Eldercare Responsibilities Research Articles

Responsibility for Child and Elderly Care: Who Should Cover the Costs? A Comparison of Baltic and Nordic Countries

AbstractBaltic and Nordic countries share historical and political connections as well as geographical proximity. Nevertheless, when their welfare regimes are compared, Baltic countries can be included in a post‐communist model that differs from the social‐democratic model of Nordic countries in many respects. This article focuses on one of these aspects, the opinion expressed towards the financial responsibility for the care of children and the elderly. In particular, childcare policies have been used to explain the development of a dual earner/dual career model in Nordic countries. Nevertheless, full‐time employment of women is widespread in Baltic countries too, although family policies and attitudes strongly differ from Nordic ones. Using data from the International Social Survey Programme (2012), we compare public attitudes towards who should cover the costs of caring in five Nordic countries (Finland, Sweden, Norway, Iceland and Denmark) and two Baltic ones (Latvia and Lithuania). We find remarkable differences between both groups of nations: citizens from Baltic countries consider the role of the family more important than their counterparts in Nordic countries. Results show Latvians holding the most familistic views in terms of covering costs, and Swedish people the least. Individual socio‐demographic variables are less important than national contexts in explaining these attitudes. We find important variations among the social‐democratic countries and, surprisingly, in the case of childcare, Sweden shows higher differences to Denmark than to Latvia and Lithuania. This finding suggests that the social‐democratic bloc in this respect is more heterogeneous than what is generally thought.

The welfare culture and the redesign of social elder-care in Finland

The welfare culture consists of doctrines and ideologies, beliefs, ideas, values and ideal norms that various groups and actors in the society have concerning the welfare state. The new ways of thinking, which are derived from the cultural turn and paradigm shift in social sciences, is in actual environments influenced and strengthened by economic and social changes, and also by the increasing number of old people. The Nordic welfare model (Denmark, Fin-land, Norway and Sweden), which is distinct from the other welfare models, is because of its basic ideological foundation, which also pertains to Finland, the general frame for the welfare culture. The characteristics of the environments in which people live, such as risks and uncertainties, impact thoughts and ideas they have about actual and preferred conditions, and influence the interest in renewal of welfare arrangements, schemes and services. Following this lead, we examine the changes in the legislation concerning social eldercare services and changes in provision and use of elder-care services in Finland. We also examine the division of responsibility for social eldercare between the public and private sector. Because the welfare arrangements are embedded in a complex cultural context, the research helps us to understand the shaping of the social eldercare. Great changes in the Finnish eldercare in favour of care at home or in a home-like environment have taken place. The goal “more home care, less institutional care” will serve even in the future as guidance in social eldercare.

The welfare culture and the redesign of social elder-care in Finland

The welfare culture consists of doctrines and ideologies, beliefs, ideas, values and ideal norms that various groups and actors in the society have concerning the welfare state. The new ways of thinking, which are derived from the cultural turn and paradigm shift in social sciences, is in actual environments influenced and strengthened by economic and social changes, and also by the increasing number of old people. The Nordic welfare model (Denmark, Fin-land, Norway and Sweden), which is distinct from the other welfare models, is because of its basic ideological foundation, which also pertains to Finland, the general frame for the welfare culture. The characteristics of the environments in which people live, such as risks and uncertainties, impact thoughts and ideas they have about actual and preferred conditions, and influence the interest in renewal of welfare arrangements, schemes and services. Following this lead, we examine the changes in the legislation concerning social eldercare services and changes in provision and use of elder-care services in Finland. We also examine the division of responsibility for social eldercare between the public and private sector. Because the welfare arrangements are embedded in a complex cultural context, the research helps us to understand the shaping of the social eldercare. Great changes in the Finnish eldercare in favour of care at home or in a home-like environment have taken place. The goal “more home care, less institutional care” will serve even in the future as guidance in social eldercare.

