Extend Care Beyond Institutions and Projects

The problem with institutional care is not just its bureaucratization, standardization, and anonymity but also the burdening of relations under the abstract category of “care.” Care receivers, and perhaps especially the guests of an emergency homeless shelter I focus on here, long for social relations and practices that do not lock them into the category of care recipient. They long to escape the category of “care” as institutional or personal project. They seek interactions that recognize them as full people and produce interdependent social relations and practices, where they are recognized as having something to give. Caregivers and care receivers alike would benefit from escaping an abstract category of “care” that presupposes that some people give care and others receive it. Institutional actors should develop social relations and participation beyond projects of care and beyond the institution. Institutions such as the emergency shelter must build shared worlds with the communities around them so that care is not abstracted from broader, interdependent social relations.

Scholars who study institutional care have been critical of the depersonalization of care. These critiques relegate institutions and programs (state and nonstate alike) to an analytical space from which they often cannot be recuperated because of their involvement in systems rooted in sexism, classism, ableism, and racism that work to produce and frame certain people as care receivers and others as caregivers, obscuring care as ongoing interdependent relations. Institutional care and humanitarianism are often violent and dehumanizing.1 The problem, at least in one telling, is anonymous care—a care purified of social relations.2

In reality, institutions, programs, bureaucratic paperwork, monitoring devices, and people are always entangled in multiscalar social relations. Even intimate relations of care are not purified of broader social contexts. Care always implicates both power and intimacy, and these are entangled and enacted as part of broader social relations. In Elana Buch’s work on Chicago’s home care industry, caregiving practices that inculcate an embodied empathy also reproduce health inequalities;3 Buch examines “both the development of compassionate, moral relationships and the ways that these relations intersect with, enable, and are constrained by institutional structures and processes of capitalism.”4 It is only through ideological work that systematically devalues certain people and ways of caring that care can be apparently voided of its complex histories and social relations. This ideological work voids care of its animating qualities, making it anonymous and depersonalizing. Working past these ideologies is necessary to restore interdependency to care relations and recognize care as a possible social relation between any two people, in or beyond an institution.

At an emergency homeless shelter in northern Arizona, modes of care are multiple—guided mindfulness sessions, lunch, Wednesday pantry for food distribution, recovery meetings such as Alcoholics Anonymous, work programs, caseworker meetings, a mail room, lunches outside, movie nights, food sharing, and brief conversations. Many of these modes of care are intentionally facilitated by the shelter; others occur informally between guests, staff, and volunteers. While care is messy, multiple, and never pure, both caregivers and care receivers use purified logics of care to make sense of their experiences of care. Both caregivers and care receivers reproduce the dichotomy of anonymous and relational care, but also hint at the possibilities of escaping anonymous institutional care that addresses “needs,” instead entering interdependent relations.

Before I began to spend time at the shelter in northern Arizona, I interviewed the director and assistant director of the community coalition founded by local faith congregations and the program manager at the shelter. In January 2018, a social worker I had interviewed from another community agency began weekly mindfulness sessions at the shelter in the evening and invited me to join. I attended these sessions and conducted interviews with willing shelter guests who consented. Mindfulness sessions were discontinued when the social worker moved out of state, but I continued to come to the shelter to volunteer, observe, and conduct interviews. Shelter guests and others came to the shelter during the day for a lunch service and Wednesday pantry.

In an interview, the then director of the shelter, John, articulated two logics of care, one “inauthentic” and one “authentic,” linking these to the person-centered psychology of Carl Rogers.5 Inauthentic care is “not in relationship with [guests]; authentic care is in relationship with [guests].” John went on, “That’s what we strive to be—authentic—and that is how I believe that we’ve made inroads . . . because folks recognize us as authentic, even sometimes in their dysfunction. . . . They still recognize there’s an authenticity there and that we are functioning in relationship with them.” John’s concern with inauthentic and authentic care is perhaps related to a central challenge of care at the shelter where relationships are fragile and fraught, beset by trauma, mental illness, and substance use. Inauthentic care is abstracted from an ongoing relationship, anonymous and anonymizing, whereas authentic care is part of a relationship. John’s use of “in relationship with them” is ideologically inflected; it does not necessarily accurately represent the experiences of caregivers and care receivers at the shelter. However, it does posit a distinction between abstracted and relational care. This distinction also came up in interviews with shelter guests.

