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Care Doesn't Scale

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361–370 of 382 posts

Re: Care Doesn't Scale

#361
post #45

The premise is wrong, you can care for more than one other person at a time. People have children, in this world we can only care about our spouse or one child? Hardly.

Depends on what you mean by "care for". Calling your parents a few times a week to make sure they're doing OK and dropping by on the weekend doesn't take too much time and effort. But as people get older they need more and more care. Caring for one person with dementia or other similar problems that comes with aging is for all intents and purposes a full time job.

And eventually if you can't afford to become unemployed to do it or pay full time caregivers, you need to move them to some kind of care home where there is minor scaling effect. Being housed together, the residents can share caregivers since most do not need continuous help.

A common arrangement is a board and care home with about 4 residents and 2 caregivers who work mostly non-overlapping shifts, and one sleeps onsite to (hopefully) be able to handle overnight care needs.

A larger place can scale a bit better. E.g. 10-20 residents can have 5-10 staff on various shifts. But some staff could be cooks or handle cleaning while others focus more on the residents' needs. And at this level of staffing, they can manage to have an overnight shift with someone who remains awake to keep an eye on things, as well as probably having other(s) sleep onsite to be on call to help with bigger events.

Re: Care Doesn't Scale

#362

Earlier quoted context omitted.

The 3am baker currently exists because the people who benefit the most from the exploitation of labor have the extra money to buy artisan products. My great grandfather had a bakery. He and my great grandmother would bake their product and my grandfather and his brothers would deliver the product to local businesses and homes. And then corporate breadmakers came in and made it impossible to compete from a price stand…

Essentially most consumers just didn't care about quality and preferred the lower price over the higher quality product. That seems like normal consumer choice. The people didn't get poorer all of a sudden when the corporate breadmakers came along - the people simply decided they would prefer to get an inferior product at a lower price. The reality is most people don't want to spend more money for higher quality good…

I don't know what I said that made you need to explain this to me when it's obviously already what I said.

Re: Care Doesn't Scale

#363
post #272

Earlier quoted context omitted.

> >We’re pretty limited when it comes to care. In any given moment, you can only really care deeply and individually for one person. The evidence very strongly points the other way, IMHO: Almost all people care deeply and individually about many others, starting with their families - spouse and children are a clear and I think irrefutable example of deep caring and love for multiple people. And for most, also sibling…

I'm not claiming that we can only love one person, it's just that the nature of love is unique to each dyadic relationship; they're not commensurable. Yes, I may show empathy and respect to strangers, patients or clients, trying hard to deal with them fairly and conscientiously. Well said. But this only operates in the short term. It doesn't mean I can love them all, or at all, or love them equally, or anything like…

Thank you for responding! I appreciate your thoughts and that someone else is thinking about these things - me too.

As you imply, I agree that much of what we say depends on our definitions of 'love', which is undefineable. To the degree it involves time (for attention), well obviously time is limited and therefore love would be limited. But I think that's a distraction, a rationalization, a tool to win a debate but not our intent.

Love at its core is about empathy, compassion, and that social emotion called love; time is a unavoidable factor but isn't necessary - love without time would still be Love (maybe moreso). I once thought Love was limited. I was trying to come to terms with the fear and trauma of evil in the world and to protect myself from it; and much more I was trying to come to terms with the lack of love I received in my past, and to justify or rationalize the lack of love I then currently gave or was involved in.

...

As I grew, I learned some things: I learned that I was avoiding a deeply painful reality - that some very important people treated me badly, I was injured by it, and that was never going to change. For me, to rationalize the limitations of love was an attempt to justify what they did, as bizarre as that sounds, so I could believe they did love me - you see, the injuries were just the natural course of things and my fault, my shameful weakness, vulnerability and resulting needs. Neglect is worse than abuse; nothing is worse than feeling meaningless (that's why people try to befriend their abusers).

Then I learned that love is much greater. I learned from someone who loved me, who showed me.

And the rationalization trapped me - it trapped me in the limitations of those who abused and neglected me. If love was much greater than what they did then they didn't love me, I was nothing (or not much) to them, and then that empty space - that feeling of meaninglessness - and the injuries are very real and cannot be undone. I can't go back and make them love me, or make them love me now.

