Managing Work and Care: A Difficult Challenge for Immigrant Families

This paper explores the strategies used by immigrant families to reconcile work and care for young children in Finland, France, Italy and Portugal. Drawing upon interviews with couples or lone parents who have children below age ten, it shows that immigrant families rely on a diversity of work/care strategies. These strategies include extensive delegation of care (mostly to formal or non‐familial informal care), negotiation of care within the nuclear family (both partners sharing the care responsibilities as well as older child care), mother‐centredness (mothers cutting back on working hours), child negligence (leaving children alone) and the superimposition of care upon work (taking children to work). Almost all immigrant families, but especially first‐generation ones, suffer from the absence of close kin networks to support childcare, strong pressure to work and from work (long or atypical hours) and various integration problems such as social isolation, lack of information on services, and problems with housing. However, our findings show that migration patterns, among other factors, have a significant impact on work/care strategies. Highly qualified “professional migration” is more associated with extensive paid delegation (often private and high‐cost), “marriage migration” with mother‐centredness, and “unskilled worker migration” with low‐cost solutions supplemented by workplace care, older child care and negligence. First‐generation unskilled worker migrant families are more exposed to occupational and residential segregation, atypical working hours, low earnings and difficulties in managing work and care for young children. Findings point to the still weak regulatory function of the different welfare states in the protection of these families.     

The experience of sole mothers balancing paid work with care for a child with a disability

There are increasing numbers of families in Australia headed by sole parents, but little is known about the experiences of those who also care for a child with a disability. Additional caring responsibilities have previously been shown to impact on the work participation of parents. This study involved qualitative analyses of interview data conducted with sole mothers with school‐aged children with disability (N = 11). Thematic analysis revealed four themes that enabled and supported participation in the workforce: social support; managing appointments; characteristics of the workplace; and the role of the school. Results suggest the importance of practical help from family and friends in facilitating participation in paid employment. Additionally, the importance of flexible appointment scheduling on the part of service providers was highlighted, as well as the importance of workplace flexibility and supportive workplace cultures. Such factors were important in supporting sole mothers to balance work with care, with important implications for personal and family wellbeing.     

Caregiving in Transition in Southern Europe: Neither Complete Altruists nor Free-riders

In the framework of the SOCCARE Project, focusing on families dealing with a double front of care for children and frail elderly people, similarities can be found in Italy, France and Portugal beyond their different welfare regimes. The comparison of family histories and caregiving strategies, by the methodology of case‐matching, gives an interesting overview of the relationship between the debate on social care and that on the intergenerational contract. The paper aims to understand which are the available combinations of family, informal and institutional resources making a heavy burden of care “acceptable and still normal”: this focuses both typical situations of each country and common features through the countries. The results show how changes in the representations of obligation and duty in the intergenerational pact produce different outcomes and demands in welfare systems. The analysis of shifting boundaries between the public and private spheres in care provides useful policy recommendations, aimed at improving choices and “sustainable” responsibilities of individuals, families and social networks. Sustainable policies seem to be more dependent on family and structural types and resources of networks than on different welfare and services support.     

Patterns of practice: An exploratory factor analysis of child and family social worker skills

There is relatively little research on the communication skills that social workers use in direct practice with families. This study explores patterns of practice skill found in child and family social work home visits. The study analysed 127 practice interactions in family homes, coding for seven dimensions of worker skill using a coding framework drawn from motivational interviewing. Exploratory factor analysis was employed to establish patterns of skill within the data and to group key dimensions of skill. The findings make two contributions. First, three fundamental dimensions of good practice emerged, which we characterize as care and engagement, good authority, and support for behaviour change. Second, in exploring the relationship between “care” and “control” elements of social work, skilled social workers were able to combine good authority and empathic engagement, whereas those who were less skilled in use of authority were also less good at engagement. This contributes to debates about care and control in social work. The usefulness of these dimensions for conceptualizing practice in child and family social work is discussed and directions for further research are suggested.     

Social Inequality under a New Social Contract: Long-term Care in Japan

The 1990s saw the beginning of new developments in the social policy agenda of Japan. A combination of further cuts in social expenditure and increases in financial resources through various means has become inevitable in response to the increasing cost burden of an ageing society, the prolonged recession and changes in the Japanese family. In this context, “kaigo hoken” (long‐term care insurance) was introduced in 2000 to increase revenue and fill the gap vacated by the family. The scheme introduced a different concept to the public: that long‐term care was no longer “expected’’ from the family or “allocated” by the state, but has become part of a “social contract” based upon a system of mandatory contributions, uniform entitlements and consumer choice. This paper first explores the role of the new scheme in creating social inequalities among individuals (and families). A panel survey is used to highlight different patterns of care provision and the varying degree of financial pressure among different income groups. Second, based on qualitative research, the paper examines how the new scheme has transformed the relationship between older people and their families who have played a central role in this arena. The scheme has consequently divided “traditional” families and their liberal counterparts, as a result of care work being “commodified”. It is apparent that this scheme has not only responded to fill the existing care gap but may also help accelerate the changes that have been taking place for the last two decades.     

