Home care services, a major component of long-term care policy, depend upon the availability of a labor pool of women hired as paraprofessional home care workers. In this article we argue that home care is a site for competing interpretations of the needs of frail elderly persons and, thus, of the character of home care work. The dominant discourse on, and powerful interests in, health and social policy making construe the work as inexpensive, semi-skilled, practical labor. Critics seeking to revalue caring labor by articulating its complexity challenge this construction. Using in depth interviews with a sample of home care workers, this study probed various aspects of home care work. Two themes critical to revaluing this work are elaborated: (1) the skills required for negotiating the content and organization of the care provided; (2) the ways in which the setting of the work hides the degree of responsibility and decision making in the job. The implications of these findings for women's caring labor, both formal and informal, are considered.