I had a choice: I could stay in that trap, within those limitations, or move beyond them and face the pain and emptiness. Like the coming of age stories - I could stay in my small town, in the bosom of those relationships and (imagined) love; or having a much greater vision than them, I could leave for the wide world, the big city, and accept the isolation of leaving my roots behind. And then they would never understand me again, and would certainly reject me because of it.

...

That's the choice of many of us and I can just tell you my story: I went for it. I chose to accept love not only as much greater than those people in my life, but as unlimited - I was going to try for the best possible result, knowing it might fall short.

It hasn't fallen short, amazingly. IME, it's unlimited. I can love, I believe you can love, without limit. Most powerfully, I can love myself. I can love deeply in an instant, in prospect, people who've harmed me, and those close to me no matter what they do. I'm not joking or exaggerating, though few will believe me.

It's not a fairy tale; life is very hard. The pain and trauma from my past remain, though I handle them much better. Those people from my past do reject me, actively at times. Other people and the world still do horrible things; they beat you down again and again; it feels awful, sometimes terrifying. I do bad things too, of course. Life is very hard no matter what you do - do you have a solution where those things don't happen? There's no pain? Have the emotional walls actually worked? Now I can get my bearings and rise up much stronger and better; there's an undercurrent, though sometimes faint or overwhelmed, of almost magical joy. I never feel defeated beyond the immediate experience:

One key for me is perceiving that many people, unfortunately ~97% of them it seems, don't know this secret. They do horrible things and act badly because they are, very understandably, scared, traumatized, and don't understand there is unlimited love for them and in them. The answer is not to fight them for survival, but to love them, to show them. Some think you must be a fool - in terms of their survival perspective, you are doing crazy things; in that survival game, acting with love can make you vulnerable; you may get knocked down. But that will happen at times anyway and, in my experience, people see and sense the love and very rarely, in my experience, fight you. Most of all, people follow you if you lead genuinely; if you lead with aggression and defensiveness, they'll adopt a defensive posture and fight you; lead with love and they will love.

...

Long ago I read many 'great books' - Shakespeare, Aristotle, Confucius, religious texts, etc. Recently I re-read the Gospels, the first four books of Christianity's New Testament. I'd read them back then and my memory is that on a philosophical level - ignoring the supernatural aspects here at HN - they seemed confusing and bizarre, another obscure religious text centered around submission to a supernatural king - grovel and they'll forgive you anything!

With no expectations I reread the Gospels and discovered something shocking: This lesson that changed my life today, someone knew 2,000 years ago! That's what the Gospels are about, for me; the faith in Jesus is necessary, by its internal reasoning, because that is faith in love's power (arguably; I'm not a theologist and others have their beliefs). I refer you to them not for the religious aspects, but because obviously they express these ideas very well - an influential, very popular book for 2,000 years.

Re: Care Doesn't Scale

#364
post #269

Earlier quoted context omitted.

The other companies are also shortstaffed, all healthcare is at the moment, and the bureaucracy layers just keeps humming along ... Buurtzorg is however cheaper, and since you cannot scale the actual care that counts.

Yes, and the actual nurses also have more job satisfaction and their patients are happier too, so the quality also improves. The main explanation given for that is that compared to solutions that require a lot of time spent on administrative work, these nurses get to focus on the actual care work, and have more personal time with the patients, meaning a bond of trust can be established. Which is also an important asp…

Imagine if we had an openly adoptable Buurtzorg model along side open source software used for adminstration. With the power resting with the carers the non-care admin work could be collectively automated through the open source model.

Re: Care Doesn't Scale

#365
Scale vs care/love is a false dichotomy, and each word encompasses many phenomena.

Years ago, a neighbor in Los Angeles went to social services and was diagnosed with schizophrenia and given some meds.

I knew what he was going thru, and I was young and rebellious, so I told him to skip the meds and take some time with good friends. In 2 months, the symptoms were gone. I can't remember the name of the meds but the side effects were awful.

