Client satisfaction with live-in and live-out home care workers in Israel

In an era of globalization where the migration of longterm care workers is common, foreign live-in home care workers can compensate for the unavailability of family members and, perhaps, even substitute for institutional care in the provision of long-term care services to disabled older persons. This study examines differences in home care satisfaction between disabled older persons in Israel with "live-in" home care workers and those with "live-out" workers, and explores some differences in sociodemographic and personal characteristics between these two groups. Face-to-face interviews were held with a random sample of 93 older persons in Beer-Sheva. Older persons with live-in home care workers were more satisfied with their home care service than those with live-out workers. Those with live-in workers were more severely disabled, tended not to have any children living in close proximity, although an adult child was available as an informal caregiver. Communication difficulties between the elderly persons and their home care workers were found not to affect negatively the satisfaction with the service.     

Client Satisfaction with Live-In and Live-Out Home Care Workers in Israel

Abstract

In an era of globalization where the migration of long-term care workers is common, foreign live-in home care workers can compensate for the unavailability of family members and, perhaps, even substitute for institutional care in the provision of long-term care services to disabled older persons.

This study examines differences in home care satisfaction between disabled older persons in Israel with “live-in” home care workers and those with “live-out” workers, and explores some differences in socio-demographic and personal characteristics between these two groups. Face-to-face interviews were held with a random sample of 93 older persons in Beer-Sheva.

Older persons with live-in home care workers were more satisfied with their home care service than those with live-out workers. Those with live-in workers were more severely disabled, tended not to have any children living in close proximity, although an adult child was available as an informal caregiver. Communication difficulties between the elderly persons and their home care workers were found not to affect negatively the satisfaction with the service.     

Immigration to Spain: implications for a unified European Union immigration policy

A unified immigration policy is one of the prerequisites for establishing the free movement of people within the European Union (EU). This paper considers the difficulties in establishing a joint policy on the free movement of people within the EU by focusing upon changing immigration policies in Spain. By comparing Spain, a country of only recent, small-scale immigration, to Germany, a country with a longer history of non-European immigration, obstacles to developing and effectively implementing coordinated immigration policies among EU members can be elucidated. The administrative control of entry, estimates of legal and illegal immigrants in the country, and the status of bilateral relations with Morocco are examined in order to highlight the political difficulties encountered in a unified immigration policy both within Spanish society and for the EU. Spain is both a threshold to the EU and a destination. Border control may be the easiest part of implementing a joint immigration policy in the EU. It is more difficult to control settlement. In addition, high rates of unemployment may result among the native host country populations as immigrants more readily accept low-skilled, low-paying jobs.     

Social Work Practice with Older Soviet Immigrants

ABSTRACT

With the recent sociopolitical changes in the Former Soviet Union, significant numbers of older Soviets have arrived in the U.S. with their families. Soviet immigrants who enter the U.S. are no longer automatically considered political refugees, which has limited their entitlement to services. Recent changes in public welfare and immigration policy place the responsibility for care of elderly members solely on the family. While caring for older adults is stressful for any family, new immigrants may be especially burdened since they have limited knowledge of services, few coping resources to provide adequate care, and little experience resolving cultural conflicts with their older parent. By using a practice model designed to evaluate late-life caregiving situations, two case scenarios are presented to examine practice and service delivery issues of older Soviet immigrants and their families.     

STEM Education and STEM Work: Nativity Inequalities in Occupations and Earnings

The recruitment of skilled workers with expertise in science, technology, engineering and mathematics (STEM) is a core component of North American immigration policies. However, few studies examine the labour market integration of immigrant STEM educated workers. Multivariate analysis of the 2011 National Household Survey show that STEM educated immigrants who arrive as adults are less likely than the Canadian born to have STEM jobs and they earn less than their Canadian born counterparts. These patterns partly reflect their socio‐demographic characteristics, particularly their lower language proficiencies (measured as a combination of mother tongue and languages spoken at home) and the receipt of their degrees in institutions outside of Canada. These immigrant workers arrived primarily in the skilled worker programme that did not require pre‐arranged employment. Policy changes in recruitment and their implications for future STEM immigrant workers are discussed in the conclusion.     

Whom Should We Serve? A Discourse Analysis of Social Workers’ Commentary on Undocumented Immigrants

We present a discourse analysis of social work practitioners’ commentaries on undocumented immigrants that were collected from a survey of practicing social workers’ attitudes toward immigration and immigrants. Analyzing 198 open-ended comments, we explore the discursive mechanisms practitioners employ to construct undocumented immigrants, and their professional responsibilities toward them. These views are illustrative of the ways in which the profession determines inclusion and exclusion, writ large in national immigration policies and laws and played out in the arenas of social work and social services. Disparate views of practitioners highlight tensions in the profession's relationships to law and social policies as well as to its own ethics and identity.     

