Research

I am a medical sociologist at the University of Chicago. I study how ordinary people build real expertise when institutions fall short, and how those institutions decide whose knowledge counts. Most of my work follows family caregivers managing Alzheimer's disease and related dementias at home; a second strand follows migrants navigating Italy's healthcare bureaucracy. The two projects draw on different data and stand on their own, but they circle the same question: when professionals and the state cannot do everything that needs doing, who fills the gap, at what cost, and with what recognition? I work across methods, pairing long-term qualitative fieldwork with national survey data, and I aim my findings where they can do work: clinical practice, caregiver support programs, and health policy.

Current Projects

Dementia Caregiving in the United States and Italy

Most of my time goes to family caregivers: the spouses, children, and siblings who take on the daily work of caring for someone with dementia at home. The field's dominant framework is caregiver burden, the idea that caregiving is a load that wears people down. Burden captures something real, but it misses most of what caregivers actually do, which is build expertise. They learn their person. They figure out how to manage symptoms, navigate the medical system, and hold a household together while watching someone they love change. Treating that work as mere burden makes it easy for clinicians and policymakers to overlook the skill involved, and to miss the moments when a skilled caregiver is close to their limit.

My work asks how caregiving expertise is built and what makes it sustainable, and I am developing two frameworks to answer that. Caregiver flourishing identifies four conditions caregivers need in order to keep going: connection to others, a sense of mastery over the work, continuity in who they are, and meaning in what they are doing. When those conditions hold, caregiving can be demanding and still be livable; when they erode, even the most devoted caregiver is at risk. Legitimacy portfolios names the patchwork of recognition caregivers assemble, from clinicians, family members, and peer caregivers, in order to be taken seriously as experts on their person. Expertise, it turns out, is not only something caregivers hold; it is something the people around them have to be willing to honor.

The empirical base pairs twenty in-depth interviews with dementia caregivers in Emilia-Romagna and the rural Midwestern United States, grounded in a year of fieldwork at a caregiver support center, with national data on older adults from the National Social Life, Health, and Aging Project (NSHAP). Working with Linda J. Waite and colleagues at the Center for Health and the Social Sciences, I am now translating the qualitative findings into measurable constructs. The next phase is the development and validation of a Caregiver Flourishing Scale: a brief clinical instrument to identify caregivers at risk of crisis or disengagement before it arrives, and to test whether the support programs we already fund deliver what they promise. This work is developing in conversation with clinicians and researchers at the University of Chicago Memory Center and through the Institute for Translational Medicine.

Migration, Bureaucracy, and Healthcare in Italy

A second, separate line of research examines how migrants, especially West African and Eastern European newcomers, access healthcare in Italy. On paper, Italy has a universal healthcare system. In practice, getting care often depends on having the right documents, knowing which office to visit, and persisting through paperwork that is sometimes unclear and occasionally hostile. I examine how these requirements work as weaponized bureaucracy: not outright denial, but a version of what policy researchers call administrative burden, sharpened until some people give up before receiving care they are entitled to. The result is a system that is formally inclusive and practically stratified, with measurable consequences for preventive care, chronic disease management, and whether marginalized communities come to trust health institutions at all. The first study from this project appeared in Current Sociology in 2025.

The Bigger Question

Both projects feed a larger program: how do institutions decide whose knowledge counts, and what happens to people whose competence is not recognized in the ways they need it to be? Caregivers and migrants make these dynamics unusually visible, but the question travels. It shows up in classification systems that sort people into categories, in clinical measurement that decides what counts as evidence, and in administrative tools that decide who is competent enough to be heard. Over time I intend to follow it there: toward a broader account of how institutions come to know, and fail to know, the people they serve.

Recent

Selected Publications

For a complete list of publications, manuscripts under review, and works in preparation, please see my CV.

Awards and Honors