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.     

Dependency and interdependency: the incomes of informal carers and the impact of social security

Consideration of the income and social security needs of informal carers has remained conspicuously absent from discussions about 'community care'. Similarly, carers have been more or less invisible in the development of social security policies. This paper reports on a study of the financial circumstances of a sample of working age carers, who were living with and providing substantial amounts of help and support to a disabled person in the same household. The study highlights first, the substantial work-related costs incurred by carers with full time employment; and second the financial dependency of carers without full time earnings, on their spouse, sibling or on the person being cared for. The implications of these findings are discussed in the light of recent developments in social security policies.     

Assessment as the Site of Power: A Bourdieusian Interrogation of Service User and Carer Involvement in the Assessments of Social Work Students

The centrality of service user and carer involvement in social work education in England is now well established, both in policy and practice. However, research evidence suggests their involvement in student assessments is underdeveloped and under researched. This study focused on the positioning of service users and carers in relation to other stakeholders involved in the assessments of social work students in England. Using narrative research methodology, 21 participants, including service users, carers, social work students, social work employers and social work educators, were offered a semi-structured individual interview. Participants’ narratives revealed different power relations among those involved in social work students’ assessments and a lack of confidence among service users and carers in making failed assessment recommendations. The paper concludes by arguing the case for social work educators and service user organisations to provide joint training to support service users and carers in their role as assessors of social work students.     

The intersection of employment and care: evidence from a UK case study

Working carers are a key focus of UK policies on health and social care and employment. Complementing national and European evidence, this paper presents a local case study of working carers. It draws on data from a county-wide survey containing a module on caring. Data were primarily categorical and were analysed using SPSS. Three quarters of all carers who responded to the survey were of working age: two thirds were employed and one third had been employed previously. The majority of working carers were mid-life extra-resident women. Over half of cared for relatives were elderly parents/in law; ‘physical illness’ was the primary cause of dependency. A tenth provided intensive care and half reported that caring adversely affected their health. Both were triggers for leaving employment. Two thirds of households received input from services and/or friends/family; being a co-resident carer appeared to mitigate against service allocation. Four issues were identified as pivotal to facilitating employment: access to advice and information, the availability of a matrix of affordable good-quality social-care services, ‘joined up’ needs assessment of the carer and cared for person, and employers identifying carers in their workforce. Europe's ageing profile underscores the study's timeliness.     

Does Returning to Work After Childbirth Affect Breastfeeding Practices?

This study examines the effect of the timing and intensity of returning to work after childbirth on the probability of initiating breastfeeding and the number of weeks of breastfeeding. Data come from the National Longitudinal Survey of Youth (NLSY79). Baseline probit models and family-level fixed effects models indicate that returning to work within 3 months is associated with a reduction in the probability that the mother will initiate breastfeeding by 16–18%. Among those mothers who initiate breastfeeding, returning to work within 3 months is associated with a reduction in the length of breastfeeding of 4–5 weeks. We find less consistent evidence that working at least 35 h per week (among mothers who return to work within 3 months) detracts from breastfeeding. Future research is needed on understanding how employers can design policies and workplaces that support breastfeeding.     

To work or to care? Working women's decision-making

Recent changes in older people's public care services in Nordic countries in particular in Finland and Sweden are based on implicit expectations that family members will increase their involvement in care. In Nordic countries, the care of small children has been acknowledged to be a social matter that concerns gender equality and the work life participation of both men and women, while the situation of working carers of older people is much less acknowledged. This study addressed the question of how Finnish working women who give care to their older parents argue for and against their decisions of working and caring and the meaning of work and care in these decisions. Majority of the interviewees emphasised the importance of work and refuted the idea of leaving work for care. The decision not to leave work for care was justified with worker identity, commitment to work, having no innate skills to be a carer, availability of support services and other carers and financial necessity. On the other hand, a few interviewees brought forward their willingness to leave work which was justified by constructing care as meaningful and valuable activity as opposed to meaningless paid employment, and with the intensification of work, and with ageing. Lengthy argumentation and several discursive tools indicate that women anticipated moral blame for the decision of giving work primacy over care, but also for leaving work. Thus, working carers balance between contrasting expectations to care and to work.     

Fragmented Sisters? The Implications of Flexible Working Policies for Professional Women's Workplace Relationships

Much is being done by governments and organizations to help workers reconcile their family and employment responsibilities. One such measure has been the introduction of flexible working policies. While academic and policy debates focus on the barriers to flexible working, less consideration is paid to those who work alongside flexible workers. Through a gendered lens, this article focuses on professional women and explores the implications of UK flexible working policies for women's workplace relations in organizations that have traditionally been based on male models of working. Drawing on interviews conducted in three English organizations, it was found that the women's interests did not always coincide and that their social relationships, with respect to flexible working, involved both support and resentment. In particular, the women's interests were affected by organizational and job‐related factors and their stage in the life course. These findings illuminate the ways in which policies are negotiated at the level of daily workplace life and show that co‐workers are a pivotal part of the wider picture of flexible working.     

