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Article
Publication date: 11 April 2017

Formal and informal long term care work: policy conflict in a liberal welfare state

Caroline Murphy and Thomas Turner

The undervaluing of care work, whether conducted informally or formally, has long been subject to debate. While much discussion, and indeed reform has centred on…

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Abstract

Purpose

The undervaluing of care work, whether conducted informally or formally, has long been subject to debate. While much discussion, and indeed reform has centred on childcare, there is a growing need, particularly in countries with ageing populations, to examine how long-term care (LTC) work is valued. The purpose of this paper is to provide an overview of the way in which employment policies (female labour market participation, retirement age, and precarious work) and social policies (care entitlements and benefits/leave for carers) affect both informal carers and formal care workers in a liberal welfare state with a rapidly ageing population.

Design/methodology/approach

Drawing the adult worker model the authors use the existing literature on ageing care and employment to examine the approach of a liberal welfare state to care work focusing on both supports for informal carers and job quality in the formal care sector.

Findings

The research suggests that employment policies advocating increased labour participation, delaying retirement and treating informal care as a form of welfare are at odds with LTC strategies which encourage informal care. Furthermore, the latter policy acts to devalue formal care roles in an economic sense and potentially discourages workers from entering the formal care sector.

Originality/value

To date research investigating the interplay between employment and LTC policies has focused on either informal or formal care workers. In combining both aspects, we view informal and formal care workers as complementary, interdependent agents in the care process. This underlines the need to develop social policy regarding care and employment which encompasses the needs of each group concurrently.

Details

International Journal of Sociology and Social Policy, vol. 37 no. 3/4
Type: Research Article
DOI: https://doi.org/10.1108/IJSSP-06-2015-0069
ISSN: 0144-333X

Keywords

  • Employment
  • Long-term care
  • Carers

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Article
Publication date: 26 April 2011

Local welfare governance structuring informal carers' dual position

Liisa Häikiö and Anneli Anttonen

Local welfare governance is approached from the vantage point of informal carers caring for older people. A bottom‐up perspective is used to construct a critical view on…

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Abstract

Purpose

Local welfare governance is approached from the vantage point of informal carers caring for older people. A bottom‐up perspective is used to construct a critical view on welfare provision and governance practices at the local level. The paper aims to discuss the issues.

Design/methodology/approach

The data consist of 23 in‐depth interviews with informal carers. Universal access to services and equal treatment of citizens is discussed.

Findings

The analysis illustrates how informal carers share care responsibilities with the municipality and gain access to services both as service providers and service users. Informal care comprises a complex mixture of public and private responsibilities that poses a challenge to universalism. There are new inequalities emerging among informal carers, while access to public resources is easier for resource‐rich carers positioned as service providers. Resource‐poor carers identify themselves often as service users in relation to municipality.

Originality/value

The use of original data provides important knowledge on informal carers' dual position in the local welfare governance and contributes to both theoretical and empirical understanding on shifts within Nordic welfare governance. Informal carers' dual position reflects the essence of mixed governance and represents future social policies.

Details

International Journal of Sociology and Social Policy, vol. 31 no. 3/4
Type: Research Article
DOI: https://doi.org/10.1108/01443331111120636
ISSN: 0144-333X

Keywords

  • Welfare
  • Governance
  • Social policy
  • Elder care
  • Equal opportunities

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Article
Publication date: 28 September 2020

Creating public value in the care at home sector: a mixed-method study about expectations of primary stakeholders using a social exchange perspective

Sascha Kraus-Hoogeveen, Pascale Peters, Els Van der Pool and Beatrice Van der Heijden

This mixed-method study aims to contribute to the scholarly debate by outlining an individual-level theoretical framework for public value creation and evaluation that…

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Abstract

Purpose

This mixed-method study aims to contribute to the scholarly debate by outlining an individual-level theoretical framework for public value creation and evaluation that builds upon a social exchange perspective. It provides insights into the normative frames of primary stakeholders in the Dutch care at home sector, that is professionals, managers, clients and informal care providers.