Combining professional work with family responsibilities – a burden or a blessing?

This paper investigates job-related distress and satisfaction with the work--family interface in various combinations of professional work and family responsibilities in Sweden. The study is based on the self-reports of 1,764 male and female university graduates in paid employment and with children at home. For both women and men, conditions at work seem to be most important. However, the division of responsibilities between partners was also found to have an impact, but in different ways for women and men. Only in families where both partners are gainfully employed and share the domestic work and financial responsibilities, was the psychological well-being and the work--family interface satisfactory for both women and men. In other families, negative effects for either women or men are noticed. The conclusion is that multiple roles and shared responsibilities and demands in the private sphere promote health among both women and men.     

Women and the Family in the British Welfare State: The Thatcher/Major Legacy

This paper reviews the moral agenda of Thatcherism, in terms of maintaining traditional family structures, family roles and family responsibilities for economic support and personal care of family members. It asks to what extent and in what ways this agenda was promoted during the eighteen years of Conservative rule; to what extent contradictory forces within Thatcherism and elsewhere undermined this agenda; and what have been the consequences for women in family and public life. The marketization of life, pursued under Thatcherism, contributed to undermining the family form which has traditionally underpinned the market. Deregulated labour markets and spreading owner-occupation in an unstable housing market have been important contributions to family breakdown, insecurity and women's access to—and need for—jobs. The idea of family responsibility was promulgated, but in practice family members have become less able to support each other.
Nevertheless, one consequence of these changes has been a stronger position for women as women by the end of this Conservative era. Access to paid work makes women less dependent within families and improves their access to public politics. Social policies geared to the Beveridge-type family had become increasingly threadbare and some changes—such as policies enabling lone mothers to do paid work—had been forced by the increasing mismatch between family realities and the Beveridge model. Many changes owed more to the women's movement than to Thatcherism, but Thatcherite policies played a (largely unintentional) part.     

“Nothing goes as planned”: Practitioners reflect on matching children and foster families

Matching children with foster carers is an important step in every nonkinship family foster care placement. Although guidelines for matching are provided in several studies, the case‐specific context of the decision can influence the practitioners' ability to adhere to these guidelines. Therefore, this study answers the following question: “How does the case‐specific context influence the practitioners' decision‐making process regarding matching in family foster care?” Using a qualitative design, 20 semistructured interviews were conducted with practitioners matching children with foster families. Three themes emerged representing different layers of practitioners' everyday decision‐making: matching as planned, matching being tailored, and matching being compromised. The results show that exceptions are part of practitioners' daily work, either due to the belief that it might benefit those involved or because of obstacles presented during the decision‐making process. When the decision is compromised, matching practitioners lower their standards, while at the same time safeguarding the quality of the match. This proves that matching in practice is more than choosing a family, and guidelines are needed to determine what “good‐enough” matching should entail.     

New Labour, Work and the Family

New Labour has put support for the family at the core of its notion of the “strong community”. Across a range of policy areas the Labour government can be seen to be developing a direct and explicit family policy. But what kind of community is the government trying to shape by these policies? On the one hand, Labour appears to support the family as the basis of a more moral, dutiful and cohesive community. On the other hand, the government has given weight to policies that support social inclusion in the community through paid work. This paper examines whether there is a tension in Labour’s social policies between its emphasis on the importance of stable family life and the primacy given to paid work. Are critics like Ruth Levitas right when they argue that the government’s emphasis on paid work devalues, and is unsupportive of, unpaid work, especially caring for children and other family members? Alternatively, can this combination of communitarianisms—community as “stable family” and community as “paid work”—be seen to be marking out some “third way” on the family? We shall show that different aspects of the government’s family policies reflect different perspectives and policy agendas within New Labour and third‐way thinking more broadly. And while recognizing the tensions between work and the family, we shall suggest that they are often overstated and fail to give sufficient weight to the complementary aspects of Labour’s welfare reforms.     

The Public Policy of Motherhood

Parents seeking to balance their work lives with family responsibilities often find the challenge made more difficult by outdated images of the ideal worker, the good mother, and the good father. Social and legal constraints on mothers' choices exacerbate the problem. While other countries have implemented national work/family policies, the climate in the United States seems unreceptive to federal government mandates for meaningful changes in employees' work hours, schedules, and paid leave, or for sweeping new child care subsidies. As a viable interim measure, we propose a statute forbidding discrimination based on family responsibilities, which would tap deeply-felt values about the importance of family caregiving, serve as an important symbolic statement, and be useful to courts.     

