Tensions between ‘consumerism’ in elderly care and the social rights of family carers: a German-Danish comparison

Birgit Pfau-Effinger,Ralf Och,Per H Jensen

doi:10.15845/njsr.v2i0.113

Birgit Pfau-Effinger, Ralf Och + Show 1 more

Open Access

https://doi.org/10.15845/njsr.v2i0.113

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Abstract

The focus of this article is on the effects of the strengthening of economic principles in the field of care that have taken place in many European welfare states since the 1990s, which are connected with new emphases on ‘choice', on the role of the market in the provision of elderly care, and on efficiency as a new main welfare value. As a central part of this development, the figure of the elderly person in need of care, who was interpreted before these changes as the client or patient, has been replaced by the figure of a ‘consumer' who makes ‘free choices'. In most countries the frail elderly can choose between offers by different providers of home care who compete on the care market and care performed by family members. The focus of this article is on the legal construction of the working conditions of the family care giver. It aims to give an answer to two different research questions: How do different welfare states legally construct the working conditions of caring family members and their relationship with the elderly ‘care consumers'? And to what degree does this cause tensions between the desire to care or not to care and actual care conditions and opportunities? In order to answer these questions, we compared the legal construction of the work situation of family care givers in Germany and Denmark, as well as the resulting effects on their relationship with the older relatives who receive care. The findings show that the degree to which ‘consumerism' in long-term care causes tensions in the situation of the caring family member and in the care relationship depends on the ways in which it is embedded in a family-care regime. In this regard, the tensions are clearly greater in the semi-formal family-care regime of Germany compared to the formal family-care regime in Denmark.      &nbsp

Highlights

The way social care is organized is crucial for the structuring of work in European welfare states
The findings show that the degree to which ‘consumerism’ in long-term care causes tensions in the situation of the caring family member and in the care relationship depends on the ways in which it is embedded in a family-care regime
A common trait of the welfare states of Germany and Denmark is that they construe old people in need of care as ‘consumers’ who have free choice in the care market

Summary

Introduction

The way social care is organized is crucial for the structuring of work in European welfare states. Members are included In part in the market competition, since the elderly person in need of care can chose paid family care instead of home care in many programmes for long-term care in European welfare states (Ungerson, 2004). The introduction of these new policies towards care has in part created substantial new tensions and contradictions in the care arrangements in European welfare states, because the new principles of care provision contradict in part other principles like the need for a high quality of care. Care work done by agencies on the basis of competition, as is allowed by the ‘Long-Term Care Insurance Act’, is strongly standardized and restricted to physical care activities, with the consequence that it often does not match the socially constructed expectations of care recipients and their relatives (Eichler & Pfau-Effinger, 2009)

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