"We are not a machine”: Personal support workers' (ante)narratives of labour, leisure, and hope amidst politics of genderacialised care in long-term care homes

Disorganized pages of highlighted transcripts and printed out images of PSWs completing the body mapping activity.
Organized pages of highlighted transcripts and printed out images of PSWs completing the body mapping activity.

Abstract

Systemic processes rooted in and reinforcing neoliberalism and capitalist production work to racialise, gender, and class bodies engaged in caring. Engaging in caring through labouring bodies, racialised women working in long-term care (LTC) homes as personal support workers (PSWs) are over represented in labours of care when compared to other sectors of the workforce. In this critical narrative inquiry, individuals through their labouring bodies tell corporeal stories of invisibility and marginalisation, as a result of intricate, complex, intersectional oppressions of racialising, gendering, and classing in settings of care. To best learn through stories told by women’s bodies engaged in caring, intersecting lenses of critical race and feminist inquiry frame how we might hear and see marginalising processes and oppressive practices that shape caring. Unpacking the caring literature revealed several politics occurring in Canada, which reinforce socio-political and economic structures that work to structure who is engaged and how caring happens. I identify eight processes related to caring work that shape the politics of genderacialised care. New language of genderacialisation was needed to inform understandings of the intricate systemic processes that weave together gendering, classing, and racialising in narratives about caring work. Genderacialisation in a care context manifests as systematic deficiencies and points of tension negotiated by individuals who work in stratified care environments. Genderacialisation also acknowledges processes working to render individuals powerless through the imposition of singular categories of race, gender, and class. How genderacialisation is embodied describes, then, experiences of genderace - the various ways gender, race, and class are attributed to, lived, and storied by individuals.  

The purpose of this study was to reveal genderacialisation and to: (1) understand how it works to structure narratives of PSW care in Canada and (2) create hopeful change-spaces with PSWs. More specifically this activist, critical narrative research has objectives to: (1) deepen knowings of genderacialisation and story how genderacialisation occurs for PSWs working in LTC homes (to inform impacts of racialising, gendering, and classing in care work); (2) story genderace as it is navigated by PSWs in settings of caring (to inform manifestations of genderacialisation); (3) map racialised women’s stories of current practices in care, leisure, and labours of care as PSWs working in a LTC home (to inform how care work is structured); (4) reveal how ideals of self-care, leisure, and care work are storied by PSWs working in LTC homes (to inform alternative realities of care labour inclusive of what the labouring body seeks); and (5) discuss implications of stories with PSWs and act to change structuring of care work (to inform sustainable labours of PSW care in LTC homes, self-care, and leisure).  

This critical narrative inquiry takes a closer look at antenarrative (cf. Boje, 2007, 2011), grand narratives, and counter narratives appearing in women’s stories about the labours of caring. To see possibilities beyond systemic politics and depart from oppressive structures, women looked to the body. First, body mapping was used as a method to hear stories of five PSWs who self-identified as racialised women. In response to guiding questions we mapped stories onto two paper “shadows” of the body. The first body maps told stories of current practices of the labouring body while caring and the second body map told stories of how one cares for the labouring body followed by reflective discussion of each map and then, the juxtaposition of both body maps. In a second meeting, women created storyboards for the creation of a digital story by selecting segments from their transcribed texts and photos of their body maps. Five digital stories were then created, one by each woman, from the storyboards women assembled. In the third and final workshop, women who participated in the study viewed the digital stories and engaged in reflective discussion. 

In the final step, I illuminated an antenarrative of caring by hearing into how women of colour were (un)able to wield agency in caring roles within larger socio-economic and political structures. Specifically, by pulling together the politics of genderacialised care, body maps by racialised women engaged in labours of PSW care, and reflective discussions that followed re-listening to stories of care, I saw how the narrative of labour gave way to an antenarrative (a pre-emergent body story) of worth. Worth was revealed as the antenarrative of the labouring body seeking worth: worth within the system, reclaiming self-worth, and self-worth as interdependent and unamenable. Snapshots of hope (for change in caring practices) were also held in the labouring body. Hope facilitated the antenarrative of worth within caring systems (and society more broadly) to come through women’s body maps of labour.  