As I interviewed Ben, who decried the way institutions provide “just enough support that people just stay alive,” a shelter worker walked by. “But again, there’s, there’s a few people will help here. She’s one of them. She does everything she can. She talks with everybody. And that’s one of the things that needs to be done. Normally it’s important to separate work and social life. However, in situations like these you need to show, ‘Hey, I’m human to know.’ If you just treat everybody like its [sic] a number . . . If people don’t feel listened to, they won’t get out.” Ben criticizes anonymous institutional care when people are treated like numbers. He advocates for a care that is intentionally interdependent—one in which shelter staff, in particular, show their humanity (“Hey, I’m human to know”). I often saw the same shelter worker outside with the lunch guests, vaping and chatting casually. Professionalization can result in a “hiding of the self in our relations with others” and the production of indifference.6 When the shelter worker shows her humanity, she enables a more interdependent care relation—one in which neither she nor the guests are necessarily locked into the positions of caregiver or care recipient. The distinction between abstracted and relational care is useful to make sense of care rhetorically, yet they often entangled in practice. A closer look at Wednesday pantry provides an example of this.

During pantry, which was held during the two-hour lunch service on Wednesdays, three tables were set up inside around one of the shelter’s entry doors. On one table were toiletries, such as toothpaste, deodorant, and soap; on another, cereal boxes and snacks; on a third, drinks and water. A rolling metal shelf held canned food, divided into categories such as fruit, meat, beans, and vegetables. Benches blocked off access to the rest of the shelter building, which was off-limits during the day. As a form of care provision, food pantries such as this are examples of care abstracted from ongoing relations. Volunteers give care; shelter guests receive it. There is no expectation of interdependency between these actors.

The pantry was run by volunteers, many of them older women who were members of local religious congregations that had founded the coalition almost two decades prior. During the several weeks I was at the shelter during pantry, individuals lined up outside the glass doors and were allowed in two at a time. They then received a plastic shopping bag and instructions from a volunteer about how many items from each category they were allowed. It was often the same older volunteer, Betsy, who gave instructions. For example: You can have three toiletries, one protein, four other food items, and two drinks. Guests could step between the tables for a hot meal-to-go before exiting through another set of shelter doors.

Vic was not a shelter guest at night, although he came to the shelter for lunch. On Wednesdays he sometimes picked up toiletries and food at the pantry, often speaking loudly and without pause about politics and popular culture, sometimes referring to people and events from fifty years ago. He was known for not answering questions, and thus interactions with Vic were sometimes more confrontational than conversational. He was banned from another social service agency for offending people with his political rants. I couldn’t always keep up with his cultural references, but I sometimes found his commentary astute. One Wednesday at pantry he asked Betsy, “What’s the magic number today?” When the volunteers, a few of whom had known him for many years, tried to hurry him along, he responded dryly, “Patience is still a virtue. Especially in a place like this.” These comments were an overt critique of an abstracted and anonymous mode of care, based on standard and procedure in the name of impartiality and efficiency. The “care” of food provision foreclosed other more interdependent and idiosyncratic forms of care. Although they were polite, the older women were relieved when Vic left. They had known him many years and had apparently grown weary of his commentary. The interactions revealed the women’s comfort with giving abstract care, but not with other, more personal relations, at least on Vic’s terms.

One day an older man, also from a local congregation, joined three women volunteers at Wednesday pantry. He took position as doorperson, letting in two guests at a time. I was conducting an interview inside the shelter. When I finished, I looked over and noticed Vic talking with the older man by the door. I stood watching, intrigued by the possibility that the two were having a conversation. Betsy, walking by, noticed me watching and said cheerily, “Isn’t it amazing? Vic likes him.” Vic was telling the volunteer about a trespassing citation he had recently received. “I told him to write down his badge number. Does that look like a badge number to you?” The procedures of pantry were relaxed as Vic talked to the volunteer, who continued to let in visitors two at a time. No one hurried Vic along.