Design/methodology/approach

A mixed-method design comprising a customized survey among 349 stakeholders, preceded by 31 in-depth interviews was used.

Findings

This empirical work shows differences and similarities in the stakeholders' normative frames revealed via three dimensions of expectations regarding the process of care delivery: personal contact, impact of rules and procedures and communication.

Social implications

These differences in interpretation have implications for the measurement and evaluation of public value creation.

Originality/value

By statistically and methodologically exploring the different expectations' scales that are developed, we intend to work toward a measure for public value creation, which can be used in future empirical work.

Details

Journal of Health Organization and Management, vol. 34 no. 7
Type: Research Article
DOI: https://doi.org/10.1108/JHOM-11-2019-0317
ISSN: 1477-7266

Keywords

  • Social exchange theory
  • Mixed-method
  • Multiple stakeholder perspective
  • Creating public value
  • Expectations

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Article
Publication date: 30 November 2012

Self‐care, plesio‐care, telecare and m‐care: a new assisted living model

Kevin Doughty, David Godfrey and Billy Mulvihill

This paper critically reviews the motivations for introducing different connected healthcare to support Assisted Living in older and other vulnerable groups. The aim is to…

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Abstract

Purpose

This paper critically reviews the motivations for introducing different connected healthcare to support Assisted Living in older and other vulnerable groups. The aim is to develop a new approach that will be sustainable in the future.

Design/methodology/approach

The methodology involves a consideration of assessment criteria currently being employed and the resulting costs and limitations in providing a person centred approach. The implications of introducing new technologies such as plesiocare and mCare are then considered.

Findings

It was found that one of the most cost‐effective applications of technology is in the support of informal carers but the telecare equipment that they are offered may not be the most appropriate.

Research limitations/implications

The findings are limited by a lack of formal risk assessments that are person centred. The implications include the need for improved training in assessment processes and access to a wider inventory of technologies.

Practical implications

Existing telecare services will need to change in order to adopt more plesiocare and self‐care approaches and to engage more actively in the development of models based on mcare.

Social implications

Governments and health ministries may achieve better and lower cost support for their ageing population by adopting a model that includes multiple layers of technology, including easier access to self‐care and mCare technologies.

Originality/value

This paper includes the first discussion on plesiocare and its relative advantages over telecare in supporting informal carers.

Details

Journal of Assistive Technologies, vol. 6 no. 4
Type: Research Article
DOI: https://doi.org/10.1108/17549451211285780
ISSN: 1754-9450

Keywords

  • Health care
  • Social care facilities
  • Telecare
  • mCare
  • Self care
  • Plesiocare
  • Informal carers

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Article
Publication date: 1 August 2008

A critical consideration of the cash for care agenda and its implications for social services in Wales

Ann James

This paper considers cash for care as reflected in direct payments and the more recent development of individual budgets in England. While the momentum to roll out…

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Abstract

This paper considers cash for care as reflected in direct payments and the more recent development of individual budgets in England. While the momentum to roll out individual budgets gathers pace in England, Wales has embarked on a more cautious approach in wishing to evaluate the impact of individual budgets on social services. The paper identifies some of the far reaching implications of cash for care in general and individual budgets in particular, for service users, carers ‐ both paid and informal ‐ and for the social work profession. The policy incoherence in relation to risk and safeguarding is highlighted. This paper supports the approach currently adopted by the Welsh Assembly Government in relation to the ‘rolling out’ of individual budgets. The Assembly's 10‐year strategy for social services focuses on the rights of citizens and the needs of communities. This paper argues that fulfilling that vision should not be wholly contingent upon an unproven extension into the field of individual budgets.

