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Sustainable care: theorising the wellbeing of caregivers to older persons
- Authors:
- KEATING Norah, MCGREGOR J. Allister, YEANDLE Sue
- Journal article citation:
- International Journal of Care and Caring, 5(4), 2021, pp.611-630.
- Publisher:
- Policy Press
The term ‘care crisis’ is invoked to denote chronic system failures and bad outcomes for the people involved. This paper presents a comprehensive wellbeing framework and illustrate its practicality with evidence of negative outcomes for those who provide care. This study finds evidence of substantial material and relational wellbeing failures for family carers and for care workers, while there has been little interest in carers’ views of their ability to live the life that they most value. Understanding and improving wellbeing outcomes for carers is an essential component of sustainable care, which requires the wellbeing of the different actors in care arrangements. (Edited publisher abstract)
Individual determinants of task division in older adults' mixed care networks
- Authors:
- JACOBS Marianne T., et al
- Journal article citation:
- Health and Social Care in the Community, 22(1), 2014, pp.57-66.
- Publisher:
- Wiley
Older adults in need of long-term care often receive help from both informal and formal caregivers. The division of tasks between these different types of caregivers may vary among such mixed care networks. Traditional models of task division suggest that formal and informal caregivers may either supplement each other or specialise in the care activities performed. This study explores division of Activities of Daily Living (ADL) andI Instrumental ADL (IADL) between informal and formal caregivers of older people in the Netherlands, using data collected in 2007 on 458 mixed care situations. Four types of task divisions of informal and formal care are distinguished: the complementation model [neither Activities of Daily Living (ADL) nor instrumental ADL (IADL) tasks shared, 14%], the supplementation model (both ADL and IADL tasks shared, 39%) and informal and formal specialisation (one type of task shared, one type of task not shared, 27% and 20% respectively). Analyses show that the intensity of care provision, the informal caregivers' motives and the presence of privately paid help – more than care receiver's health – are related to type of task division with formal care. For example, when the informal caregiver provides more hours of help and out of a strong personal bond, the likelihood of informal specialisation increases, whereas the likelihood of formal specialisation decreases. When privately paid help is present, the complementation model is more likely, whereas the supplementation model is less likely to be found. Results are discussed regarding the differential consequences for co-ordination and co-operation in mixed care networks. (Edited publisher abstract)
Caregiver physical and mental health predicts reactions to caregiving
- Authors:
- DE FRIAS C. M., TUOKKO H., ROSENBERG T.
- Journal article citation:
- Aging and Mental Health, 9(4), July 2005, pp.331-336.
- Publisher:
- Taylor and Francis
Self-reported health and reactions to providing care to older adults with cognitive or physical impairments were examined. Health status was examined on a single occasion in 177 persons (aged 63–94 years) referred to programs within a comprehensive set of geriatric care services and the 133 family members involved in their care (ages 31–96 years). The five-scale Caregiver Reaction Assessment (CRA) was administered to the family members. Reliability analyses revealed that the CRA had good internal consistency. Being older was related to experiencing greater health problems in the caregiver role. Greater health problems from providing care were reported by caregivers in worse physical health and also when the care recipient had more physical pain. Caregivers who reported fewer health problems attributed to caregiving reported better mental health and less depressive symptomatology. Caregivers with health problems may be at increased risk of suffering from stress from caregiving.
Using carer biographical narratives to explore factors involved in proxy reporting of quality of life in people with dementia
- Author:
- ROBERTSON Jane M.
- Journal article citation:
- Aging and Mental Health, 21(4), 2017, pp.416-425.
- Publisher:
- Taylor and Francis
Objectives: Quality of life is an important focus of research on dementia, with interest in direct reports of people with dementia and proxy reports of their carers. By exploring the subjective perspectives of unpaid family carers and paid care workers, this study aims to understand how carers construct meaning in narratives about quality of life with dementia. Method: A case-centred approach involved biographical narrative interviews with 10 carers to explore what was important for people with dementia to have a good quality of life. Detailed narrative analysis attended to the linguistic and structural features of accounts to consider how dementia is conceptualised by carers in the framing of quality of life. Results: An individual's perception of how dementia impacts on awareness and behaviour was central to their understanding of quality of life. Carers who constructed dementia as a loss of skills and abilities were able to represent quality of life in positive terms despite the challenges of dementia. Carers who constructed dementia as eroding identity represented quality of life less positively and centred on their own means of coping with a challenging care situation. Conclusion: Findings highlight the importance of helping carers develop positive constructions of quality of life that are associated with understanding dementia as a loss of skills and abilities, rather than as a loss of self. Engaging with subjectivity in carers’ biographical narrative accounts is important in the development of quality of life assessment to understand the meanings and emotions that underlie proxy perspectives. (Publisher abstract)
A triadic perspective on elder neglect within the home care arrangement
- Author:
- AYALON Liat
- Journal article citation:
- Ageing and Society, 36(4), 2016, pp.811-836.