Conflicting views on elder care responsibility in Japan

I examine the attitudinal ambivalence created by conflicting social expectations regarding parent-child devotion, filial obligation and family membership, and gender norms in a national population of Japanese adults. I ask: in a context of rapidly changing family and elder care norms, how do different beliefs and attitudes overlap and conflict and how are they related to elder care preferences? I analyze data from the 2006 Japanese General Social Survey and use Latent Class Analysis to identify latent groups in the population defined by their beliefs and examine the relationship between class membership and elder care preferences. I found variation in the population with respect to the measured beliefs as well as a relationship between patterns of beliefs and choice of elder caregiver. I found conflicting expectations regarding elder care responsibility in one latent class and this class also expressed elder care preferences that conflict with at least some of their strongly held beliefs.

Elder Care, Multiple Role Involvement, and Well-Being Among Middle-Aged Men and Women in Japan.

Japan's population is aging at an unprecedented rate. Combined with the tradition of family responsibility for elder care, this rapid population aging has resulted in middle-aged Japanese people being much more likely today than in past decades to face the responsibility of caring for their elderly parents alongside their other major roles. Using nationally representative Japanese data, this study assessed the individual and combined implications of caregiving and other role involvements for the well-being of middle-aged men and women. Some evidence was found for deleterious psychological consequences of the caregiver role. However, in contrast to expectations, the interaction between the roles of caregiver and worker was positively associated with well-being among both men and women. The results suggest the importance of middle-aged adults being able to keep working when they have to care for their aging parents. Another important finding was significant gender differences in the psychological consequences of holding multiple family- and work-related roles and in combining these with the caregiver role. Further analysis showed that the spousal role was also negatively associated with depressive symptoms and positively associated with satisfaction for men but not for women. Gender differences in the findings appear to reflect the significant gender asymmetry in role experiences in Japan.

Employees’ eldercare responsibilities, workplace support, and occupational well-being

Employees’ eldercare responsibilities, workplace support, and occupational well-being

Attribution of Elderly Responsibility in Relation to Income in Qatar

This study investigated the attribution of kinship responsibility by drawing on attribution theory of locus and controllability. The analysis draws on the actor versus observer model using income as an intervening variable. A cluster sampling technique resulted in a sample of 935 respondents. Analysis of covariance using gender as a covariate resulted in non-significant main effects. An interaction effect was statistically significant in the high income group who supported the attribution of responsibility of the government and the low and middle income groups who supported their parents. Social actors were more inclined to provide an attribution of the responsibility for elderly care to the government, whereas high income individuals than those in the middle and low income group.

Intergenerational solidarity: An investigation of attitudes towards the responsibility for formal and informal elder care in Australia

This paper sets out to explore the Australian instance of a significant international problem: Intergenerational solidarity and the willingness of younger generations to support the future care of older people. It draws on Bengston’s intergenerational solidarity theory, in particular his conception of normative solidarity relative to filial obligations, to analyse data from the Australian Survey of Social Attitudes. This data demonstrates evidence of intergenerational solidarity at the policy level and a need for a continued role for government in the provision of residential care, insurance schemes, and the payment of income to full time and occasional carers. At the family level there is less support for the role of adult children in the payment of formal care or the provision of informal care. There is also a significant difference between men and women concerning the direct provision of informal care to ageing parents. Suggestions for future research are highlighted.

Who cares? UK lesbian caregivers in a heterosexual world

Women undertake most caring responsibilities for older family members and models of family caregiving implicitly position women carers as heterosexual-by-default. This UK-based study examined the impact of eldercare responsibility on the “outness,” socialisation, and personal relationships of seven lesbians (aged 48–62) who provided care to elderly relatives. The women were interviewed and the resulting transcripts were analysed using the method of constant comparative analysis yielding four themes: 1) duty and obligation, 2) loss of lesbian identity, 3) connections with lesbian communities, and 4) boundary setting. Lesbians incorporate elder caring into the framework of their lives in diverse ways, demonstrating “normative creativity” (Brown, 1989) in the absence of clear models of lesbian familial caregiving. These lesbians highlight new understandings of caregiving that wrestle with hegemonic discourses, and extend understanding of the normative creativity of lesbian lives to the domain of elder care.

