Feminist Theory

In a 1972 article in the International Journal of Aging, Myrna Lewis and Robert Butler asked why feminism ignored older women. A more pertinent question today is: Why are gerontologists ignoring feminism? Aging can be defined as a feminist issue because women make up the majority of older adults, and because older women are disproportionately affected by poverty and chronic illness. In addition, community-based, long-term care of older adults largely depends on the labor of women caregivers who are unpaid (i.e., family, friends), underpaid (i.e., nurses aides, personal aides), and often invisible. The demands of providing such care can have negative consequences for women in old age, particularly low-income women of color. Employment discontinuities created by caregiving across the life span frequently translate into lower retirement and work income in old age. A feminist approach thus seeks to make visible and to validate the importance of women's daily experiences as family caregivers, and to show how this role affects their social, economic, and health status in old age. A feminist analysis of old age cannot be separated from one of older women and, in turn, of caregiving throughout women's lives. Caregiving of older adults is thus one way to illustrate feminist theory related to aging.

Constructs of a feminist theoretical perspective on old age include the following:

• • Gender roles are socially constructed, not a biological trait, across the life span
• • Women have often been oppressed within the family and undervalued in employment
• • The public (employment) and private (family) domains are interconnected
• • The personal (private) and political (policy) spheres are interrelated
• • Women's experiences differ by race, ethnicity, class, sexual orientation, and age, yet a shared consciousness exists
• • Gender justice, implicit within feminism, can benefit both men and women

A more traditional gender-difference approach defines gender as a biological trait of individuals. Accordingly, variations in aging are generally explained as sex differences. For example, researchers typically identify male-female variations in the extent and type of caregiving. Yet sex and age tend to be shaped more by social structure and power relationships than by biology. In a feminist approach, gender exists in socially constructed interactions, not in the individual. It is a property of structures of subordination based on power differentials that shape people's work and family experiences. To illustrate, women frequently provide more care because they generally have a lower income than their male counterparts; because of gaps in long-term care financing; and because of limited choice about whether to, or how to provide care—not because they are naturally more nurturing. Family obligations that may keep women out of the paid labor force, and the resulting restricted opportunities and incomes, can also create negative economic repercussions in old age. Since gender is socially constructed, systemic changes in the structure of work and family across the life span are necessary to ensure gender equity among older adults.

Because of such gender-based structures, family care tends to systematically disadvantage women as a group across the life span. These inequities are often intensified in old age. For example, work discontinuities can mean that women are less likely to have full Social Security and private pension benefits or private insurance to supplement Medicare. Accordingly, since more older women than older men are poor, they are more likely to depend on Medicaid and Supplemental Security Income, which can translate into a lower quality of care. A feminist perspective thus articulates the interdependence among women who both receive and give care across generations.

The place of women in the social structure fundamentally differs from that of men because most women have experienced oppression and been devalued in both the home and labor market. By articulating women's oppression, feminism differs from other progressive social welfare approaches that advocate structural change, such as the political economy perspective. Under capitalism, the sole operating principle of the marketplace (or public sphere) has historically been profit, not family or community responsibility. Work has typically been defined as measurable output and wages, rather than nurturing and maintenance. By removing production from the home and isolating women within domestic situations, a gender-based division of labor has emerged. Men's work in the labor market has typically been viewed as productive, while women's life work—the nonmonetized and nontechnological work of caregiving—is often regarded as nonwork. Instead, it is seen as a private activity within, and an antidote to, the public marketplace, rather than a central force in shaping it. This can create oppressive conditions and deny women societal power.

When women gain access to the public sphere of employment, their opportunities, income, and access to benefits are often restricted to undervalued, temporary, or contingent service and support occupations. As of 2001, women still had fewer benefits and earned 30 percent less, on average, than men. Low-income women of color, in particular, often provide free labor in the home and inexpensive labor in public settings. Accordingly, society is unaware of the true costs of care by nurses, home health aides, and relatives. The unpaid or underpaid work of women underpins the economy, yet is considered peripheral by traditional economic criteria. As a result, the family obligations that keep women out of the paid labor force for periods of time, and the restricted options and incomes for many of those employed, translate into gender-based economic inequities across the life span, particularly in old age.