On the other hand, in my mid 30s I started to appreciate all the little details around infrastructure and design in various countries, and I often get the feeling of "being loved" by workers I've never met because the way it works is so nice or because it protected me in some way I didn't think of.

Re: Care Doesn't Scale

#366

Earlier quoted context omitted.

> Are you suggesting there is no provider of high quality nails at industrial scale? Nails was one of the examples cited by the gp, which I found funny since there is one famous example of nails being lower quality by definition as a result of centralisation. That example isn't the case for all nails (nor for all the gps examples), but it is still an excellent, if isolated, example: cut nails. Most carpentry nails yo…

> by definition This an empirical argument about nails. Are you just saying that to emphasize your confidence? > cut nails I just googled and there are literally dozens of brands of this product. Even so this preference appears to be a niche opinion of artisan woodworkers, not a failure mode of furniture and construction. > The switch to wire was a detail of the manufacturing processes, not of consumer demand Yes it…

> Are you just saying that to emphasize your confidence? [...] people like to reminisce about hand made goods. [...] I guarantee we can find a supplier of many varieties of decorative nails

A nested HN thread is likely not the best place to go into great detail on the precise practicalities of trade work, & I know I can't expect any given commenter to become an expert in a possibly niche topic just to engage in discussion, but this level of dismissiveness is a little difficult to reckon with. Nobody is buying nails for their "decorative" qualities - they get embedded in materials. They're not a visual feature.

Re: Care Doesn't Scale

#367
post #331

Earlier quoted context omitted.

In general people take care of their kids. In general the family is good you can always find edge cases.

> According to recent statistics, 70%-80% of Americans consider their families dysfunctional. https://mcnultycounseling.com/moving-past-dysfunctional-fami...

Compared to what some Ideal sure. Compared to being raised or cared for by the state my guess is that would change.

Re: Care Doesn't Scale

#368
post #341

Earlier quoted context omitted.

I see another comment like this one, so here I will respond to both. I've known quite a lot of rich people, all vastly richer than ourselves. As for us, we are so rich we don't think we can financially justify spending more on cars than my 23 yo pickup and my wife's 8 yo Prius. Our house in an astoundingly banal suburb is worth ~$300K. We can't afford to retire to a cool US city. I find it hilarious that SWEs posting…

Ever stop to think that the fancy restaurants they're going to are using these artisan bakers? The vast majority of high-end restaurants are not baking their own bread or doing their own pastries. They're outsourcing them because of the sheer amount of space you need to do that sort of specialized work.

I don't think that's right, but I could be wrong here as I have no data.

The problem I see is volume. Once an "artisan" baker is running an operation scaled up to likely more than one restaurant, how do they remain artisan? Why doesn't Baumol's cost disease apply?

Re: Care Doesn't Scale

#369
I disagree. There's plenty of historical and present evidence of people who cared deeply for a collective of people (country, village, town, group, family).

There have been people who would risk their lives, and in some cases commit suicide in various capacities, for their country and people. There are people who go to world's most unstable places just to help people there.

A more concrete example, one of many, would be María Santos Gorrostieta Salazar[1], who had a total of 4 assassination attempts against her, with the final one eventually getting her killed, as a result of fighting organised crime. You can't tell me this person didn't care deeply for her people and country.

I think the possible cause for indifference today, especially in developed countries, is because people can afford to be indifferent with little consequence to their quality of life. You can go about your life only caring about your most immediate circle, and things will still be relatively comfortable. I speculate that it's the matter of having no need to go beyond your comfort zone apart from moral ideals. Even then, people are just fine living with a slight discomfort of not living up to their ideals, or straight up re-evaluating and adjusting them like in this post.

1 - https://en.m.wikipedia.org/wiki/Mar%C3%ADa_Santos_Gorrostiet...

Re: Care Doesn't Scale

#370
post #107

I assumed the opposite. Knew a women who worked 100% as foster mom. Had 3 children at a time, age 6 to 13. Everything was well organised. It seemed to me, child care can work pretty well of it's your main job and you get paid by the state.

3 children. If it's 10, 20, 30, this doesn't work. This is the entire point, that care work does not scale like manufacturing or farming or software or entertainment or...

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