Details

The Journal of Adult Protection, vol. 10 no. 3
Type: Research Article
DOI: https://doi.org/10.1108/14668203200800017
ISSN: 1466-8203

Keywords

  • Wales
  • Cash for care
  • Individual budgets
  • Direct payments
  • Paid carers
  • Informal carers
  • Personal assistants
  • Assessment
  • Community care

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Article
Publication date: 25 April 2008

From the workhouse to the home: evolution of care policy for older people in Ireland

Virpi Timonen and Martha Doyle

Care of older persons in their own homes has in recent years received much attention in Ireland. The proponents of domiciliary care draw on both economic and quality of…

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Abstract

Purpose

Care of older persons in their own homes has in recent years received much attention in Ireland. The proponents of domiciliary care draw on both economic and quality of life arguments, many of which are identifiable in policy documents since the 1950s. However, little detailed analysis of the evolution of the formal care services for older persons, and the shift in emphasis from institutional to domiciliary care, has been presented. The paper aims to focus on the issues.

Design/methodology/approach

Using archival, administrative and policy sources, the authors traced the changing nature of formal care policies in Ireland, and analysed changes in key organising principles and features, including subsidiarity, the role of the Church and the basis of entitlements (residual vs universal).

Findings

The first type of formal care to emerge was institutional, and did not adhere to the subsidiarity principle as it was mostly delivered by the State. Subsidiarity came to the fore more clearly with the establishment of the earliest home care services by religious and voluntary organisations. The current trend towards cash‐for‐care (home care packages) is arguably a modern‐day manifestation of the arm's length attitude that the subsidiarity principle recommends the State take.

Research limitations/implications

The fact that care services are increasingly delivered by private sector companies and informal carers operating in the grey market increases the complexity of the care regime and therefore makes the task of developing social care regime classifications more complicated; it also means that regulation of the care sector in Ireland is a particularly urgent task that is yet to be undertaken in a comprehensive manner.

Practical implications

The policy challenges involved in attempts to regulate the complex care mix are considerable.

Originality/value

The paper utilises both historical methods and policy analysis to highlight the changing meaning of key concepts such as subsidiarity.

Details

International Journal of Sociology and Social Policy, vol. 28 no. 3/4
Type: Research Article
DOI: https://doi.org/10.1108/01443330810862151
ISSN: 0144-333X

Keywords

  • Modern history
  • Elderly people
  • Elder care
  • Ireland

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Article
Publication date: 14 June 2013

The INTERLINKS framework for long‐term care of older people in Europe

Jenny Billings

This paper aims to describe the methodological approach to and outcomes of a European multi‐consortium EU 7th Framework funded project entitled “INTERLINKS”. The project…

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Abstract

Purpose

This paper aims to describe the methodological approach to and outcomes of a European multi‐consortium EU 7th Framework funded project entitled “INTERLINKS”. The project sought to develop a concept and method to describe and analyse long‐term care and its links with the health and social care systems, and formal and informal care.

Design/methodology/approach

Through the development of a template, it accumulated and validated practice examples that described good policy and practice, transferable across EU member states.

Findings

The outcome was to assemble a range of themes, sub‐themes and 135 key issues into a web‐based framework for LTC that is illustrated by over 100 examples of validated practice in LTC for older people.

Research limitations/implications

Key messages emanating from the project are provided, with an emphasis on the need for greater investment and pluralist evaluation of initiatives that seek to address the interfaces and links between care services.

Originality/value

The project is unique in that it provides a comprehensive and accessible interactive European database of policy and projects that directly address the problems of interfaces between service provision for older people, and contributes towards the evidence base in discrete areas of LTC.

Details

Journal of Integrated Care, vol. 21 no. 3
Type: Research Article
DOI: https://doi.org/10.1108/JICA-02-2013-0007
ISSN: 1476-9018

Keywords

  • Integrated health and social care
  • Long‐term care
  • Older people
  • Health care
  • Social care
  • Elderly people

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Article
Publication date: 28 November 2019

A methodological approach to accessing informal dementia care

James Rupert Fletcher

A growing body of research seeks to include people with dementia as both participants and co-designers. It is also increasingly recognized that dementia research must pay…

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Abstract

Purpose

A growing body of research seeks to include people with dementia as both participants and co-designers. It is also increasingly recognized that dementia research must pay greater attention to informal care, provided by family and friends in non-institutional settings, because this is the situation of most people affected by dementia. Accessing these kinds of naturalistic care sites through meaningfully inclusive studies can be challenging for researchers in many fields. The paper aims to discuss this issue.