Caregiving work thus cuts across the personal and political boundaries of family, employment, and policy. Accordingly, traditional family values affirm a woman's place in the domestic sphere as natural and ideal, and family care as superior to publicly funded care. Public policy has tended to implicitly expect that the family will provide long-term care to older relatives. This occurs because many policymakers define family life as a private matter and care of relatives as an individual responsibility. Feminism thus articulates the interconnections among the values of individualism, independence, and private responsibility that underlie this prevailing policy model where the family is the preferred locus of care. When gender-based elder care is presumed to be nonwork, caregivers are economically penalized and the need for comprehensive long-term care policies is minimized.

While caregiving involves an intensely personal relationship, it cannot be examined apart from the public policies surrounding it. The phrase personal as political means that there are no private solutions to women's public problems (Bricker-Jenkins and Hooyman, 1991). Women's experiences in old age—and as caregivers across the life span—are shaped by their interactions with public social service, health, mental health, and long-term care systems and policies. Family, institutional, political, and societal norms, as codified in current long-term care policies, tend to maintain and reinforce gender inequities. This points to the necessity of fundamental structural changes in social institutions and values to accord greater societal recognition to women's work and to ensure flexibility and choice for both those who require and provide care. Under a feminist approach, the aim of such change is to reduce inequities based not only on gender, but also those deriving from class, race, and sexual orientation. This approach recognizes the multiple realities of the aging experience shaped by the social constructs of race, ethnicity, social class, sexual orientation, and age cohort experiences.

A more traditional women's issues approach defines caregiving and its resultant inequities as individual, not societal, responsibilities. For example, caregiving research has typically identified the primary problem to be the subjective stress and burden of caregivers. Individual interventions, such as education, counseling, social support, and incremental changes in services, are viewed as solutions. Yet these interventions may inadvertently blame women for their physical, emotional, or financial burdens. In contrast, feminism views these problems as being caused by gender-biased policies, structural conditions of economic inequity and occupational segregation, and socially constructed expectations of women. Feminism seeks to alter such expectations and values and to foster policies and practices that promote gender justice. This translates into ensuring a choice of caregiving and employment roles for both men and women across the life span. Feminism targets the whole system, not from the margins, but from the center, with the participation of all men and women. From a feminist perspective, policies need to move away from outdated notions of family toward defining care for older relatives as a collective societal responsibility. This could result in caregiving that is more equitable and humane, and in it being valued by those who give and receive care.

The following principles underlie a possible feminist agenda for both those who receive and give care:

• • Caregiving is defined as legitimate work for women and men, a normal part of the family life cycle, and a societal responsibility
• • The importance of family care and family relationships are publicly valued, rather than devalued as private responsibilities
• • Public policy recognizes both the benefits and costs of family care of relatives across the life span
• • The goal is gender justice for women and men that balances the needs of those who receive and those who give care
• • Changes must be structural and systemic, not made at the individual level
• • Intergenerational alliances across the life span transcend traditional boundaries based on age and type of disability/chronic illness

Components of a feminist approach to care include:

• • Economic supports, which would attach market value to the socially necessary work of caregiving (e.g., comparable worth for women's work in the marketplace, and adequate compensation for caregiving, both in and outside the home); family-responsive workplace policies would broadly define family and dependent to recognize the wide variety of contemporary family structures
• • A comprehensive long-term care policy, which would coordinate integrated community support services to ensure adequate information, choice, and quality of care for adults across the life span
• • Broad-based cross-generational coalition building, which would help empower those who receive and give care

Although a feminist approach is not yet feasible, the act of questioning basic assumptions about caregiving and aging can begin to alter societal values, attitudes, and policies.