Document Type


Degree Name

Doctor of Philosophy (PhD)


Social Work


Lyle S. Hallman Faculty of Social Work

First Advisor

Anne Westhues

Advisor Role

Dissertation Advisor

Second Advisor

Rianne Mahon

Advisor Role

Dissertation Co-Advisor


This dissertation reports a qualitative study of 23 care workers in the home care program for older people in Shanghai, China. Using grounded theory methodology, a model was developed to account for care workers’ experiences of relationships with older clients. Care workers were found to resist the image of care work as demeaning labour performed by lowly migrant workers and re-construct care as valuable work for those in need accomplished by a caring self. As a mechanism of care relationship formation, care workers engage in tuning, a dynamic process of identity negotiation that shifts in between two contrasting states: dissonance occurs as a care worker’s self-concept is perceived to be rejected in interaction with an older client; consonance is reached when self-concept is in congruence with a situated identity negotiated and formed through interaction. Care workers’ narratives revealed that the process of tuning involves both managing emotion and referencing cultural symbols and imageries. The model suggests that the interplay between the relational and instrumental aspects of care is key to understanding home care work. In particular, scope of work and time management for a home care dyad are shaped in a relational context. Instrumental care work in turn, influences how a care relationship is developed.

The emergent model was compared with three extant theories on home care relationship: the boundaries thesis, the emotional labour thesis, and the welfare institution thesis. It contributes to the literature by unravelling an underlying mechanism of relationship formation at the interpersonal level. Its implications for home care policy, services, and research in the Chinese context and beyond lie in its theoretical and practical applicability.

Convocation Year


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