- Publisher:
- Cambridge University Press
The present study evaluates a conceptual model of elder neglect within the home care arrangement that takes into consideration the older adult, his or her family members, and the home care worker. Data from 223 complete care-giving units, which consist of an older adult, a family member and a home care worker, were analysed using structural equation modelling. Overall, 31.5 per cent of the older adults, 18 per cent of the care workers and 32.3 per cent of the family members reported at least one type of elder neglect. The proposed model showed a reasonable fit to the data. There was an inverse effect from type of home care to family member's burden and elder neglect, with live-in (around the clock) care being associated with lower levels of family member burden and elder neglect compared with live-out Israeli home care (provided for several hours per week). The amount of informal assistance provided by family members was inversely related to the amount of burden reported by home care workers, with greater informal assistance being associated with lower levels of worker burden. The findings call for the important role of formal home care by demonstrating a potentially protective effect for live-in migrant home care. The study also emphasises the shared burden between formal and informal sources of care. (Publisher abstract)
The view from within: "good" care from the perspective of care professionals: lessons from an explorative study
- Authors:
- SHULMANN Katharine, et al
- Publisher:
- European Centre for Social Welfare Policy and Research
- Publication year:
- 2016
- Pagination:
- 16
- Place of publication:
- Vienna
Policy briefing which focuses on care quality from the perspective of professionals working in the field of long term care in Austria. Specifically the briefing looks at what care professionals consider to be high quality care and how it should be defined; and what structural-, process- and outcome-related factors they believe affect outcomes. The study draws on interviews and workshops with representatives from various professional groups, as well as 24-hour carers and family carers, to identify themes and issues central to discussions of "good" care. The interviews and workshops identified a number of factors for the provision of high quality care: the continued development of a distinct long term care identity, rather than a separate identity of health/social care; working conditions; relationships, including between care professionals and users, and between professionals and informal carers; the way that care services are financed and structured, which has a strong influence on the delivery of care, interaction and cooperation; and the importance of multidisciplinary care teams. The authors propose recommendations to directly and indirectly improve quality of care through action at the macro, organisational, and individual levels. (Edited publisher abstract)
Care between work and welfare in European societies
- Editors:
- PFAU-EFFINGER Birgit, ROSTGAARD Tine, (eds.)
- Publisher:
- Palgrave Macmillan
- Publication year:
- 2011
- Pagination:
- 272p.
- Place of publication:
- Basingstoke
This book provides insights into the theoretical framework of 'tensions' related to care for children and the elderly in the context of recent welfare state reforms. It brings together experts in the field of research on welfare and work from different disciplines and from different European countries. The different chapters introduce the current debates on tensions related to care and discuss specific types of new tensions that have developed in the context of welfare state reform. Analyses relate to new tensions that are connected with different types of formal and informal child and elderly care, and with migration related to care. Also, tensions within care cultures, and between the cultural and the institutional framework of care are analysed. Moreover, it is shown if and under which conditions welfare state reforms have contributed to strengthen existing tensions or even to create new tensions, and under which conditions they have contributed to relax such tensions.
Governing home care: a cross-national comparison
- Authors:
- BURAU Viola, THEOBALD Hildegard, BLANK Robert H.
- Publisher:
- Edward Elgar
- Publication year:
- 2007
- Pagination:
- 224p., bibliog.
- Place of publication:
- Cheltenham
This book offers a comprehensive analysis of the principle issues surrounding the governance of home care. In this context home care is taken to mean any care and support offered to older people in their homes. The analysis maps out governing arrangements in relation to formal and informal care services, informal care, care workers and users of care across nine countries: Estonia; New Zealand; Italy; the United Kingdom; Sweden; Japan; Germany; the Netherlands; the United States. The authors explore the ways in which country specific contexts shape governing arrangements and bring together insights form social care and public policy literature.
Family and family-like interactions in households with round-the-clock paid foreign carers in Israel
- Author:
- AYALON Liat
- Journal article citation:
- Ageing and Society, 29(5), July 2009, pp.671-686.
- Publisher:
- Cambridge University Press
This paper reports a study of family and family-like interactions and transfers, or exchanges of goods and resources, between paid, round-the-clock, Filipino home carers and those they care for in a sample of households in Israel. Qualitative interviews about their experiences and attitudes concerning the care role were conducted with 22 family members and 29 Filipino home-care workers. A thematic analysis of the interview data identified three major themes: the structure and internal dynamics of the adapted family or family-like system of care; the role of family members; and the role of Filipino home-care workers in the new system of care. Sons and daughters tended to appropriate the care-management positions and to reduce their social and emotional support for the care recipient. In contrast, spouse care-givers continued to provide some of the personal and emotional care even when a Filipino home-care worker was employed. Filipino home-care workers were made responsible for daily care and domestic routines and provided emotional and social care. It was found that family members do not relinquish their role as care-givers when round-the-clock foreign carers are on hand, but the nature of their role changes. The results suggest that foreign home-care workers' job description needs to be redefined to acknowledge the substantial social and emotional care that they provide.
Long term care policies in Italy, Australia and France: variations in cash-for-care schemes
- Author:
- Da ROIT Barbara
- Journal article citation:
- Social Policy and Administration, 41(6), December 2007, pp.653-671.
- Publisher:
- Wiley
Cash benefit provisions have been at the core of many recent reforms in the long-term care sector in Europe. The respective schemes, however, vary widely in terms of the definition of entitlements, the level of benefits, and the ways in which benefits can be used by recipients. This article investigates cash-for-care schemes in three European social insurance countries. It asks whether the diversity of these schemes indicates different paths or just differences in the pace with which the respective policies address the risk of dependency. A characterization of the three schemes and a discussion of the implications for care work arrangements lead to the conclusion that the context and timing of long-term care reform processes are in fact quite variegated. All three countries have histories of cash schemes and of applying the cash approach to support – and to some extent relieve – traditionally strong family obligations. Differences predominate in terms of linking cash to employment, although some convergence is apparent in the effects on qualifications, working conditions and wages in care work.