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UBC Theses and Dissertations

Bare care : working within/reworking restructured long-term care Molinari, Nicole


In the past nearly two decades in British Columbia (B.C.), Canada, the provincial government has restructured its responsibility for elder care, ceded to the private and financial sector an ever more prominent role, and opened up investment potentials for global capital. With this as context, I investigate the political economic developments and priorities, as well as everyday and uneven geographies of long-term care sector restructuring. Through comparative ethnographic case studies in a for-profit and a non-profit care facility in Vancouver, B.C., I explore how restructuring shapes the everyday conditions, practices, and relations of work and care. Drawing on workers’ experiences and perspectives, I generate a nuanced and intimate account of care work reorganization and labour process change. Understanding labour as embodied, I look at how workers’ bodies and subjectivities are enrolled into and affected by restructuring. I find that restructured care work entails dehumanization and is premised on the expendability of workers’ bodies, and emotional and mental energies. But it also contradictorily requires, cultivates, and draws on workers’ emotional labour to ensure quality care under deteriorating conditions. I look at how the embodied impacts of restructuring, including work intensification, injuries, and burnout, erode workers’ quality of life, future security, and even their family relations. I also explore the potentials and limitations of institutional and worker strategies that are employed to manage, buffer, or exploit restructured care settings. Disrupting dominant conceptions of restructuring as rigid and uniform, these case studies show that restructuring processes and outcomes are not only flexible and particular, but are mediated by a constellation of actors, motivations, relationships, and practices. They also reveal that very different levels of care and quality of work, as well as distinct forms of privatization, emerge from the same restructured residential care system. Overwhelmingly, state and capital’s neglect of the basic requirements for quality care and work results in deficits that are borne by frontline caregivers as well as those who must survive within this regime of care. At the same time, the work these caregivers do to fill the gaps in care ultimately aligns with and enables state and capital interests.

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