Tug of War: Caring for Our Elders While Remaining Productive at Work

As countries around the world experience the graying of their populations, longer life expectancies mean greater possibility of illness and incapacitation. At the same time, demographic trends are altering the traditional arrangements for eldercare. Given that a high percentage of caregivers are employed outside the home, the tension between employment and caregiving responsibilities is likely to increase. However, the relationship between eldercare responsibilities and work outcomes is understudied, especially in the management literature, and the results are inconclusive. This article analyzes 31 empirical studies on the relationship between eldercare and work published in peer-reviewed academic journals since 1995. Although methodological limitations exist in the current literature, a number of noteworthy advances have been identified that have implications for future research directions and the ways in which organizations respond to the eldercare needs of their employees.

Informal Eldercare and Work-Related Strain

In light of an aging workforce, reconciling informal eldercare and paid work becomes increasingly pertinent. This article investigates the association between informal eldercare and work-related strain and tests for both the "competing demands" and "expansion" hypotheses. The sample of 938 Austrian employees consisted of employees caring for older relatives and a control group of employees without eldercare obligations. We ran a Tobit regression model on work-related strain with different measures of informal eldercare as explanatory variables and controls for both personal and workplace characteristics. Accounting for different characteristics of eldercare within one estimation model revealed that informal eldercare was associated with work-related strain in 2 ways, that is, it increased with both care hours and subjective care burden. However, after controlling for these burdensome attributes of eldercare, the carer status as such was found to be negatively associated with work-related strain. In addition and independently of care commitments, work-related factors, such as advanced skills and job motivation, reduced work-related strain. This article lends support to both the "competing demands" and the "expansion" hypotheses. Commitment to eldercare can enhance work-related outcomes but entails work-related problems if care burden and time demands of eldercare are substantial. Thus, workers with eldercare responsibilities cannot be considered less productive from the outset. An individual assessment of their situation, considering the care and work setting, is required. Findings from this study support the design of workplace initiatives to uphold workers' productivity in general and bring specific attention to policies alleviating workers' eldercare burden.

“DO I STAY OR DO I GO?”—JOB CHANGE AND LABOR MARKET EXIT INTENTIONS OF EMPLOYEES PROVIDING INFORMAL CARE TO OLDER ADULTS

This article examines whether providing informal eldercare to an older dependent person predicts employees' intentions to change jobs or exit the labor market and, if so, which particular aspects of both caregiving (e.g. time demands, physical/cognitive care burden) and their current work environment shape these intentions. We used data from a sample of 471 caring and 431 noncaring employees in Austria and split the analyses by gender. We found different aspects of informal caregiving to be associated with the intention to change jobs and with the anticipated labor market withdrawal of male and female workers. A time-based conflict between informal eldercare and paid work was significantly and positively related to the intended job change of female workers but not of their male counterparts. Flexible work arrangements were found to facilitate the attachment of female workers to their jobs and the labor market. Intentions to exit the labor market of male workers appeared to be triggered by a physical care burden rather than time demands. We studied the effects of providing informal eldercare on the turnover intention of men and women in a group of workers who were also the main carers providing support to a dependent older person with substantial care needs. The intention of male and female workers to change jobs and exit the labor market is shaped by the different characteristics of informal caregiving. Time-based conflicts between informal care and paid work are associated with a higher relative risk of anticipating job changes for female workers. Flextime facilitates the job and labor market attachment of female workers with eldercare responsibilities. The intensity of personal care provided to an older relative is significantly positively related to male workers' relative risk of anticipated labor market exit. Care to an older person in need of supervision makes the labor market exit of female workers less likely, lending thus support to the idea of the respite effect of work.

