In this revealing look at home care, Cynthia J. Cranford illustrates how elderly and disabled people and the immigrant women workers who assist them in daily activities develop meaningful relationships even when their different ages, abilities, races, nationalities, and socio-economic backgrounds generate tension in the intimate encounter that is home help. As Cranford shows, workers experience devaluation within racialized and gendered class hierarchies, which shapes their pursuit of security. Home Care Fault Lines analyzes the tensions, alliances, and compromises between security for workers and flexibility for elderly and disabled people, and Cranford argues that workers and recipients negotiate flexibility and security within intersecting inequalities in varying ways depending on multiple interacting dynamics. What comes through from Cranford's analysis is the need for a new unionism that builds deeply democratic alliances across multiple axes of inequality. She argues for an intimate community unionism that advocates for universal state funding, designs worker-recipient run, culturally sensitive labor market intermediaries to help people find workers and jobs, and addresses everyday tensions in the home-workplaces in order to support both flexible care and secure work.