Intergenerational photo with grandmother and grandchild

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Caregiving as Infrastructure

Caregivers and staff act as bridges and roads into their loved ones’ lives.


When it comes to infrastructure, most of us think of roads, tunnels, and bridges as physical infrastructure, and banks and monetary institutions as economic infrastructure. These entities support some of our activities of daily living, but not all of them.

Think more along the lines of needs of human beings. What if we also viewed caregiving and its associated efforts as infrastructure?

Caregiving as Infrastructure

Recent headlines about President Joe Biden’s American Jobs Plan include many references to infrastructure. Looking at the Latin roots of that word, infra means below or under (as in supporting) and structure comes struere, meaning to build.

In my mother’s care home, she was tended to by a nutritionist, a cook, a maintenance person, an activities director, nurses, aides, caregiving staff, and the executive director. And of course, family and loved ones. We were the infrastructure which helped give momentum to her life. For older adults still living at home, family members are charged with overseeing care and neighbors help grocery shop. Someone mows the grass. The occasional aide visits for a check-in. The medical staff rounds out this scaffolding of love.

If any of the above fails and there are no safeguards in place, the system does not perform as expected or required. Essentially, our loved ones suffer from this lack of reinforcement. Those surrounding them are at risk too.

“Care has always been infrastructure,” says Ai-Jen Poo, the executive director of National Domestic Workers Alliance and director of Caring Across Generations. “From childcare to paid leave, to home and community-based services, care is a need shared by all at some point in our lives and is fundamental to enabling economic activity.”

Public Policy Shaping Care Services

By 2040, about one in five Americans will be age 65 or older, up from about one in eight in 2000. The question of who will care for older individuals and in what settings became the basis of particular concern for many in the aging field when the pandemic revealed the many cracks in our nation’s care system.

Questions continue to swirl about the definition of infrastructure in our current society. Should it be limited to the current standards? Yet, going back as far as 1994 in a report by Emmanuel Jimenez, there have been ongoing discussions around infrastructure as it relates to humans.

The author states, “by definition, the basis for development is infrastructure - whether services for human infrastructure (health, education, nutrition) or physical infrastructure (transport, energy, water). Although the infrastructure sectors are diverse, what they have in common is that public policy has had a great deal to do with how these services are provided and financed in almost all countries.” 

Caring Bridges

Our highways and by-ways do act as connectors, transporters, conveyors and as utilities. They help feed, clothe, and house our citizens. Most caregivers will tell you they act in a similar manner over the course of years, keeping the lights on for their loved ones.

And in the midst of the pandemic, we learned how essential it was to lift up the thousands in the medical community and the staff inside care centers who all were left to contend with the outcome of daily testing and viral outbreaks. They were taking care of our loved ones. But who was taking care of theirs? One childcare worker showed her credentials at a grocery store so she could shop during early hours for her daycare, a business that took in the children of physicians working at nearby hospitals overflowing with sick patients. She was denied access.

In a New Yorker interview, Morales Rocketto, of Care in Action, a group who advocates for the work of parents and other family caregivers, stated, “Care is not just a personal responsibility. It’s a collective responsibility. And I think the pandemic has made it really, really clear how hard it is to do it alone and how little support infrastructure there is for families. Because of the pandemic, we are seeing just a seismic shift in how people are thinking about care.”

If we have a collective responsibility for our viaducts and railroad crossings, then we also have a collective duty to respond to the needs of those in our care.

Annette Januzzi Wick is a writer, speaker and author of I’ll Have Some of Yours: What my mother taught me about dementia, cookies, music, the outside, and her life inside a care home (Three Arch Press), available online, and is a recipient of a 2020 National Society of Newspaper Columnists award. Visit to learn more.