Design/methodology/approach

This paper describes a methodology designed to facilitate meaningful inclusion and access to hard-to-reach dementia care networks. It describes the implementation of this methodology in the field, the problems that emerged and the lessons learned.

Findings

A two-step sampling approach was used. People with dementia were sampled through organizations unrelated to dementia. Care networks were sampled through ecomapping with people with dementia. The strategy successfully accessed the desired population, but it was labour-intensive and biased the sample in several respects.

Originality/value

It is hoped that this outline will encourage further reflection and discussion regarding methodological approaches to complex sampling and recruitment issues in dementia research.

Details

Working with Older People, vol. 23 no. 4
Type: Research Article
DOI: https://doi.org/10.1108/WWOP-09-2019-0022
ISSN: 1366-3666

Keywords

  • Care
  • Dementia
  • Informal
  • Recruitment
  • Sampling
  • Ecomapping

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Article
Publication date: 28 December 2020

Relationship-centred CogniCare: an academic–digital–dementia care experts interface

Leah Macaden, Kevin Muirhead, Giulia Melchiorre, Ruth Mantle, Geraldine Ditta and Adam Giangreco

This paper aims to reports on an academic–industry service development innovation to advance the symptom monitor and track feature within the CogniCare app to support…

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Abstract

Purpose

This paper aims to reports on an academic–industry service development innovation to advance the symptom monitor and track feature within the CogniCare app to support family carers of people living with dementia. Expert opinion from dementia care professionals identified key monitoring strategies for enhanced carer competence and confidence in the early identification of relevant symptoms that would help facilitate meaningful hospital/social care consultations.

Design/methodology/approach

A co-production approach between industry and academia included stakeholder representation from NHS Highland and Alzheimer Scotland. Dementia care experts validated items to be included for symptom monitoring and tracking using a newly developed A2BC2D2EF2 framework as part of this project and recommended additional strategies for monitoring symptom change, including carer well-being.

Findings

Dementia care experts perceived the symptom monitoring and track feature to have the potential to support family carers with dementia care at home and foster a relationship-centred approach to dementia care to facilitate meaningful hospital/social care consultations.

Originality/value

The CogniCare app is the first platform of its kind that aims to support family carers to care for people living with dementia at home. This unique service development collaborative combined dementia and digital expertise to create innovative digital solutions for dementia care. The proposed monitoring and tracking feature is perceived by dementia care experts as a tool with the potential to enhance carer confidence and thus enable safe and effective dementia care within the home environment.

Details

Working with Older People, vol. 25 no. 1
Type: Research Article
DOI: https://doi.org/10.1108/WWOP-05-2020-0016
ISSN: 1366-3666

Keywords

  • Family carers
  • Digital
  • Co-production
  • Dementia
  • Informal care
  • Relationship-centred care

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Article
Publication date: 1 June 2007

‘The hard thing is the changes’: The importance of continuity for older men caring for their wives

Jonas Sandberg and Henrik Eriksson

Few studies have been conducted into the contextual and relational aspects of male caregiving that include analysis by gender and family relationships. The aim was to gain…

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Abstract

Few studies have been conducted into the contextual and relational aspects of male caregiving that include analysis by gender and family relationships. The aim was to gain understanding of the experience of older men as caregivers for an ill spouse. A narrative approach was adopted for this study. Interviews were conducted with three older men between 65 and 78 years, who had been caring for their wives for between one and 12 years. Two main categories emerged: taking on a new and unfamiliar role, and learning to live with the new role. The results also show how the men seek to maintain continuity in their relationships with the wives they are caring for. The findings can be understood in the light of a major life transition of how older men providing care for a spouse create new roles and how they cope with the changes in the marital relationship. A sense of continuity in the process of caring is important for men to help them find the strength to continue as caregivers.

Details

Quality in Ageing and Older Adults, vol. 8 no. 2
Type: Research Article
DOI: https://doi.org/10.1108/14717794200700008
ISSN: 1471-7794

Keywords

  • Elderly care
  • Informal care
  • Male
  • Narratives
  • Spouse caregivers

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