In Search of a Better Life: The Experiences of Working Poor Immigrants in Vancouver,Canada

We utilized data from 72 in‐depth interviews with immigrant hotel and hospital support workers employed in the service sector of Vancouver, Canada to analyse migration decisions and subsequent experiences after arrival. We found that migrant social networks were centrally important, both as a stimulus for migration and in shaping post‐arrival experiences. At the same time, the working conditions faced by immigrants after arrival, such as low pay and long work hours, resulted in serious challenges. While some struggled with multiple jobs to make ends meet, others felt their economic circumstances prevented them from even bringing their children to Canada. In some cases, children were returned to their country of origin. Features of low‐wage service sector jobs also limited the time available for participation in community life. The findings both support and advance recent theoretical contributions about the incorporation of immigrants in the United States and Canada. As immigrants frequently face occupational downgrading and are channelled into low‐wage service sector jobs, the conditions of work and social policies are important for their post‐arrival experiences and incorporation. Going beyond traditional conceptions of citizenship in the immigration literature, some respondents acted through their union and community organizations to attempt to change society and improve their fortunes. While some sought social justice through political activism, others used their limited family and community life time to reterritorialize values from their countries of origin. Part of their activism was transnational, such as sending remittances to help loved ones back home, but other involvement included participation in organizations with the aim of promoting social justice or improving life in their new country. The experiences of immigrant service sector workers in Vancouver suggest a need for greater emphasis on the role of both immigrant and non‐immigrant specific social and labour policies for understanding immigrant incorporation in North America.     

Family comes first or open all hours?: How low paid women working in food retailing manage webs of obligation at home and work

This paper draws on qualitative findings from a study exploring work-life balance issues amongst female employees within food retailing. Whilst female employment is fundamental to this sector, there is limited evidence on employees' experiences of reconciling relatively low-paid work and the particular demands of food retailing with domestic and caring responsibilities. Managing competing discourses and demands at home and work is a feature of many women's lives. For those in low-paid jobs, with fewer material resources to fall back on, such webs of obligation, often stretching over the lifecourse, may be particularly difficult to navigate or escape. In food retail work, as in caring/domestic emergencies, timeframes may be tight and demands made on workers at short notice and outwith the standard working day. The study showed that sustaining their moral identities both as good mothers/daughters/family members ('family comes first') and as good and reliable workers ('the store must be staffed') was, therefore, an everyday practical accomplishment for these food retail employees. We explore women's accounts against the backdrop of particular familial, workplace and socio-cultural expectations and constraints, identifying overlapping sets of values between home and work as well as points of contradiction and tension.     

Resurgent Irish immigration to the U.S. in the 1980s and early 1990s: a socio-demographic profile

Irish immigration to the US has been motivated traditionally by a lack of employment opportunities at home. With the passage of the US Immigration and Nationality Act of 1965, however, Irish immigrants were no longer explicitly favoured. Family reunification became the primary path of entry, which worked against the Irish who had lost their immediate generational link with US residents.
During the severe Irish recession of 1980–85 a resurgence in Irish outflows resulted in a large undocumented Irish population in the US. Most of this population was later legalized as a result of special legislation that targeted the Irish. There have been concerns in Ireland that the outflow in the 1980s, unlike prior flows, included a high proportion of skilled persons, leading some to characterize the outflow as a "new wave".
This article uses US immigration data to assess how the occupational characteristics of recent Irish immigrants compare with prior immigrant cohorts and also examines how Irish immigrants are incorporated into the US economy.
Recent Irish immigrants to the US spanned the occupational spectrum: accountants, engineers, nurses and other professionals found a booming job market in the most advanced sectors of the US economy, while less skilled immigrants found jobs in the informal economy. While the number of entering Irish professionals increased, flows of the less skilled increased even more dramatically, resulting in an overall decline in the occupational selectivity of Irish immigrants.
The 1980–85 Irish recession has been followed by robust growth for more than a decade. Ireland is now experiencing a net inflow of persons, including many Irish professionals returning from the US. However, Ireland continues to experience a net outflow of the young and less skilled which may once again result in a large undocumented Irish presence in the US.     

