This multi-method dissertation explores the lived experiences of direct care workers who provided essential in-home care for older adults in the United States. I expand beyond opposing narratives that spotlight positive or negative experiences and consequences for direct care workers, and instead highlight the complexity and nuance of care work. First, using quantitative content analysis, I explore the relationship between emotion work requirements and pay rates in online job advertisements for home health aides which shows that these workers are undercompensated for their labor. Next, I use semi-structured qualitative interviews to discuss how the often deeply personal ties and intrinsic motivations for joining the direct care workforce open opportunities for deep meaning-making, but also for institutional exploitation. Then, I investigate how the COVID-19 pandemic impacted direct care workers’ experiences of work, which suggests that they experienced challenges both personally and professionally. Lastly, I explore direct care workers experiences of and vulnerability to disenfranchised grief when their clients die. I suggest that the social construction of their close relationship with clients and a lack of agency/institutional support delegitimizes care workers’ grief. Through this analysis, I show that social and professional blurred boundaries and marginalization shapes experiences of work, mental health, and overall well-being for this critical workforce. This work has important implications for policy implementation and practices to better support direct care workers including increased pay rates, peer-support groups, increased training programs, and mental health coverage under insurance.