Elder care and the impact of caregiver strain on the health of employed caregivers

As the baby-boom generation moves towards middle age, and their parents toward old age, the number of employees who combine care for an elderly dependant and work will increase in number. These employees are "at risk" of experiencing caregiver strain. This paper advances our understanding of these trends by examining the relationship between caregiver strain and the health of employed caregivers. Our study involved the analysis of data from the 2001 Canadian National Work, Family and Lifestyle Study (N= 31,517). MANOVA was used to determine the relationship between caregiver strain and three situational factors: (1) gender; (2) where the care recipient lives compared to the caregiver; and, (3) family type. Regression was used to determine the relationship between caregiver strain and mental health. We found that caregiver strain depends on gender, family type and location of care. Emotional strain was a significant predictor of mental health. These findings support the need for organizations to expand their thinking around work-life balance to include employees who have eldercare responsibilities.

Flexicurity from the Individual’s Work-Life Balance Perspective: Coping with the Flaws in European Child- and Eldercare Provision

Based on a comparative analysis of work and care situations of employees with caring responsibilities in Finland, Portugal and the UK, this article argues that workers with eldercare responsibilities seem more likely to face difficulties than working parents, although many working parents also struggle to combine work and childrearing. The constraints such employees face in their daily lives due to caring responsibilities have significant implications for their flexibility and employability in the labour market — mainly because of inadequate care services and inflexible employers. However, such work—life balance constraints are rarely examined in most flexicurity studies and their effects on other forms of flexibility and security are therefore often overlooked. This article calls for a more nuanced concept of flexicurity, which takes the individual’s work—life balance perspective into consideration.

Caring for one's elders and family-to-work conflict.

The authors investigated whether workers caring for elderly family members reported the same types of family-to-work conflict (FTW) as did workers caring for their children. The authors also tested the validities of common FTW measures using a single sample that included elder- and childcare providers. Full-time employees (e.g., staff, faculty, administrators) of a large university were surveyed; 571 useable surveys were returned. Participants included those with elder- and childcare responsibilities (n = 16), childcare but not eldercare responsibilities (n = 177), eldercare but not childcare responsibilities (n = 41), and those with neither childcare nor eldercare responsibilities (n = 330). The mean age of participants was 46 years. Elder- and childcare providers each reported time- and strain-based conflict. Childcare providers reported higher levels of FTW than did nonchildcare providers across FTW measures in this study, supporting the measures' construct validities. The authors did not find differen...

Assuming Elder Care Responsibility: Am I a Caregiver?

Caregivers of the elderly face conflicting legal demands; they must make certain the elder's needs are being met while not forcing undesired care on an adult capable of informed decisions. This dichotomy may be a reason a large number of reported elder abuse derives from unintentional neglect on behalf of informal familial caregivers. The current research examines this possibility with exploratory interviews and an experiment. The interviews between elders and their family (30 dyads) revealed that many did not intend for the living arrangements to become permanent and the nonelders were largely unprepared for the magnitude of changes and responsibilities that would result. The elders often expressed a sense of loss for their former life and feeling supernumerary in the family. In the experiment, we examined whether a person recognizes when a care‐giving relationship exists and the factors that contribute to notions of being a caregiver. Results suggest that potential caregivers (124 community members) focus on the relationship with the elder more than the elder's physical and financial needs, and generally have stronger feelings of moral responsibility rather than legal responsibility to provide care.

