Home care is a new social relationship for many of its participants; its roles, relations, and responsibilities are unfamiliar both to those who are aging and in need of care and those who work in home care, increasingly migrants from the African continent, where paid elder care is unknown. This paper examines how mainly wealthy and white aging patients and their West African care workers in the United States understand and represent this growing field of employment. It argues that this new social relationship is understood in light of adjacent relationships with which participants are more familiar, namely domestic service. Within this context, racial identities become salient for patients, while for African care workers, seniority and gender are more significant axes of inequality. Still, they come to adopt the racial categories attributed to them by their patients, thus identifying with the American racial classification system and using the language of slavery to challenge demeaning work relationships.