The Third Shift: Employment, Housework, and Now Informal Healthcare

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While many women continue to struggle with striking the delicate balance between family household responsibilities and paid employment, an additional shift is taken on by many women, too: informal healthcare providers.

More than 20 years ago, the seminal work by the sociologist Arlie Hochschild gave voice to many women who found themselves caught in the “second shift”: women who spent long hours employed outside the home but were still expected to complete the family’s housework, too.

While many women continue to struggle with striking the delicate balance between family household responsibilities and paid employment, an additional shift is taken on by many women, too: informal healthcare providers.

With an aging population and a healthcare system that increasingly expects families to provide informal healthcare for ailing loved ones, women continue to deny themselves of leisure time so they can devote themselves to providing informal healthcare. Recipients of informal care are often aging parents/in-laws and children.

But don’t take my word for it. One study by the Commonwealth Fund found women are twice as likely as men to be providing informal healthcare for an ailing family member. Many of these caregivers come from lower-income households, where approximately 40% live in households with incomes below 200% of the federal poverty level. In many cases, the study found, caregivers are not currently working; but when they are, there is a high percentage of job absenteeism.

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Two questions emerge. One question is: What does this emergent “third shift” mean to the health of women who serve as informal healthcare providers? The Commonwealth Fund study found caregivers are more likely than non-caregivers to be in fair or poor health. In fact, nearly one-half of caregivers reports having a chronic health condition and one-quarter reports having a disability. Other studies have noted women caregivers are more likely than non-caregivers to suffer from stress and depression.

Something’s gotta give, as there are not enough hours in the day to complete these three shifts. Which leads me to the second question: What’s the solution? Luckily we have the Family and Medical Leave Act, right? Thanks to the Family and Medical Leave Act (FMLA), women are able to take 12 weeks of unpaid leave to attend to the birth or adoption of their child, care for a loved one’s illness, or care for your own illness. Don’t get greedy, though–you can take FMLA only once a year. So if you find yourself in multiple circumstances where you need to take FMLA in the same year, and you’ve run out of leave time, that’s too bad: you’re out of luck. If you find yourself working in a small organization, with fewer than 50 employees, then you’re really out of luck: FMLA doesn’t apply to you. And should you take FMLA, don’t be surprised if you come back to a “similar” job, which is somehow not quite the same as the job you originally had.

That’s the best solution this country has produced. FMLA is our national policy, and has been the case for the past 17 years. Must we continue to devalue the triple shift work performed by many women, especially when we know the consequences? Why is it our national “pro-family” employment policies invariably involve unpaid leave and provide such a small window of time “off” to attend to family matters? Would the US economy really collapse if employers were required to provide paid leave? (Note: Recently, the US economy nearly collapsed, but I don’t think it had anything to do with women.) Similarly, of the industrialized nations, the US is the only country that does not provide paid maternity leave, but let’s save that for another blog…

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