Coaching Family Caregivers to Become Better Problem Solvers When Caring for Persons with Advanced Cancer

Family caregivers of persons with advanced cancer often take on responsibilities that present daunting and complex problems. Serious problems that go unresolved may be burdensome and result in negative outcomes for caregivers’ psychological and physical health and affect the quality of care delivered to the care recipients with cancer, especially at the end of life. Formal problem-solving training approaches have been developed over the past several decades to assist individuals with managing problems faced in daily life. Several of these problem-solving principles and techniques were incorporated into ENABLE (Educate, Nurture, Advise, Before Life End), an “early” palliative care telehealth intervention for individuals diagnosed with advanced cancer and their family caregivers. A hypothetical case resembling the situations of actual caregiver participants in ENABLE that exemplifies the complex problems that caregivers face is presented, followed by presentation of an overview of ENABLE’s problem-solving key principles, techniques, and steps in problem-solving support. Though more research is needed to formally test the use of problem-solving support in social work practice, social workers can easily incorporate these techniques into everyday practice.     

The Social Construction of Reality in the Realm of Children's Mental Health Services

ABSTRACT

Across the United States, systems of care have emerged to provide mental health care to children and their families; fragmentation inhibiting the success of collaboration by stakeholders is common and compromises these systems of care. Survey data were collected from 1,428 respondents in a Midwestern state to examine problems that exist within systems of care from the perspective of the different stakeholder groups. Stakeholder group membership was based upon the respondent's employment or involvement within various child-serving systems and included those in child welfare, juvenile justice, and education, mental health providers, and consumers (i.e., caregivers/parents). Group differences revealed patterns of “finger pointing” by the stakeholder groups on where specific problems exist within systems of care. The findings provide insight into how the social construction of service delivery and practice emerges as stakeholder groups describe, understand, and evaluate problems within the system of care as a function of their own practice location within the system of care. Future research should consider exploring methods that might minimize the competitive nature of disparate child-serving systems and its potentially negative impact upon system performance and treatment outcomes.     

Admission to Nursing Homes in Taiwan

The population of Taiwan is facing a radical ageing process. A proportion of the growing number of people aged 65 and over is expected to need nursing home care. This research concerns the family context of decision‐making in the process of admission to a nursing home in Taiwan. Employing survey data from interviews with elderly people in nursing homes (235 interviews) and their carers/key families (265 interviews), the factors affecting their views about admission were explored. Bivariate analysis and a logistic regression model were also used to examine perceptions of alternatives to nursing home care among family members with elderly relatives in nursing homes. Most elderly people in Taiwan are cared for in their own homes by their families but, in some circumstances, entry to a nursing home seemed inevitable. This research found that the decisions were taken mainly within a family context. The adult children of the elderly people, carers/key families’ preferences and the availability of carers influenced the decision. Apart from the important need factors of elders, families’ views about alternatives to nursing homes were significantly influenced by their preferences. This study has important implications for long‐term care in Taiwan. It is hoped that this will be needs‐led, both by elderly people and their families.     

Calling the Question of “Possible Dying” Among Nursing Home Residents

Abstract

Glaser and Strauss reported decades ago that in order for a person to be treated as dying, he/she must be defined as dying. Defining nursing home residents as “dying” can be complicated because most residents are in advanced old age with multiple chronic conditions. Using a social construction theoretical framework, this study looks at the step before the declaration of dying, that is, the consideration of the possibility of dying. This qualitative study is a secondary analysis of prospective data collected during 16 months of fieldwork on behalf of 45 nursing home residents whose health was considered declining. The purpose of this paper is to build understanding about the social construction of “possible dying” by reporting triggers that can call the question of possible dying and stimulate a discussion about the nursing home resident's status, prognosis, care options, and preferences. These triggers include: Health status decline; noncompliance with diet or medications; available medical interventions not being well suited for the residents; and family consideration of an out-of-town trip. The paper also reports barriers (family, staff, and disease process) and facilitators to calling the question of possible dying, including families having a sense of treatments they would like to avoid and having the opportunity to talk through options. Findings are discussed in light of basic assumptions of social construction. Implications for social workers include helping residents, families, and staff anticipate and address the possibility of dying, and to reflect these discussion in care plans, as well as the need to be available to help residents and family members with psychosocial issues related to living and dying in the nursing home setting, including the profound issues that can be provoked or exacerbated by resident health status decline and possible dying.     