Is there any merit to the merit-based immigration system? What Sub-Saharan African immigrant labor and housing market outcomes tell us about U.S. economic and immigration systems

For decades, U.S. immigration policy debates have centered on creating a merit-based system limiting entry to high-skilled immigrants. Yet the emphasis on merit-based immigration ignores the fact that high-skilled immigrants already enter the United States in merit-based immigration assume high-skilled immigrants benefit the U.S. economy because they are better able than low-skilled immigrants to translate skills into economic success. Using Sub-Saharan (Black) African immigrants' labor and housing market outcomes, I show that meritocracy only partially explains U.S. labor and housing outcomes, leaving a merit-based system unlikely to address America's economic needs. The majority of immigrants to the U.S. are non-White, and racial discrimination in the labor market results in occupational and wage disadvantages in the U.S. Due to the public charge rule, high skilled immigrants may be less likely to get their visas renewed or green card applications approved because of these labor market disadvantages. Without stable visa status, high-skilled immigrants will be less likely to make long-term economic investments in the United States—an important way of contributing to the U.S. economy. Together, research indicates that U.S. immigration reform will not work without first enacting policy addressing racial disparities in economic systems.     

Older lesbians' experiences with home care: Varying levels of disclosure and discrimination

ABSTRACT

There is considerable evidence that lesbian, gay, bisexual and transgender (LGBT) older adults have experienced barriers to health care access and have profound fears about how they will be treated in the long-term care system, but the specific experiences of older lesbians have received less attention. Most older adults needing long-term services and supports (LTSS) prefer to remain at home, and this is true for lesbians as well. This article reports on a national, qualitative study of the experiences of 20 older lesbians (age 65 and older) with home care workers. The experiences of six informal partner caregivers with home care services are also included. Emergent themes regarding level of disclosure, experiences with homophobia, evaluation of care received, and thoughts about ideal LTSS are described. Most study participants did not disclose their sexual orientation to their home care workers. A significant minority experienced homophobia, but nearly all ultimately found workers who provided good care with which they were comfortable. Their visions of ideal LTSS included greater affordability and particular qualities that were important for home care workers to possess, such as competence, caring and acceptance. Practice and policy implications are outlined including careful recruitment, training and supervision of home care workers to foster lesbian-sensitive care, but also improved wages and work conditions in order to maintain a quality home care workforce.     

“No Matter What I Do They Still Want Their Family”: Stressors for African American Grandparents and Other Relatives

Grandparents and other relatives increasingly assume the role of primary caregiver to minor children. This study interviewed family members caring for children whose parents were not available due to parental incarceration, other involvement in the criminal justice system, and substance abuse-related issues. Interviews with 25 African American women examined the impact of caregiving including stress and depression. Stress included caregiver issues related to finances, time allocation, care responsibilities, and concerns about the absent parent, as well as issues specific to the children related to school concerns, child behavior, and emotional problems. These stresses were examined along with caregiver depression scores using the Center for Epidemiological Studies Depression Scale, which indicated more depression related to caregiver illnesses, older caregivers, and care for older and a larger number of children. This study suggests that caring for these children is both challenging and stressful, and caregivers are at risk for depression and other mental health concerns. Health and service providers should carefully assess the needs of caregivers when determining the needs of families where children are under care of nonparental relatives. Family-based services are needed that include caregiver supports as well as support for children.     

Explicit Versus Implicit Family Decision-Making Strategies Among Mexican American Caregiving Adult Children

Changing U.S. demographics make it increasingly vital to investigate experiences of Latinos caring for aging parents, with specific emphasis on how these families, who often value family closeness, make decisions about caregiving. This study investigates relationships among use of implicit versus explicit decision-making strategies, generation since immigration, and orientation toward family. Findings suggest that those with more recent immigration to the United States were more likely than those who immigrated longer ago to describe family decision making about their parents' care as implicit. Those that were classified as using predominately implicit decision making were also found to be not significantly different from those classified as predominantly explicit with regard to their overall support of a collective orientation toward family. There were exceptions to this, however, regarding two specific aspects of orientation toward family: engagement in shared activities with family members and avoiding family conflict by making choices that are consistent with the family values. In both cases those categorized as implicit expressed stronger endorsement of these specific values. These findings suggest that the relationship between family decision-making strategies, generation since immigration, and orientation toward family is more complex than suggested previously in the literature. Implications for future research and practice are offered.     

International Migration,Immigration Policy and Welfare Spending

Increasing immigration is often linked with the public pressure for lower levels of publicly funded social expenditures. However, the empirical evidence on the effects of increasing immigration on social expenditures is discordant and depends on which countries are studied. This article argues that the employability of new immigrants as well as their entitlement to public benefits explains the observed impacts of immigration on social expenditures. Moreover, these same features can help to explain the increasing stringency of immigration policies.     

