked alongside his home aide to clean him up.  I cleaned his legs, and changed the excrement-soaked bandages that covered his pressure wounds, then made sure those wounds were clean.  I scrubbed the floor while she laundered his soiled clothes.  Was it something I'd choose to repeat?  No.  But neither was I phased by it.

When there have been other emergencies, I have coped with them, and that requires reserves of will and intention.  Caregiving requires deep emotional resilience, as you encounter moments of trauma as the one who must remain strong.  Sure, you feel it.  How can you not?  There've been moments where I have thought, if I were the anxious, sensitive boy I once was, I would be terrified and weeping right now.  I am still sensitive and prone to anxiety.  But as a caregiver you do not have the luxury of indulging your fears, of freezing or coming apart as you watch a loved one struggle for breath or cry out in pain.  It demands a firm stoicism, a calm focus on what must be done right now.  That, leavened with gallows humor.

I have a duty to ensure that my parents are cared for as they age.  A sense of duty is countercultural these days, a little fusty, a little "square."  Duty oppresses you, culture whispers.  Duty prevents you from being your best selves, from being creative.  But I do not see it that way.  Duty is a defining commitment, an integrating center that presses back against self-interest and personal gain.  Duty is moral obligation, the sense of responsibility that rises from a fundamental assumption about what is good.  

From my Christian moral framework, I understand that it is a fundamental good to provide care, and not simply care conceptualized as tending to the physical processes of those in need.   Caregiving rises from caring, and I care for my parents.  It's grounded in love, and my love for family is not external to my identity.  It's a defining feature.  It is a part of me that makes me who I am.  That "best self," understood through my faith.

As I have been called to small church pastoring, a vocation that does not...and should not...sparkle with lucre, I act on that love-grounded duty by offering my time, my thoughtfulness and the work of my hands.  I am willing to set other things aside if need be, because they are less important.  Wealth.  Influence.  Career attainment.  None of these other things are central to the integrity of my person, or my sense of my best self.

Honor is also a vital part of caregiving.  When we act rightly, when we orient our words and deeds so they align with our moral assertions, we act honorably.  There is nothing dishonorable about caregiving work.  We are, as a culture, really fond of praising those who perform those roles in our society.  It's good work, necessary work, labor that has clear and unquestionable worth.  It must be done, and done well.

If it is honorable work, why don't we want to do it?  

It is humble work, labor that does not confer the prestige of wealth or power.  It does not require four years of college education, and a masters, and a doctorate.  It isn't the sort of thing you slap up on Tik Tok. "Hey guys, scrubbing feces from the bathroom floor! #lol #mybestlife"   It's physical labor, it's often difficult, sometimes tragic.

And why, particularly for those who share my XY chromosomal makeup, are men so underrepresented among caregivers?   Sure, it's not a cultural expectation.  It is hard work, work that does not mesh with how our society defines success.  It is service, and there are some who conceptualize servant labor as weak.  "Servile."  "Submissive."  "Unmanly."

Like, say, in the ancient Near East, when you would enter a house.  Your sandals would be removed, and a servant would wash your dust covered feet.  It was a necessary action, but not something you did if you were powerful, or successful, or a social influencer.  And in Judea, once upon a time, there were a group of men who had gathered around a man they believed to be their anointed king.  They thought he was going to lead a revolution.  They understood him in terms of power and victory, the sort of man who riles crowds and stills storms.

And there he was, kneeling before them, cloth and basin in his hands.   Laying down his life for the people he cared for.  Giving care.