The vicious layering of multilevel governance in Southern Europe: The case of elderly care in Italy and Spain

Aging and changes in family arrangements and female employment have brought about important policy developments in long‐term care (LTC). Southern European countries have relied for a long time on family care and residual social care for the dependent elderly. Two paradigmatic cases, Italy and Spain, have shown two apparently different trends during the last 15 years: while in Italy, reforms seem to have been persistently blocked, in Spain, an ambitious reform has fallen short of expectations. Based on data on services and institutional arrangements, the article shows that a complex and inconsistent allocation of responsibilities across government levels, a sort of “vicious layering” of multilevel governance, may be playing a key role in this situation. The article discusses the dysfunctional effects of such arrangements, namely territorial inequalities, cost‐shifting between government levels and towards users, and misallocation of resources. We suggest that the development and reform of LTC in Southern European countries must address these problems if they want to avoid getting marooned by a complex network of vetoes and resource allocation problems.     

The Family Group Within the Nursing Home:

An ongoing monthly family group was implemented in an intermediate care facility in hopes of improving communication between staff and families of long term care residents. Other objectives of the group were to provide families with information about policies and procedures, education about the aging process, and to facilitate an informal support group network where families could share problems and concerns. The feedback and evaluation process indicated that sharing feelings of anger, quiet, frustration and other emotions helped the families deal with the responsibilities of institutionalizing a relative and helped to facilitate better communication between staff and family members.     

Work and Care Strategies of European Families: Similarities or National Differences?

This paper examines the work and care strategies chosen by full‐time working families with children in Finland, Italy, Portugal and the UK. It asks whether European families in different countries, facing the same problems of balancing employment and childcare responsibilities, respond to their situations in similar ways. An increase in dual‐earner families where both parents work full‐time represents a general employment trend in today's Europe. Also, within families with children, such employment patterns are now more common than they were previously. National differences may therefore not any longer be as marked as often indicated by country‐based surveys. The qualitative data from the SOCCARE Project offer a way to examine this issue. The focal point of the paper is to make a comparative analysis of couples in similar work and care situations. Using their working hours as the common denominator, this paper analyses their daily childcare arrangements and how these are impacted by gender roles, working schedules, flexibility of workplace, income levels, parents’ educational background and availability of care facilities. The paper concludes that European families’ work and care strategies have many similarities whereby national differences may not be as marked as often indicated by contemporary research.     

Social work with middle‐class Spanish families: The challenge of the work–family conflict

In the current economic crisis, middle‐class families often find themselves immersed in a process of downward social mobility. These are families in which both spouses work, and where many relational conflicts begin in the sphere of work–family reconciliation and the allocation of household responsibilities. This article presents the results of a research study we conducted on middle‐class families in Spain. We focus specifically on the problems associated with work–family reconciliation and gender, and the mitigating role played by social support. Based on our results, we want to call the attention to a prevalent and ‘new’ conflict in family‐based practice social work in Spain: the work–family conflict.     

"Never right, never wrong": child welfare and social work in England and Sweden

When are parents “unfit” to care for their own children? As in many other countries, social workers in England and Sweden have the unenviable task of forming such judgments. On behalf of society at large, social workers must balance the rights of parents to provide continuing care with the responsibilities of the state in ensuring adequate care of children. They are involved in professional judgments which are also inherently political. In both England and Sweden social workers are able to seek legal orders which, if granted, permit compulsory removal of children against the wishes of parents. In such cases social workers are centrally involved in processes which remove ordinary rights of citizenship from their fellow members of society. The rights of parents and children, together with the responsibilities of the state to each class of citizen, are clearly in focus: intervention in family life requires both grounds and legitimation. But what is the basis of intervention in the two societies? Social work practices in Sweden and England suggest very different answers to this question. In explaining these differences it is necessary to address much broader variations of social and political culture in the two societies. In so doing, variations in social work practice can be located in different cultural values and systems of legitimation. Instabilities and pathologies of professional practices can also be identified within both England and Sweden. These too are quite different in the two societies.     

再论清代皇室之乳保

清代皇室乳母、保母属宫廷仆妇群体，是宫廷女性的重要组成部分。从性别视角再研究清代皇室之乳保，详细辨析乳母、保母称谓及职责的不同；阐释了皇室乳保与皇子女之间存在的稳固的亲情关系和伦理关系，以及由此形成的乳保群体在宫廷中身份地位的特殊性。她们充分利用这种特殊身份，突破自身的性别和阶级局限，提升其在家庭中的地位，发展起以女性为核心的家族体系。在为自己家族带来“特权”的同时，乳保群体也对清代皇族的家事和国事产生一定影响。