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Lex maniac

Investigating changes in American English vocabulary over the last 40 years


(late 1980’s | therapese, doctorese | “nurse,” “attendant,” “companion,” “aide”)

Sociologically speaking, this word has grown up with the sandwich generation, the baby boomers who had children late and wound up raising them and tending to their parents at the same time. The word “caregiver” has always applied most readily to those looking after the very young or the very old; when a caregiver turns up around anyone in between, they’re usually disabled. Another reweaving of the social fabric, the rise of working mothers and day care in the 1970’s, played a role, too. If you were already talking about day care, which Random House Unabridged dates from the early 1960’s, it didn’t require much of a leap to get to “caregiver,” although the even clunkier “day care provider” was more common.

Semantically the word represents an attempt to cover as many situations as possible. It’s not easy to come up with a general term for all the kinds of people who can offer medical or personal services — related to the patient or unrelated, licensed or unlicensed, with or without a degree — especially if you don’t want it to sound condescending or pejorative. The medical profession had a use for a word like that, and “caregiver” is what they came up with. One of the earliest significant uses of the term goes back to psychiatrist Erich Lindemann in a book called “Urban America and the Planning of Mental Health Services,” published in 1964 by the Group for the Advancement of Psychiatry. He offered it as a synonym for “caretaker,” already a familiar word. It seems to have been intended to refer primarily to medical practitioners or at least people with MSW’s. A concurrent long-term trend toward high-falutin occupation names (“sanitation engineers,” etc.) had a twofold effect: “caretaker” was promoted to “custodian” or “janitor” — thus making it unavailable for those who look after human beings — and “nurse” came to be reserved for holders of particular credentials. That meant that the woman who looked after the kids or the old people couldn’t be called “nurse” any more and a new word had to be found. (Even in the early days, “caregiver” was rarely glossed or swaddled in quotation marks; the meaning was that obvious.)

“Caregiver” can have a wide range of referents: parent, relative, babysitter, day-care provider, social worker, home health aide, nurse, therapist, even an undertaker who offers grief counseling. A study published in 1978 was titled “Hairdressers as Caregivers: A Descriptive Profile of Interpersonal Help-Giving Involvements” (i.e., they acted as therapists). A doctor might be called a caregiver but probably not, more likely a “medical professional” or “healthcare provider,” Lord help us. Yet it seems to have settled into steadiest use as a word for “one who spends a lot of time taking care of a completely or partially helpless person.” As often as not, the caregiver is the member of the family who, for whatever reason, draws the short straw when an aged relative is no longer competent. The web site aims itself at “families caring for loved ones with chronic, disabling health conditions.” In British English, “carer,” a word with even less poetry in it than “caregiver,” has become, or is becoming, current. The growing group of “home or personal care aides” in the U.S. refers to people who are licensed and paid for this kind of duty.

To me, the word has a reassuring sound — when the caregiver shows up, we can all relax. I don’t consider it felicitous. “Giver,” recent children’s fiction aside, isn’t idiomatic, and “caregiver” partakes of its awkwardness. It’s not utterly offensive to my ear, but I’d have a hard time using it without a wince.

My buddy Mark down Florida way fed me this word last weekend and asked me to look into it. No sooner said than done!


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