Findings from this inquiry propagate a need for further research in the areas of the labouring body, caring, and worth and hope. Of particular interest to leisure scholars is the positioning of leisure within this conversation. Theoretically, this research contributes understandings of genderacialisation and genderace in different areas of caring labour with possibilities of application to other sectors where marginalisation creates disparities in access to care for self, worth, and hope. Methodologically, pairing narrative inquiry with the method of body mapping and a focus on antenarrative presents a new and exciting way of knowing individuals’ stories through their bodies and the potential for hope. Specifically, findings of this work with the politics of genderacialised care are important for further supporting PSWs in their ongoing negotiations for fairness in pay, time for reprieve and reflection, and access to resources (like leisure) to care for their labouring bodies. I plan for future work to include: the creation of resources to assist individuals in understanding and supporting PSW roles in caring; making available online the digital stories that women in this study agreed to share broadly for community engagement and labour practice change, integrating being with through caring into care policy towards sustainable, rejuvenating, and relational care practice; and deepening understandings of worth and hope as antecedents to meaningful labour and socially justice in caring, leisure, and labour practices. 


Keywords

critical narrative inquiry, personal support workers, labours of caring, genderace, intersectionality, racialised women, body mapping, digital storytelling, antenarrative, long-term care, genderacialisation, politics of genderacialised care 

Presentations

Genderacialised, Labouring Bodies in Long-Term Care Homes in A Time of “Woke” with Dr. Kim Lopez

The Gilbrea Centre

The “Burned out” “Backbone of health care”. The “Thankless” “Hero”. The “Discriminated” and “Disrespected” “essential” worker. Just some of the words used by personal support workers (PSWs) labouring in long-term care homes and living through public awakenings to COVID-19 and systemic racism; two, mutually serving, public health pandemics. In a precarious line of work that sees an overrepresentation of Black, Indigenous, and other Persons of Colour, these awakenings have only amplified the amount of emotional labour needing to be done by PSWs and other care workers in an already fractured system. PSWs and other health care professionals are celebrated with words like “hero” [sic] amid staffing shortages, lockdowns, vaccine refusals/protests, outbreaks, and profound illness, death, and loss casting doubt on personal worth, effectiveness, and promises for change. Further, for individuals who live with racism, a widespread awakening to racial injustice in addition to performances of allyship become difficult to process and support over time when little change is made. There is little doubt that these storms have brought rage, tension, struggle, and exhaustion to many. This presentation will discuss the danger of attending to (anti-)racism (among other -isms/-phobias) in a time of “woke” (a co-opted Black watchword, *used critically here) for care labourers of colour in a system compromised by COVID-19.

Watch the recorded presentation (VIDEO).

For more information on this presentation, please contact us.

Genderacialised labour and remediating embodiments of systemic harm: the need for care in labour for restoration and well-being

Leisure Studies Association Conference 2024 (Scotland, United Kingdom)
Jaylyn Leighton, PhD, Giana Tomas, PhD(c), Kimberly J. Lopez, PhD, Ashley K. Flanagan, PhD, Dr. Sherry Dupuis, PhD, and Michelle Fleming

Personal support workers (PSWs) make up 58% of the long-term care workforce and account for 70–80% of paid care work. Despite the critical role PSWs play in Canadian health care system, unregulated professions (like PSWs) are often excluded in research on experiences of care-giving that inform care labour policies. Systemic shortcomings of LTCHs (care staff shortages, poor wages, over-work, burnout, high stress environment, etc.) leave genderacialised – racialised, gendered, and classed - care workers vulnerable to race and gender-based harms (RGBHs). RGBHs in LTCHs perpetuate care work as labour that (re)produces genderacialised bodies that labour solely for capitalist production; further burdening PSWs, compromising ability to rest, recover, and temporarily relieve oneself from the physical, mental, and emotional load of care work. Care in labour that prioritizes holistic well-being can (re)produce possibilities of care for self and community outside of work through restoration and leisure. The ‘Free from Harm’(FFH) Projectaims to lay the groundwork for reporting RGBH harm in LTCHs.Informed by critical feminist concepts and theories -- reproductive labour and social reproduction theory) -- this presentation will highlight RGBHs experienced by genderacialised folx labouring in LTCHs. This paper will share the experiences of genderacialised LTCH workers as they describe embodiments of safety and un-safety in the workplace. Shared conceptualizations of systemic support can be used to inform harm-reducing policy reform across intersections of race, gender, and care labour equity in spaces where genderacialsed folx labour, play (leisure), and live. This work can aid in restoring trust in a fractured care system and promote leisure as a rights-enhancing environment. 

Selected references available upon request.

