Who cares? When picturing a caregiver, the person who comes to mind is almost invariably female. She is young (or young-ish). She looks healthy. She is usually in a uniform, the kind associated with nursing, to show that she is what she does. And she is never pictured alone, because what she does – caring – is defined by the relationship she has with the other people. In advertisements, textbooks and news reports, this ‘carer’ is pictured standing alongside a ‘cared-for’ person, who is usually seated and smiling up at their caregiver with gratitude. The carer smiles down upon them, reassuringly. Theirs is an asymmetrical relationship: the cared-for is vulnerable and has needs, while the carer is capable and needless.
I have felt burdened by the asymmetry of care. When I’ve become a caregiver in the past, on cancer wards in London and Cambridge, my vulnerability didn’t magically fly away. Yet the figure of the needless carer followed me. And it continues to dominate the ways we view those who care. But as we look longer at this figure, questions emerge: what might this carer need? What of her vulnerability?
In the influential book Caring: A Relational Approach to Ethics and Moral Education (2nd ed, 2013), the American philosopher Nel Noddings emphasises asymmetry through her definition of the two parties in a caring relationship: the ‘one-caring’ and the ‘cared-for’. The one-caring is characterised by their ‘engrossment’ in the interests of the cared-for and by ‘motivational displacement’, which arises when the carer puts aside or defers the pursuit of their own interests. Perhaps the most familiar example of this kind of relationship is a parent and their small child: if both parties are hungry, the child is fed first (or only the child gets fed). Parents forego a lot for small children, especially sleep.
For Noddings, the figure of carer is always engrossed. She is defined by the cared-for, by the uniform she wears, by the way she smiles at the vulnerable people she attends to. She is poised, ready to be needed; she is herself without vulnerability, and empty of need.
Now try thinking of another figure: the ‘vulnerable carer’. You may find it hard to imagine what on earth that could mean. I tried searching online for images using that term, but all I could find were photographs of the familiar asymmetrical relationship: a vulnerable person – the cared-for – pictured with their counterpart. The cared-for is clearly the one who possesses the vulnerability; the carers, again, are needless. The main difference is that the ‘vulnerable’ carers are less likely to be in uniform. They are the family members of vulnerable people – carers, not care workers. They haven’t chosen caring. It has happened to them. And there are untold millions of these accidental carers worldwide. An analysis of the UK’s 2011 Census by the Office for National Statistics showed that there were around 5.8 million (or one in 10) people in England and Wales providing unpaid care for a friend or family member.
A US survey in 2015 found that approximately 43.5 million (one in around seven) people had been unpaid caregivers to an adult or child in the previous 12 months. I would assume that, since the onset of COVID-19, this number can only have increased.
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