Caregiving in Family Systems: Exploring the Potential for Systemic Therapies

Families in the U.S. face increasing responsibility for elder care. Our goal was to provide a preliminary examination of the relational needs of families caring for an elderly member with cognitive impairment such as Alzheimer’s or dementia, and to suggest how systemic therapists may serve this population. To bridge research and practice with lived experience, we compared the caregiving treatment literature with interviews of formal and informal caregivers. We conclude that systemic therapists are well situated to provide services that address the systemic concerns of caregiving families. Approximately 25% of U.S. households participate in some type of caregiving for adults over the age of 50, constituting 44.4 million caregivers (National Alliance for Caregiving [NAC] & American Association for Retired Persons [AARP], 2004). About 83% of these caregivers are providing care to a relative such as a spouse or parent (NAC & AARP, 2004). The growth in family caregiving has been associated with an aging U.S. population, longer life expectancies (Maples & Abney, 2006), reduced services provided by healthcare systems (Gibson, 2005), and reluctance to seek outside assistance (Adams, 2006). Although reasons for family caregiving are varied, many older adults who receive care from family members suffer from cognitive impairments (CI) such as dementia or Alzheimer’s (Biegel, Sales, & Schulz, 1991). Due to the stress associated with caring for a family member with CI, caregiver burden has been the

Assuming Elder Care Responsibility: Am I a Caregiver?

Assuming Elder Care Responsibility: Am I a Caregiver?

Workplace Practices for Retaining Older Hospital Nurses: Implications From a Study of Nurses With Eldercare Responsibilities

Attempts to address the nursing shortage must consider the aging nursing supply and the decreased labor participation among nurses at age 55 and older. Efforts to retain older, experienced nurses have been meager, and little attention is paid to the role of eldercare in decisions to leave the profession. This pilot study examines current workplace practices that may contribute to early withdrawal of older nurses from the hospital workforce. Interviews with 28 elder caregiving registered nurses and assistive nursing personnel at a New York hospital were conducted. Respondents reported that successful management of their dual roles rests on identifying units and shifts that suit their needs, erecting clear boundaries between home and work, and their love of nursing. "Caregiver-friendly" practices such as creative, flexible scheduling; access to social workers; financial and legal services; and increased awareness among managers about caregiver strains were recommended.

Ethical challenges related to elder care. High level decision-makers' experiences.

BackgroundFew empirical studies have been found that explore ethical challenges among persons in high public positions that are responsible for elder care. The aim of this paper was to illuminate the meaning of being in ethically difficult situations related to elder care as experienced by high level decision-makers.MethodsA phenomenological-hermeneutic method was used to analyse the eighteen interviews conducted with political and civil servant high level decision-makers at the municipality and county council level from two counties in Sweden. The participants worked at a planning and control as well as executive level and had both budget and quality of elder care responsibilities.ResultsBoth ethical dilemmas and the meaning of being in ethically difficult situations related to elder care were revealed. No differences were seen between the politicians and the civil servants. The ethical dilemmas mostly concerned dealings with extensive care needs and working with a limited budget. The dilemmas were associated with a lack of good care and a lack of agreement concerning care such as vulnerable patients in inappropriate care settings, weaknesses in medical support, dissimilar focuses between the caring systems, justness in the distribution of care and deficient information. Being in ethically difficult situations was challenging. Associated with them were experiences of being exposed, having to be strategic and living with feelings such as aloneness and loneliness, uncertainty, lack of confirmation, the risk of being threatened or becoming a scapegoat and difficult decision avoidance.ConclusionOur paper provides further insight into the ethical dilemmas and ethical challenges met by high level decision-makers', which is important since the overall responsibility for elder care that is also ethically defensible rests with them. They have power and their decisions affect many stakeholders in elder care. Our results can be used to stimulate discussions between high level decision-makers and health care professionals concerning ways of dealing with ethical issues and the necessity of structures that facilitate dealing with them. Even if the high level decision-makers have learned to live with the ethical challenges that confronted them, it was obvious that they were not free from feelings of uncertainty, frustration and loneliness. Vulnerability was revealed regarding themselves and others. Their feelings of failure indicated that they felt something was at stake for the older adults in elder care and for themselves as well, in that there was the risk that important needs would go unmet.