Is care work, fair work? politics of genderacialisation in long-term care homes

West Coast Conference on Aging: Equity influencers: Transforming Healthcare for Aging Populations (May 31 – June 1, 2024)
Rachel Almaw, BSc, Kimberly Lopez, PhD, Jaylyn Leighton, PhD, Giana Tomas, PhD(c), Ashley Flanagan, PhD, Sherry Dupuis, PhD and Michelle Fleming
 

Care workers such as personal support workers (PSWs) provide essential care labours to support Canada’s aging population across the long-term care (LTC) sector. Systemic processes rooted in and reinforcing neoliberal, capitalistic production work to racialise, gender, and class bodies who engage in care work. Many care roles are taken up by women of colour who are overrepresented in labours of care (pink labour) when compared to other sectors of the workforce. Labouring bodies are not only forced to over-work in systems that undervalue their care labours, but they also face inequitable and inhumane racial, gender, and class disparities that limit their potentials and impacts their care (care-for-others and care-of-self). Inadequate responses to workplace stress and safety across LTC homes creates further disparities for labouring bodies as they navigate inequitable pay, poor working conditions, and harms incurred while at work. Systemically, Canada's health and social care systems fail to acknowledge institutional stratification's entrenchment of structural racism, highlighting an oversight in addressing racialized differences for care workers. Using a critical race and feminist lens, [AUTHOR 2’s] doctoral work explored the marginalized and oppressive processes that continue to shape caring practices (both care-of-others and care-of-self) through experiences of racialisation, gender, and class. Examining care literature in a revealed politics of genderacialisation – that is, the intertwining gendering, classing, and racializing of labouring bodies [9] – work to identify systemic deficiencies (who is engaged in care and how does pg. 2 care happen) and points of tension navigated by labouring bodies working in a stratified care environment like LTC. In this presentation we will speak to eight processes related to caring work that shape the politics of genderacialised care that were identified in this work, including: (1) lack of clear, accessible information leading to PSW readiness; (2) visible over-representation and labours of care; (3) racialising and gendering reproductive labours; (4) stigmatization of LTC homes and PSW care; (5) labour force invisibility and precarious working conditions and stressors; (6) crises of care in Canada that maintains systemic inequity through transnationalization of care work; (7) invisibility of stress and burnout in caring work; and (8) the politics of leisure in welfare and self-care. The politics of genderacialisation help recognize how labouring bodies are differently racialised, gendered, and classed and commonly experience race- and gender-based harms while performing care work. This work has the potential to remediate harms of race- and gender-based care labour precarities and injustices across the LTC sector by offering recommendations for establishing useful reporting systems and transformative justice-informed care for affected labouring bodies. This work advocates for needed systemic changes that acknowledge and appreciate the critical role care workers (in this case, PSWs) play in promoting wellness for all by upholding the health and dignity of aging individuals to move towards more equitable and compassionate approaches to care across Canadian health and social care systems. 

Selected references available upon request.

Posters

Intersectional Front-line Care Labour Precarities in Canadian LTC Homes

Kimberly J. Lopez and Ashley K. Flanagan   
Regina, SK – Canadian Association on Gerontology

The era of COVID-19 has amplified a great need to attend to critical gaps in Long-Term Care Home (LTCH) structuring and resourcing. In particular, resident care and life quality is perpetually truncated as staff tend to higher care loads to accommodate ill/burned-out staff. While medical research is largely focused on the prevention and treatment of COVID-19, less research is being done to address psychological and social well-being of affected LTCH care staff members. Front-line care staff, like personal support workers (PSWs), often incur additional stresses (i.e., moral job injury, lack of communication, poor work/life balance, and lack of financial security) in their work with older adults and disabled persons living in LTCHs. Further, legacies of gender and race politics and labour allocation have shaped the nature of PSW and other “minority”-dominated care labour, facilitating a disproportionate number of persons of colour and women/non-binary-identified persons living perpetually under-waged, precariously employed, susceptible to chronic stress and violence. 

A literature and popular media synthesis focused on contemporary expressions of legacies of reproductive labour reveal and contextualise vulnerabilities to race and gender-based care labour precarities/harm from LTCH administration and colleagues, family members, and residents in LTC homes. Towards the reformation of LTC practices through social justice – for all who live, work, and visit LTC homes – the goal of this paper is to identify the ways LTCH care workers are vulnerable/subject to hate, discrimination, and violence in their places of employment due to race or gender identity or expression.

For more information on this presentation, please contact us.