Caregiving

Taking care of someone else is the difference between a society of sole operators out for their own benefit, and a community that nurtures each other. All societies that have survived have worked to provide nurturing. 

Many paid careers involve this gentle care of others, from the pilot who flies people safely to the doctor who tends their health, from the police officer who protects them, the school teacher who empowers them with skills, to the plumber who keeps their homes and offices functionning well.  There is a care aspect to most paid jobs.

However even more basic than that are the nurturing roles in the home- the ones who tend the young, sick, handicapped, frail elderly and dying, who are not paid but whose work society depends on.  They are the first tier of education, the first tier of health care, the first tier of care of seniors, the first tier of life. They are the ones who make sure the home runs smoothly so those with paid careers can rest assured all is well with the loved ones, as they do their paid work.

The unpaid sector is the volunteers who drive the patients to medical treatments, coach the sports teams, flood the community skating rink, bake for the funerals, visit the lonely, read to the blind.  They too have not been recognized in official economics tally and have as a result been ignored for their contribution to a healthy community.  Pressure to get all adults to do paid work threatens the unpaid care and volunteer sector, reducing its ability to provide this nurturing, creating cracks in the pillars it has provided, unthanked, to keep the economy afloat.

 
Each of us has been a receiver of care in our infancy and childhood, and during illness. Each of us also is called from time to time to be a caregiver.  Sometimes this role is taken on by choice, and at other times, it is from a crisis situation about which we had no choice. It can be as some have said ‘the job for which you did not apply’, and yet it is done out of deep love for those who need help. It anchors society.

It ensures that physical needs are met – food, clothing, shelter, exercise, health care.  It also ensures that the practical needs are met – to teach the young to crawl and walk and talk, to read and understand math, to learn to handle money, study a skill, navigate the community, drive a car. It ensures that the emotional needs are addressed – to listen for concerns, to notice interests, to stimulate the mind with toys and games, crafts, hobbies, sports so that the person feels loved and valued, and develops self confidence, courage and resilience.  It ensures the social needs are met so the person learns how to take turns, share, be kind, be dependable, honest, and a friend.

It takes time and patience to provide care.  It is not on a shift that ends at five for its demands may surface at any time of the day or night. It has been said that we are all one phone call away from being called to be a caregiver.  And yet this type of service has also been compared to the firefighter role, to be on call, when needed, for those we love.

It has historically been a woman’s role more than a man’s.  Women tended the hearth while men were hunter-gatherers for the group. This interdependency however was less clear when economies used money to pay for products and services, and when the role men did was the only one that was deemed worthy of money. This imbalance extended ultimately to the definition of work itself, to only count roles men did as real work, to only count roles of men as labor force activity, and to only count paid roles outside the home as economic activity. This tilt towards ignoring the care role reached its peak when gross domestic product ignored care roles in the home and when governments, blind to such roles as factors, started to discourage the care role itself. Governments started to create tax policies to urge women out of the  home, as if for their own good, to liberate them. And so many nations created an individual based tax not a  household based tax that identified when income is shared.  Governments forced designation of the caregiver at home as a dependent, akin to a minor and, reduced spousal deduction amounts, tiered tax rates to nudge women out of the home by providing pensions only to those who had paid work. Since economic tally was blind to income loss, the ‘cost’ of care of children was only counted if a third party was paid, and households where a person wanted to be home with the child were considered to have no ‘cost’ of childcare and ironically to be lacking in childcare, as if potential customers unable to access paid care.

Since economies did not count care roles, it was easy for them to see any who did them as nonfunctioning, inactive, unemployed in the economy and have therefore created tax policies to actively pressure women and men both out of the  home and its perceived laziness. Women’s rights movements of the 1920s that sought the vote for women, and presence in government empowered women to not just be taken for granted. Women’s rights movements of the 1960s to enable them to pursue higher education, use their skills in paid careers, enabled them to also move into the paid economy and eventually with pay equity, but still did not value the care role back at home, for either gender.  The devaluing of the traditional care role became so intense that women who were at home with children were deemed to not work and were just ‘staying home’ terminology that suggested malfunction and laziness. The idea that women were liberated only if they left the home to do paid jobs, further insulted the value of the role and of women. But it also had consequences in two other ways- the ones who needed care, and on the economy.

To further nudge women out of the home, benefits for the care role were also tied to paid work. Many nations provided maternity and parental benefits based on the paid work of the parent, and expenses paid to a third party, sitter, nanny, school lunch program or nanny were also only deductible if the parent had paid work.  This tilt to only see care roles if they were tied to paid work created ironies such as government being willing to help with care of an aging senior or frail family member only if a third party was hired – any care by a family member was invisible to the state for its costs.

