Uncompensated Care Work, It’s What We Do

Liana Cassar, MPH, MBA
4 min readMar 31, 2022

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Searching for a job is profoundly different from the way we make our way to caregiving roles.

Adding a child to the family or taking care of an elder can feel alternately like something to be excited about or something to be burdened by.

Either way, it’s a job (generally unpaid), whether it’s full-time, part-time, or occasional.

Flipping the calendar on another year of a landscape-altering global pandemic is a good time to get perspective on how we care for ourselves and for others. The way we care doesn’t ever have to revert to the way it was before. What I mean is that it doesn’t have to revert to a time when we don’t talk about the challenges of informal or unpaid caregiving.

I first heard the term ‘uncompensated care’ at a hospital where I worked early in my career. It was (and still is) a term used to describe the cost of health care services for patients with no means to pay. The patients had neither health insurance nor the financial resources to pay out of pocket. The total value of those services amounted to the uncompensated care provided by the hospital. The numbers needed to consistently be calculated to be able to plan for the resources and finances of the facility.

I found the term interesting back then and saw many human and systemic complications attached to it at the time. Over the 20+ years since I first learned of uncompensated care I’ve borrowed the concept and have started to put it to broader use.

The uncompensated care I’m most concerned with now is care work. Specifically, I’m concerned with the unpaid (and underpaid) labor and tasks we do as care work for ourselves and our loved ones, outside of health care settings. The care we provide varies across logistical, emotional, physical, and financial caregiving to assure that our own or our loved one’s basic needs are met.

Some care gets paid for, like child care and elder care, while other care does not. There is little-to-no financial compensation exchanged for the care work we do for others and there is never compensation provided for the care work we do for ourselves.

It’s entirely fine that we don’t always pay for or get paid for care services. Just as we sometimes buy meals prepared by others, we also prepare food ourselves at home. There is significant value to what is done in the name of care. But, when we don’t get a picture of what that uncompensated care amounts to, energetically and financially, it can be undervalued.

Society needs, and will always have, compensated and uncompensated care. Yet, as individuals, we can value the uncompensated care that we and others do. If we don’t, our communities will continue to treat this work as if it is invisible and it will continue to be taken for granted. Our care roles are too important and integral to our relationships and our humanity to go without the nurturing and deliberateness they deserve.

The habit of only valuing that which has a external financial impact perpetuates our undervaluing of the work of our care roles. This, in turn, causes us to be less deliberate about how we fit care into our lives, which impacts how we care, how we feel about the care we provide. It impacts our relationships and our effectiveness, and most certainly, it impacts the professional plans we’ve got.

If you, by default, due to family dynamics, are serving as a caregiver or if you have been recovering from an illness or surgery or live with a chronic health condition, it can be helpful to take a step back and get clarity about what is happening regarding your uncompensated care role. Identifying where you can be deliberate regarding that role can help ground your work and assure you are allocating the necessary resources and you’re delivering this care in the way that works best for you.

Though we don’t apply to care roles the way we do our paid positions, perhaps we’d benefit from applying some similar ideas to how we approach them.

We can start by asking questions about any uncompensated care we provide to others or ourselves:

Did I choose my caregiving role?

How do I feel about my caregiving role?

If I could change one thing about my caregiving role, what would it be?

What does it look like when I’m successful in my caregiving role?

Bringing a more deliberate eye to our care, especially our care roles, can help us manage them in more satisfying ways, especially our incredibly valuable uncompensated care.

If there’s a chance for us to integrate our care work and the goals we envision for ourselves, as care work continues to take a center stage in this chapter of the Covid pandemic, now is a great time to take it.

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Liana Cassar, MPH, MBA
Liana Cassar, MPH, MBA

Written by Liana Cassar, MPH, MBA

Liana Cassar is a strategy & operations consultant focused on the care economy & women-led ventures, and a legislator in the RI House of Representatives.

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