Research

I study how ordinary people build expertise in moments when institutions fall short, and how those institutions decide whose knowledge counts. Most of my work focuses on family caregivers managing Alzheimer's and related dementias at home, and on migrants navigating Italy's healthcare and immigration systems. Across both, I am interested in the same underlying question: when professionals and the state can't or won't do everything that needs doing, who fills the gap, and at what cost? My research is theoretically grounded in medical sociology but oriented toward findings that can inform clinical practice, caregiver support programs, and health policy.

Current Projects

Dementia Caregiving in the United States and Italy

Most of my time goes to studying family caregivers, the spouses, children, and siblings who take on the day-to-day work of caring for someone with Alzheimer's or another dementia at home. The dominant framework in this field is "caregiver burden": the idea that caregiving is a load that wears people down. That framing captures something real, but it misses 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.

My work asks how that expertise gets built and what makes it sustainable. I'm developing two related ideas. The first is caregiver flourishing: a framework that identifies four things caregivers need in order to keep going, namely connection to others, a sense of mastery over the work, a stable sense of self, and meaning in what they're doing. The second is legitimacy portfolios: the patchwork of recognition caregivers assemble from clinicians, peer caregivers, and family members in order to be taken seriously as experts on their person. Together, these ideas reframe caregiving as a skilled, social activity that depends on whether the people around the caregiver, doctors, family, support groups, will recognize what they know.

The empirical work draws on twenty in-depth interviews with caregivers in Emilia-Romagna and the rural Midwestern United States, paired with national survey data on older adults from the National Social Life, Health, and Aging Project (NSHAP). I am currently extending the qualitative findings into measurable constructs, with the longer-term aim of developing and validating a Caregiver Flourishing Scale that can be used in clinical settings to identify caregivers at risk of disengagement and to evaluate whether existing support programs are doing what they claim to do. This work is being developed 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 strand of my research looks at 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. My work examines how these administrative requirements function as a kind of weaponized bureaucracy: not outright denial, but enough friction that some people give up before they get the care they're entitled to. The result is a healthcare system that is formally inclusive and practically stratified, with measurable consequences for whether marginalized populations can access preventive care, manage chronic conditions, and trust health institutions over time.

The Bigger Question

Both projects are starting points for a larger question I hope to keep working on: how do institutions decide whose knowledge counts, and what happens to people whose competence isn't recognized in the ways they need it to be? Caregivers and migrants are useful sites because the dynamics are easy to see there, but the question travels. Wherever ordinary people develop real expertise that institutions struggle to make sense of, classification systems that decide who fits into which category, clinical measurement that decides what counts as evidence, administrative tools that decide who is competent enough to be heard, the same underlying problem shows up. The empirical worlds I work in now will probably not be the only ones I work in. Over time, I want to follow the question into wherever it leads, including places that look quite different from caregiving and migration. But that's a project for a long way down the road... (for now)

Selected Publications

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

Awards and Honors