Gailrae's writing on caregiving  in general and her 24/7 care of her mother in particular was too important to be buried in the excellent larger interview. That interview is  here. Gailrae blogs at "Let Me Write That Down."

If you have been an elder caregiver, what care arrangements have you made?  Do you believe you had real choices or were your options constrained by harsh economic reality and US family policy?  How difficult was it/will it be to resume your career?

 I attempted to make care arrangements but they didn't work out from a cost and quality perspective.  Every single time I engaged professional caregiver arrangements, my mother was neglected and/or put in danger and/or treated inappropriately, even as I performed scrupulous research to guarantee quality care.  After a couple of years of trying to do this, I gave up.

 I took a huge risk in deciding to stop paid work and work solely as my mother's 24/7 caregiver.  At this point I looked into the possibility of being reimbursed by the state for caregiving.  We made too much money, even after I stopped paid employment.  We also considered having me be "employed" by my mother as her caregiver.  This arrangement would have bankrupted her within a couple of years.  However, because of our unique relationship and the experience I had with professional caregivers, it was unconscionable for me to abandon her to the pros. 

Although my care of her put me in the position of being sole inheritor to her estate, per my sisters' decision after my mother's death, this does not, unfortunately, make up for even a third of the societal benefits, including pay, I would have received if I had continued to work full-time in the agreed upon workplace for those twelve years.

In addition, I am having a hard time convincing potential employers that I did anything of value during those years.  I seem to be minorly favored for caregiving work, but, frankly, I'm not interested in "professional" caregiving for a variety of reasons, not the least of which are that professional caregivers are poorly paid regardless of experience, I have no desire to do for anyone, again, what I did for my mother and I'm not a natural caregiver, thus, caregiver professions are not careers I would ever have chosen if my mother hadn't needed caregiving or had died before coming to that point.  I'm only beginning to discover how badly my own options have been affected by dint of doing this for 12 years to the exclusion of working in the world for money and prestige, although I'm beginning to get intimations, which are extraordinarily discouraging.

 No, I did not have any real choices that made sense.  Every choice I was offered carried huge risk.  Thus, I chose the option I could live with, from the points of view of love and conscience, rather than choosing the option that would have guaranteed a somewhat better economic existence after my mother's death.  I am positive that this dilemma is created by the fact that caregiving, in our society, carries no value, primarily because it is work that has been and still is identified with women.  And, yes, that's sexist, disastrously sexist, and we are all deleteriously affected by this age-old sexist disaster.

Once the value of my mother's estate was determined, I decided to figure out how much per hour I was compensated for those years I worked exclusively as her companion and caregiver.  First, I figured only 8 hours per day, 7 days per week, which ignored, of course, two thirds of the hours I actually worked in this capacity.  The hourly wage came to 6.26/hour, no benefits, no raises (despite the fact that promotion is implicit in the nature of the work, as it requires more of one the further one goes and, as well, requires almost constant on the job training and retraining), no retirement, no workplace status.  Last, I decided to figure out my compensation based on a 24/7 week, which is what I actually worked (I was "on call" even when I was sleeping and my duty as needed companion and caregiver was particularly important at night, when anything could, and did, happen).  My wage came to 2.09/hour, no benefits, no raises, no retirement, no workplace status.  This wage did not take into consideration that prior to working as her companion and caregiver 24/7

I had already become, throughout the preceding three years during which I also worked in the world of outside employment, not only her companion but her personal business manager in addition to her household manager.  Within a year of becoming her 24/7 companion and caregiver, I was her full time, full service medical advocate, as well as handling, with what would be considered professional competence, a variety of jobs enumerated in this essay that I wrote in 2004.  In regard to real world compensation for caregivers, in 2006 I followed the above linked essay with an addendum which cited one resource's fee for caregiving, called "Concierge Service", which approximates the type of companionship and caregiving I extended to my mother.

Although I am not specific about caregiving being women's work in this particular essay, I am in several others on that website.  What I say about the economic dungeon of caregiving applies to parenting, as well, of course.  Why do we consider avocational caregiving deserving of no or very little economic status and vocational caregiving worthy of very little remuneration?

Caregiving is the most important aspect of society; it is, in fact, the basis of everything we do.  It is the reason society exists.  It is time that we begin to recognize that not only should it not be considered the primary province of one gender, it should ALWAYS confer advanced survival status upon each of us.  No one's survival should ever be at risk by virtue of what one does to survive, period.  And, yet, the survival status of those we choose to call "caregivers", who obviously do the most important work and are mostly women, is always at stake.  What's wrong with this picture?????

Was my choice respected?

Informally and verbally, yes, however that "respect" was based mostly on sentiment; you know, "Your sacrifice on your mother's behalf is amazing and should be rewarded."  I hate this attitude.  From my perspective, my intention wasn't to "sacrifice"...that was inevitable because of the society we live in.  And, of course, my "sacrifice" hasn't been well rewarded, either, by my society.  It is, in the main, considered little more than a long blip in my life that should be dismissed, now that my mother is dead.  In addition, most people have absolutely no ability to perceive, let alone express respect for, the tremendous benefits to my character from having done what I did.

Do you anticipate and plan for caregiving challenges?

 Even though both my parents are dead and my career as my mother's companion and caregiver are over, I cannot help but speak out on behalf of those who are looking forward to these challenges.  At this point your options, in this country, are limited to, excuse my French, shit.  All professional caregiving requires unstinting, constant oversight, which, in itself, is a time and energy drain, as well as being continually emotionally frustrating. 

Just recently, an article in the New York Times extolled the availability of superior care facilities.  It didn't mention that these facilities are few and far between and that it isn't uncommon that any particular state may likely have no facilities of such quality, except to say that one should not be niggardly in regard to choosing a location for superior elder care.  The article, tellingly, wasn't particular meticulous in stating exactly how the three facilities it specifically mentioned are superior.  The article did, however, emphasize, that the job of oversight doesn't end when one has found a superior facility for one's elderly family members.  It concluded with what sounds like (and is, I can assure you, from having overseen my mother's two short term stays in skilled nursing facilities) an exhaustive and expensive list of oversight tips. 

The article also gave very short shrift to what it acknowledged as the preferred type of care, "...long term nursing care...provided in the patient's home, the most economical solution and the stated preference of 9 in 10 older Americans."  Although this option was similarly and shortly extolled, there was a stunning lack of advice on how to accomplish quality, in-home care for the elderly.  For good reason:  It is impossible for most people, economically and socially, to allow for this without taking huge economic and life-altering risks.  Although those of us who decide to take those risks are not a small portion of the population, we are effectively ignored from economic and legal standpoints...men, women, entire families.  This is, folks, because it's "women's work" and, as such, not generally valued. 

Yes, there are a few more sparse resources available than there were 15 years ago when I began my journey with my mother.  They remain, though, expensive (not because the actual caregivers are well-paid, except for Professional Care Managers, whose regulation is spotty, but because the businesses who hire the caregivers are well paid), poorly regulated, haphazard in quality, not easily available and demanding constant oversight including becoming familiar with the always revolving members of the always over-worked floor staffs, most of whom were women, by the way.  In addition, it is very tricky to negotiate oversight.  Believe me, keeping an eye on the care of your elderly charge, mentioning deficiencies and taking steps to correct them, including administering needed care yourself (which I often did), even if done in the most diplomatic manner, will not endear you to the staff of the facility.  If you are a woman you will be considered some form of harridan.  If you are a man you will be tagged as someone who knows absolutely nothing about what he is talking about.  Sexism at work, folks.