The Feminist Daughter
Dementia Dilemma

The first gender norm we must face is at the core of gender theory, wherein men and the masculine are privileged over women and the feminine, placing women and feminine concepts, things, ideas, and ways of being on a devalued plane. The second gender norm to reckon with is that women are the ones who care. This idea ripples off the tongue so effortlessly that it feels self-evident, natural, even. So deeply ingrained in the cultural fabric that it is rarely questioned. As a result, care becomes gendered feminine, and women who provide care are rendered devalued, unseen, unrecognized, and unconsidered. How did this conflation of gender and care come to be and how is it continually reinforced? To answer this, one must consider three overlapping lenses: biology, preference, and performativity.

From the perspective of biological determinism, women are biologically predisposed to care, driven by an evolutionary imperative to nurture. This view suggests that women are inherently suited to caregiving, as they naturally exhibit traits like kindness, empathy, patience, and gentleness, qualities essential for care work. In this framework, "biology is destiny," and caregiving by women becomes an unavoidable fact of life. As research corroborates, women indeed perform the majority of caregiving labor. When families face the question, "Who's going to care for Mom?", it is overwhelmingly women who "step up."

Another explanation often offered for the conflation of women and care is that women prefer to care. While this notion moves away from biological determinism toward a framework of autonomy and free will, it is problematic. Preference as a justification fails to fully account for the social pressures and life circumstances that shape women's decisions. This leads us into the realm of obligation and societal expectations, where caregiving is deeply intertwined with "gender performativity."

As feminist theorist Judith Butler explains, we are born into an "always gendered existence," where our identities as gendered individuals are shaped by the reenactment of learned behaviors, gestures, ways of speaking, and interactions with others, where identity is continually constructed through repetitive acts that align with societal expectations. Women learn to perform caregiving as part of their feminine role, a performance so deeply ingrained that it becomes essential for social survival. To deviate from these expected behaviors risks social ostracism and punishment. Paradoxically, caregiving, despite being undervalued, becomes a source of societal validation for women.

With these gender norms, or "structures of constraint," the identity of caregivers is held in biology, preference, or performativity. For a moment, let's assume that women universally want to care, whether because of biology, preference, or performance. This arrangement and understanding of care is unjust, unsustainable, and outdated. Women are not volunteering for severe depression, loss of income, erosion of their social networks, and the other burdens of dementia caregiving. Nurturing tendencies do not justify leaving women isolated, their futures altered, to care for a loved one with a severe, chronic brain disability. These gender norms are foundational to the crisis of unpaid family dementia caregivers who deserve to be held in the same regard as their non-caregiver peers or, said differently, other members of their family.

The family is often heralded as the foundational unit of care. It is equated with love, support, warmth, and the comfort of shared holidays and traditions. Families, as groups whose "fates are bound up together," are expected to support one another through all of life's challenges, including the overwhelming responsibility of dementia caregiving.

However, this idealized vision of family care obscures a troubling reality. To minimize costs, both private and public healthcare institutions have engaged in what is known as the "re-familization of care." This shift positions familial ties as the primary source of care for society's most vulnerable members, particularly those suffering from serious illnesses like dementia. While this re-familization of care is presented as a return to more traditional values, it brings with it several problems.

First, the emphasis on "care for one's own" weakens broader social ties, fostering an isolationist mindset that undermines communal solidarity and support networks. Second, framing the family as the ultimate support system for caregiving is not only unrealistic but verges on "utopian" thinking. In reality, some of the most profound traumas individuals experience are deeply tied to familial relationships. Third, not every family has the necessary resources, emotional, financial, or otherwise, to provide sustainable and equitable care.

Fourth, and most critically, in reconsidering the structures of care, I argue that the term re-familization is misleading. The more accurate term would be the re-womanization of care. This re-familization, in practice, often means a reliance on the unpaid labor of women who happen to be members of a family. The term family serves to obscure the fact that the work of caregiving disproportionately falls on women, keeping their labor and the work they perform invisible. Even though women may be part of a family, it is often they who bear the brunt of the caregiving responsibilities, facing the crisis of caregiving alone.

The norm of care as the responsibility of the family confines the identities of unpaid family dementia caregivers to biology, preference, and performance, often leading to the same devastating results. Applying sociologist Kathleen Gerson's work on childrearing, just as the reproduction of the current generation is "inherently a social, and not merely a female, task," the same can be said of care for those with dementia. Dementia caregiving, done with dignity and equality for all involved, is simply unaccomplishable by one unpaid woman. Women deserve better. Dementia patients deserve better. By studying shared responsibility of care through a feminist lens, we can begin to build social arrangements of care based on reality, based on what is needed, what is right, what is moral, and what is fair.