Sibling caring roles and responsibilities when a child suffers from a chronic illness

Siblings' lives and well-being are potentially affected in profound ways when their brother or sister suffers from a chronic illness in childhood. The shift in the care of chronically ill children from the hospital to the home in recent years has had an impact on family relationships and interactions. Whilst studies on caregiving have focused on the parental care of children who are chronically ill; siblings may nevertheless take on some caring roles and responsibilities. This article intends to make a novel contribution to the sociological literature on siblings, caring, and chronic illness by presenting a review of the literature addressing siblings' caring roles and responsibilities in families of children with a chronic illness. Knowing about the caring roles and responsibilities undertaken by siblings when a brother or sister has a chronic illness, may be beneficial to healthcare professionals and influence their caring practice. In addition, this work may contribute to a better understanding of family relationships and further improve healthcare policies.     

Redressing Inequity in Parent Care Among Siblings

When inequities occur in the division of labor among adult siblings caring for older parents, conflict may result. This paper uses equity theory as a framework for understanding the processes used by siblings to rectify imbalances in their parental responsibilities. The study is based on a sample of 40 focus group participants who described caregiving relationships among siblings. Consistent with equity theory, these participants used two approaches to redress inequities in their sibling caregiving relationships: requesting behavioral changes from siblings and making cognitive changes. The findings suggest that these two approaches can result in more perceived equity but may also lead to even greater perceived inequity and distress.     

WORKING CARERS OF OLDER ADULTS

Juggling work and care presents particular challenges to carers and employers. Employers are increasingly under pressure, both from within organizations and from recent government legislation and policy, to develop family-friendly policies to support informal carers in the workplace. Yet existing ‘family-friendly’ schemes and services are still primarily designed for working parents of young children and rarely address the needs of employees who care for older or disabled adults. This paper reports on a study which investigated how working carers and managers in two public sector organizations — a Social Services Department (SSD) and a National Health Service (NHS) Trust — combined their work and caring responsibilities. A multi-method approach was adopted consisting of five phases. First, a profile of the two organizations was established, followed by a short screening questionnaire to all employees to identify who was caring for an older adult over the age of 60. Third, a lengthier postal survey was sent to the 365 carers who had indicated a willingness to participate further. In the fourth and fifth phases, carers and managers were interviewed in depth about their experiences. This paper reports briefly on the survey, but then concentrates in particular on what was said in the interviews about what helps and hinders working carers of older adults. Despite the existence of policies to support carers, our findings suggest that these were far less important than informal support from colleagues and a sympathetic manager in the workplace. Commuting distance between work, home and the older person also posed difficulties for carers, along with inflexible schedules and work overload. Employers are urged to explore these issues further if they are serious about recruiting and retaining employees, and developing the work – life balance agenda to meet the needs of those caring for older and disabled adults.     

Story sharing: restoring the reciprocity of caring in long-term care

Residents in long-term care facilities often experience an interruption in the reciprocity of caring, inadvertently cut off when they enter the unfamiliar surroundings of a residential health care system. This transition from the give and take of caring to being completely cared for often leads to a breakdown of meaning, a loss of identity, and loneliness. This article addresses how an intervention called story sharing can restore the reciprocity of caring. Beginning with a review of the significance and functions of storytelling and listening, a specific story sharing intervention-the mutual sharing of everyday experiences among nurse aides and the nursing home residents for whom they care-is described. The theoretical and practice implications of story sharing are discussed.     

Living together again: families surviving Italian immigration policies

In this article we provide an understanding of the challenges that immigrants have to face to relocate their nuclear families abroad. We will show that immigrants are often forced to leave their dependent relatives behind for much longer than expected, and that, despite their efforts to maintain intimacy at distance, the transnational managing of remittances and care entails certain risks. Both the separation experienced and the living conditions that reunited members face in Italy can make reunification itself a very sensitive moment in the life-course of these families, since the process of adaptation to the receiving society leads relatives to reshape and renegotiate their respective family roles and responsibilities. We are going to highlight how the availability of extended ties can represent a concrete form of support for many immigrant couples and lone mothers both during the separation and in their struggle to reunite their relatives, as well as after the reunification has taken place.     

Immigration and the earnings of youth in the U.S.

"This article reports findings that have emerged from an effort made at statistically measuring the effects of immigration on the earnings of U.S.-born youth. The presence of immigrants arriving before 1965 has a positive impact on youth earnings. Recently arrived immigrants impact negatively, however. These results are consistent with recent findings that the skill level of immigrants arriving within the last two decades is lower relative to that of immigrants arriving earlier. The results also show that the negative effects diminish as the youth ages, reflecting skill acquisition and job mobility of the young worker into jobs less vulnerable to competition from immigrant workers."