What Helps Working Informal Caregivers? The Role of Workplace Characteristics in Balancing Work and Adult-Care Responsibilities

Population ageing and expected labour shortages mean that successful reconciliation of adult care and paid work is becoming a key issue for employers, employees and frail older people alike. Based on the detailed workplace-related variables in the fourth European Working Condition Survey, we examined differences in levels and determinants of carers’ and non-carers’ role conflict and one of its outcomes, absenteeism. We found caregivers to exhibit higher levels of perceived work–family conflict. Work schedules and time regimes affect carers’ and non-carers’ work–family conflict alike. However, good friends at work and work overload have a larger impact on carers’ work–family conflict. Furthermore, we found indications for a trade-off between perceived work-to-family conflict and absenteeism via workplace policies.     

Cash payments in context: (self-)regulation in the new social relations of assistance

Cash payments to meet social care needs offer the possibility for the direct employment of personal assistants using public funds. Empirical work internationally has identified the benefits of cash payments. However, there has been less interest in the relationships between employers and their employees. This article offers some reflections upon the employment relationship from the perspectives of employers who have learning difficulties and their personal assistants. The study involved eight employers, their supporters and their personal assistants in an English city. A grounded theory approach was utilised and interviews were analysed using a framework approach. This article argues that the relational aspects of direct employment arrangements have not been adequately considered in academic literature and the policy framework. These insights can add to debates around how social care support mechanisms can offer responsive assistance whilst questioning the assumed ‘empowering’ effect of an unregulated market.     

Promises and Pitfalls: Involving Service Users and Carers in Social Work Manager Education

Partnership working occupies an increasing amount of social work managers' time and budget, requiring skills and abilities not always developed previously within social work programmes. Much discussion around partnership working centres on building collaborative inter-agency and inter-professional relationships with less emphasis on the need to ensure good working relationships with service users and carers, despite their being the ultimate recipients of the process. This article explores efforts to develop a focus on service users and carers within a module for social work managers as part of post-qualifying (PQ) social work education. It documents a process where, initially, service users and carers provided personal testimonies of being recipients of services and then subsequently occupied more authoritative roles within teaching, to the current position when they are again less actively involved.

In describing these developments it explores possible reasons why involving service users and carers within this module has proved challenging. The article acknowledges that there is relatively limited literature about the involvement of service users and carers in PQ education. It suggests that lessons learned from involving service users and carers in qualifying social work training cannot directly be transposed to the post-qualifying context.     

A Hitchhiker's Guide to caring for an older person before and during coronavirus‐19

Coronavirus‐19 (COVID‐19) has reconfigured working lives with astonishing velocity. Older people have suffered the worst effects of the pandemic, with governments marginalizing or overlooking their needs. Women perform the majority of care for older people, often compromising their working lives and health. Yet in academic articles their voices are often filtered or aggregated in quantitative studies. Based on a weave of personal experiences and secondary research, the article traces a path through UK forms of care and shows how the inadequate response to COVID‐19 stemmed from existing policies embedded in health and social care. COVID‐19 has severed important informal care work, rendering the vulnerable yet more exposed and carers anxious and bereft. Longitudinal research capturing the trajectory of care from the perspective of older people and their carers would lead to improved support hence gender equality.     

Informal care and support for carers in Sweden: patterns of service receipt among informal caregivers and care recipients

This study describes and analyses the kinds of support received by different categories of informal carers, and the kinds of help that care recipients receive in addition to that provided by various categories of carers. Data were collected in a Swedish county in 2000, by means of telephone interviews. The net sample consisted of 2,697 individuals 18–84 years old, and the response rate was 61%. The results showed that relatively few carers in any care category received any kind of support aimed directly at them as carers. The most widespread form of support received by providers of personal care was relief services. Those most likely to be receiving care from the public care system were people also receiving personal care from an informal caregiver. Nevertheless, the majority of those receiving personal care from an informal carer did not receive any help from the public care system or from voluntary organizations or for-profit agencies. These results indicate that social policy and social work need to clarify the aims of the services they provide. They also need to take the needs of both caregivers and recipients into account when discussing support systems.     

Caring at a distance: Learning and practice issues

Emphasis on support for informal carers focuses on those who provide, in the words of the Carers (Recognition and Services) Act 1995, 'substantial' and 'regular' care. Following research and policy, professional education has also developed interest in those who live with the people they support, such as co-resident spouses and children of all ages. This article considers those who probably do not define themselves as carers and are usually referred to as 'relatives' or 'family', living at a distance from an older relative. It explores their possible need for support as well as the form and level of their involvement in relation to care managed services. It describes key areas or events to draw out practice issues and concludes with a discussion of the extent to which care management can work with such relatives. In many ways caring at a distance forces an examination of what is meant by 'care' and who can legitimately claim this as an emotion or status. The rationale for such interest is therefore three-fold. If social workers and social work educators restrict the meaning and their definitions of carers to those who provide 'hands on' services, as part of the care package, they risk alienating relatives from the learning experience of students. In doing so they may neglect these highly valued supports of older people and may leave relatives distressed and disempowered by anxiety over their contract with social work agencies.     

