Abstract

"Old is New Again: the 'Longevity Economy' and the Reinvention of Home Care"

John Rudnik, University of Michigan (jrudnik@umich.edu)

The scope and rapidity with which the US population is growing older casts the contemporary moment as one uniquely influenced by population aging. Since the late twentieth century, public and academic discourse has been animated by concerns about the most appropriate way of resourcing older adults and the societal consequences of various approaches. In this paper, I explore how these discussions have transformed market-based eldercare in the United States in the late twentieth and early twenty-first centuries. I argue that the past decade has seen the emergence of a new moral narrative of aging that works to embed "the economy" in issues associated with late life and care. This paper develops an association between historical transformations in the home care industry and shifting discourse on aging.

The late twentieth century saw the emergence and rapid growth of privately-managed assisted- and independent-living facilities as alternatives to public nursing homes. Since the early 2000s, most growth in the long-term services and supports (LTSS) sector has been driven by home care providers. The most recent innovations in the industry have been driven by Silicon Valley-based startup firms that offer services through digital marketplaces, or platforms. These developments temporally coincide with increasing tendencies to think about old age in economistic terms. To identify the link between these phenomena, I draw on a document analysis of academic and trade materials to trace the ideological narratives that accompanied historical shifts in care provision in the US. I pair this historical approach with interviews of technologists working at platform-based companies to identify how practitioners justify their work. The paper thus offers new insights into the emergence of new moral and political economies of care. It also contributes to research regarding the historical and contemporary regulation of non-medical home care, especially in the context of new organizational forms.