Caregiving has also been a legal obligation. To protect the vulnerable child, it became a legal requirement to provide supervision and safety and to ensure provision of the necessities of life.  In some countries care of elderly relatives was also a legal obligation of the family.  However  economies that required care but also discouraged it, faced a problem.  The quick answer was for the state to provide the required care of the young, with large daycare programs paid for by the state. This group care over the years moved from being just for emergencies when family members were not available, to large operations, often private and commerically driven with governments subsidizing costs and salaries there so that parents could do the economically valued activity of paid work not caregiving.

This tilt to have government provide the care, turned out to be very costly.  Taxes went up in Sweden to cover the new costs of having to pay for what economies use to get done for free – care of the young.  In some countries the pressure to use the daycare system grew more intense with bans on home schooling and with offerings of long term childcare, overnight and several days in a week care to enable parents to do their paid work intensely.  This shift away from parental and family based care had several consequences.

Some tragic flaws of the economic blindness surfaced. In the 1990s the UN itself noted that unpaid caregiving work had been left out of official tallies, creating a huge gap in accuracy of economic predictions and all member UN nations vowed to notice such roles officially.  However few knew now how to enter unpaid work into the tally for the savings it produced when those who needed care did not require costly tallied work be done.. In the last few decades economists have noted that GDP tallies that ignore care roles are seriously flawed. When they count any job creation as good, and any flow of money as good, they actually see economic value in forest fires and crime waves for the jobs needed to handle them. 

The effect of ignoring the care sector in the home was successful to urge women and men out of the home, often due to financial pressure and despite polls indicating that people wanted more options.  Over time birth rates dropped around the world, moving way below the 2.2 needed for economic sustainability.  It turned out that women were not anxious to have children as much if time with them was not valued.  Unavailability of the ‘family firefighter’ to come out and help in crisis created a new crisis of loneliness among seniors and of wayward behavior among teens. Drug use, teen pregnancy, teen alcoholism rates increased as did forays into juvenile deliquency, teen bullying, predatoary behavior towards vulnerable teens, and gang membership. Young adults facing huge education and housing costs in an economy focused only on earning, found that their student debt delayed many of their lifestyle options for years and many were living at home in their twenties or unable to begin adult launching experiences such as buying their own home or marrying and starting a family.  Birth rate went even lower.

The loneliness of seniors became so severe that the UK set up a Ministry of Loneliness to try to address it. Mothers and parents’ groups around the world started to lobby governments to value the care role back in the home and to stop penalizing it.
Some governments recently have taken small moves to address these concerns with birth benefits, benefits for large families, and some nations have returned to a household based tax to ensure that being home with someone who needs care might be affordable again.

However most nations have not made such moves. The official push to only count paid work continues and the push to large group housing of seniors, the handicapped and the young who need care.  The one size fits all approach for care in large group settings ignored options for dads at home, moms at home, nannies, grandparent care, care by sitters.  The tilt to only have large group care funded by all taxpayers created an irony that a liberation for women was forcing them into roles and lifestyles they may not prefer.  Polls showed wishes of women for part time not full time paid work, for flex time, for banked time, for work from home options, though all of those were also discouraged by governments that only saw and valued full time paid work outside the home.

The 2020 pandemic has however raised global attention to the risks of such overcrowded facilities as seniors in care homes became key victims of the covid 19 virus. Large group care anywhere, – in universities, hospitals even prisons clearly was a high risk for infection as were crowded industrial operations.

The value of the mundane at home care role again surfaced, as many households returned to the home out of necessity, due to social distancing, isolation and curfews dealing with the pandemic. There they discovered new options for paid work- online meetings, webinars, telecommuting and businesses discovered the lower office costs of permitting such ways to do paid work.  Adults back in the home rediscovered the demands young children have for time and attention and the care role again was noticed as an anchor to society.

However governments facing huge bills to recover the economic costs of assistance programs to the newly unemployed, and trying to ‘restart’ the economy, risked falling again into the blindness towards the part of the economy that had never stopped- the care sector.

A move to push people again out of the care role, to get more men and women’ back to work’ is a common theme of government leaders in the post-pandemic plans. And yet such a move would return society to the problems of ignoring caregiving.

New tallies of what does matter in an economy not GDP tallies but broader ones counting caregiving, volunteer work and nurturing the environment unpaid are now being proposed to replace GDP and to get governments to notice what they were taking for granted all along.

So this is a time of opportunity.  We have had problems. We have tried to address them and taken some detours away from what will ultimately be best for everyone. But we can learn from our history and not make the same mistakes again.

Caregiving is one third to one half of an economy, if it is counted.  If we do not count it, we make plans blind.  If we actively discourage it we create huge risk down the road for exploding costs to government, low birth rates and spiralling economic crises handling the mental health, opiod crises and other acts of desperation of those who suffer for lack of attentive care by someone they love.

We can do this differently. We have to.