Families, work, and an aging population: developing a formula that works for the workers

This article examines the intersection of family caregiving, work, and long-term care. Supporting families who provide care in order to minimize negative work effects while enhancing the acceptability of care options is of common concern to employers, state and federal policymakers, and the homecare professionals in the community-based care system. The contribution of families to the long-term care system, how employer policies have developed, how the public policy agenda has addressed family caregiving, and the importance of a more effective partnership on the state level are discussed.     

The Role of Carers and Caseworkers in the School-to-work Transition of Young People in Care

Abstract

How young people in State care decide upon future careers, and the support offered for this process by carers and child protection caseworkers, has received little research attention. This qualitative study sought the views of young people in care, foster and kinship carers, and child protection caseworkers about career development for in-care youth. We found young people were thinking about career options but encountered a safety driven, acute casework approach, which sidelined education and work planning. Career development was not viewed as a caseworker responsibility, and, by default, was primarily developed by carers. The study highlights the need for a greater focus on the transition to adulthood and the inclusion of career development in policy and practice development.     

Families,Work, and an Aging Population

Abstract

This article examines the intersection of family caregiving, work, and long-term care. Supporting families who provide care in order to minimize negative work effects while enhancing the acceptability of care options is of common concern to employers, state and federal policymakers, and the homecare professionals in the community-based care system. The contribution of families to the long-term care system, how employer policies have developed, how the public policy agenda has addressed family caregiving, and the importance of a more effective partnership on the state level are discussed.     

One step forward? Advances and setbacks on the path toward gender equality in families and work

Men and women increasingly express egalitarian preferences for organizing family life, but workplace norms and practices are still based on relatively traditional assumptions about the gender division of labor in families. In this article, we unpack this discordant feature of the cultural landscape with recent sociological research on gender, work, and family. We begin by discussing the growing body of evidence on preferences for gender–egalitarian relationships and specify how these egalitarian desires are incongruous with workplace norms and practices. Such a mismatch between desires and reality tends to produce negative personal and career outcomes, including work–family conflict, stress, and job and marital dissatisfaction. Then, we offer a critical review of the recent actions taken by some employers and policymakers to address this issue. We observe some progressive changes in both the public and private sector in regard to family leave policies, flexible work arrangements, childcare support, and fertility benefits, but these policy initiatives still fall short of supporting gender–egalitarian arrangements for working families. We conclude with a discussion of how researchers could better evaluate and increase the effectiveness of workplace initiatives.     

Workplace support of fathers’ parental leave use in Norway

ABSTRACT

This article highlights the importance of social policy and working life contexts for employed fathers’ use of parental leave. It directs attention towards the Norwegian model, which is known for its gender equality aims and welfare-state support to families, but which is also active in the regulation of working life. Based on interviews with fathers who have used the father’s quota (a statutory, earmarked, non-transferable leave), findings run counter to work–family research where gendered assumptions in work organizations are found to prevent active fathering. The interviewed fathers report positive attitudes and supportive practices among employers. Fathers’ stories show that their use of the leave is subject to cooperation and compromising processes at the workplace level that research on fatherhood and organizations have hardly addressed.     

An Employment Project as a Route to Social Inclusion for People with Learning Difficulties?

Government policy to reduce social exclusion focuses on increasing employment opportunities and incentives, especially for disadvantaged groups. This paper discusses the findings of an evaluation of a project in the North West of England for people with learning difficulties, which sought to create opportunities for paid and/or integrated employment. The findings suggest that this goal can be undermined by many factors such as the isolation of social care services from employers and the disinclination of service organisations to include users, carers and staff in the development of new service approaches. Social welfare policies also mitigate against this aim, by failing to enable providers to translate the rhetoric of social inclusion into a reality. We discuss some of the obstacles preventing people with learning difficulties from inclusion into mainstream employment, by considering their impact upon the achievements of the North West project.     

Comparison of specialist and mainstream programs for older carers of adults with intellectual disability: Considerations for service development

Older carers of adults with intellectual disabilities experience unique challenges. Outreach initiatives identify a high number who are unknown to support services and a case is made to proactively engage them to assist in future planning for their adult children. An earlier study by the authors suggested that, in Victoria, specialist case management programs for older carers occupied a unique place within the service system. The present paper discusses a study that further explored the functions of specialist programs for this group through a comparsion with a mainstream disability case-management program. Few differences were found, although mainstream programs did not undertake outreach and community education functions. Models that build on the capacity of mainstream case management or carer support programs to work with older carers and target outreach more effectively are discussed.