While I cannot speak to Vic’s inner world, it is possible to see Vic chafing against an abstracted and anonymous mode of care when he asked, “What’s the magic number today?” and chided volunteers “Patience is still a virtue.” His interaction with the volunteer serving as doorperson might initially seem peripheral to the provision of care, but to see it this way reveals assumptions about which practices count as care and which people are caregivers and which recipients. To re-embed care in relational exchange allows us to see Vic not only as an anonymous recipient of care but as a fuller person with particular experiences. Care extends beyond the institutional interventions of pantry and lunch and encompasses an idiosyncratic exchange as Vic entertains the volunteer with the story of his trespassing citation. Vic is no longer anonymous.

Vic was talking; the volunteer was listening. The volunteer did not offer any help or even commiseration beyond a few utterances that signaled he was still listening. Vic was standing next to the volunteer. The volunteer continued to let in two persons at a time, no longer including Vic in the count. In this moment it is possible to see Vic—with the volunteer, by the door, no longer counted as a guest—momentarily escaping the category of care recipient as defined by the shelter through its pantry service. Vic escapes the identity of care recipient as he offers something—a story, a distraction, a laugh—to the volunteer.

Returning to shelter guest Ben’s description of a worker at the shelter: “She does everything she can. She talks with everybody. And that’s one of the things that needs to be done. Normally it’s important to separate work and social life. However, in situations like these you need to show, ‘Hey, I’m human to know.’” Ben emphasizes that it is a problem to abstract care work from social life. Social relationships of mutuality, reciprocity, and exchange are integral to experiences of relational care. At the same time, Ben is clearly talking about the need for the advocate to show her humanity—not the guest. His charge recognizes that relationships between caregiver and care receiver are often unequal in terms of need, dependency, and vulnerability. One way to slightly destabilize the caregiver–care receiver assignments is for the caregiver to show her humanity, to invest in an economy of care that moves beyond institutionally delimited forms of care provision. Everyday social interactions—for example, vaping and chatting with guests—can also be seen, perhaps fleetingly and imperfectly, as escaping the category of caregiver and exceeding care as defined by the institutions and societies that provide it. Care becomes more of an ongoing, interdependent relationship. These moments are not just important because they make better institutional care possible, which they likely do. These moments are important because they develop ongoing interdependent social relations in excess of institutional and societal projects of care.

In Buch’s review of the anthropology of care, she writes that care “is involved with the social constitution of personhood”—personhood referring to “membership, roles, or status in society” that emerge in social relations.7 According to Buch, some care atomizes while other care creates “social persons.” She defines care as “a moral practice with the potential to recuperate fractured relations.” Institutional care that offers people relations primarily as either care receivers or caregivers, however, may still be limiting, offering people narrow and overdetermined social positions. People need ongoing interdependent social relations and practices in excess of care as an intervention that seeks to resolve “needs.” The possibility of moving between and beyond positions of dependency, vulnerability, security, and recognition is important for care receivers and caregivers alike. Everyone needs to receive care; everyone also needs to give care. This is care as human interdependency rather than care as a personal, institutional, or societal project.

For institutions like the emergency homeless shelter in northern Arizona, an economy of care would mean greater political and economic commitments, but these commitments cannot have the consequence of further separating and excluding the unhoused from social relations. Instead, policies and programs must address the interface between shelter guests, volunteers, staff, and communities beyond the shelter, building shared worlds through programming that is less institutional care and more community event, where the positions of caregiver and care recipient are not fixed and more fluid. Institutions must foster social relations beyond their projects of care. They should bring people into richer and more diverse fields of social participation where everyone is recognized as both a care receiver and a caregiver. Institutions should also make connections with other organizations and groups to offer broader landscapes of social participation and care practices, recognizing that care, in its essence, is interdependency with others. While interdependent relations at the shelter may seem minor—for example, the shelter worker vaping and chatting with guests and Vic telling a story to a shelter volunteer, momentarily eluding the shelter guest count—these instances allow people to escape the categories of caregiver or care recipient and enter into less determined interdependent relations. An economy of care means more opportunities for social interdependency.