ABSTRACT
As a result of privatization strategies in the long-term care sector, paid staff and unpaid family carers are facing contradictions between responsibility and autonomy. Drawing on the examples of food, laundry, staffing levels, and violence, we articulate tensions that emerge as policies and practices simultaneously hold the primarily female paid workers and family members and especially the women in them responsible for care, and yet limit their capacity to act autonomously. As a contrast, we then illustrate some situations where individuals have the autonomy to engage in care work in desirable ways. We not only highlight the contradictions that arise from market-oriented strategies, but we show how alternative approaches to the organization and delivery of long-term care can support meaningful work.
