Paid Care Services Research Articles

Shadow Labor in Care Services: Why Do South Korean Women Care Workers Work Such Long Hours and Get Paid So Little?

Abstract Korea is a country with extremely long working hours and severe gender inequality in the labor market. Based on twenty-nine in-depth interviews with Korean women care workers, this study investigates key mechanisms that reproduce unpaid and unrecognized shadow labor in paid care services. Accordingly, it argues that the presumption that it is mostly Korean men who suffer from working long hours is incorrect. Women workers work long hours, and they often do so without compensation for overtime. They also engage in labor that is not included in their original job description. The Korean labor market supplies an unlimited number of women for cheap labor in the care service sector, meaning the government can depend heavily on private organizations and businesses to meet increasing care needs among the population. Because women care workers could not specify an employer who is responsible for their wages and working conditions, they could not see themselves as employees with basic labor rights. Instead, they take the familiar roles of dutiful daughters and caring mothers, consenting to the very situation that makes them susceptible to severe wage penalties and unrecognized and unappreciated long working hours.

Measuring spatial availability of children for older adults with disability

BackgroundHaving an adult child living with or nearby may prevent parents with disability from moving to nursing homes and reduce the use of paid care services. Despite the profound implications for care resources and utilization among older adults, there is no measure summarizing the spatial availability of all adult children for an older adult. Our study aims to develop a holistic measure of adult children's spatial availability to assess potential family care resources for older adults with disability. MethodsData were obtained from the population-based, longitudinal study in the U.S., the Health and Retirement Study (HRS). We selected a nationally representative sample of older adults 55+ years with disability. Using multivariable two-part regression models, we developed a care-weighted child spatial availability for caregiving (CSAC) index, which summarizes the spatial dispersion of all adult children accounting for potential caregiving associated with distance. We also constructed a reference index of child spatial proximity (CSP) focusing only on spatial distance by employing Gaussian kernel weighting functions. ResultsCSAC index highlights the great importance of having an adult child in the same household (vs. nearby or far) for receiving care among older adults with disability, compared to the CSP index, showing relatively a gradual decline over the spatial distance. Both indices vary substantially by older adults’ sociodemographic attributes. ConclusionsThe holistic indices of adult child spatial availability will contribute to assessing care resources for older adults, albeit future development is needed to extend the utility of the indices tailored for specific care needs.

Care workers’ sense of responsibility, working conditions, and the quality of care in South Korea

As countries like South Korea expand their paid care services, ensuring quality care has become critical. Since care work involves significant emotional labor, a worker’s sense of responsibility for the care recipient's well-being affects the quality of care delivered. In this study, we explore this particular determinant of quality care that has been underexplored to better understand its nature. However, a worker's sense of responsibility or commitment level is not static and varies depending on various factors including working conditions. Using 2018 Korean childcare and eldercare survey data, we empirically examine the relationship between a worker's commitment levels and working conditions by conducting Tobit and generalized maximum entropy (GME) analyses. Results indicate that training, shorter commutes, predictable schedules, and easy interactions with the care recipient’s family are associated with higher levels of commitment. Our findings highlight the importance of supportive working conditions in promoting quality care.

Paid Care Services and Transitioning out of the Community Among Black and White Older Adults With Dementia.

Paid care provided in the home includes important support services for older adults with dementia such as cleaning and personal care assistance. By reducing unmet needs, these services could delay the transition to residential long-term care, but access may differ across racial groups. This study examined the relationship between paid care and transitioning out of the community among Black and White older adults with dementia. Using data from 303 participants (29.4% Black) with probable dementia in the 2011 National Health and Aging Trends Study, competing risk hazards models estimated the association between receiving paid care at baseline and the probability of transitioning out of the community over 8 years (through 2019). Covariate selection was guided by the Andersen model of health care utilization. Paid care was associated with lower risk of transitioning out of the community (subhazard ratios [SHR] = 0.70, 95% CI [0.50, 0.98]). This effect was similar after controlling for predisposing factors and most prominent after controlling for enabling and need for services factors (SHR = 0.65, 95% CI [0.44, 0.95]). There was no racial difference in the use of paid care despite evidence of greater care needs in Blacks. Furthermore, Black participants were less likely to transition out of the community than Whites. Paid care services may help delay transitions out of the community. Future research should seek to explain racial differences in access to and/or preferences for home-based, community-based, and residential care.

Erken çocukluk döneminde ailelerin evde ücretli bakım hizmetlerine yönelik talepleri

Bu araştırmada, ailelerin erken çocukluk eğitimi ve bakımı (EÇBE) döneminde evde ücretli bakım hizmetlerine yönelik talepleri üzerinde belirleyici olan nedenler ve bu süreçte karşılaşılan sorunların ortaya konulması amaçlanmıştır. Araştırma tarama modelinde betimsel bir çalışmadır. Araştırmanın çalışma grubunda 218 aile bulunmaktadır. Veriler araştırmacı tarafından geliştirilen anket yoluyla elde edilmiştir. Verilerin çözümlenmesinde betimsel istatistiklere başvurulmuştur. Ailelerin evde ücretli bakım hizmetlerine talepte bulunmalarındaki nedenlerin başında ebeveynlerin çalışıyor olması, çocuğa bakacak başka kimsenin bulunmaması ve çocuklarının yaşının küçük olması gelmektedir. Güvenilir olma bakıcılarda aranan öncelik bir özellik olarak öne çıkmaktadır. İşe alınacak bakıcıların tanıdık olması tercih edilmektedir. Evde ücretli bakım hizmeti alma sürecinde yaşanılan sorunların başında, bakıcıların zamanında işe gelmemesi yer almaktadır. EÇBE döneminde evde ücretli bakım hizmetinin arz boyutunu oluşturan bakıcı kadınlar üzerinden, onların bu süreçteki algı ve deneyimleri ortaya konulmasını içeren araştırmalar yapılması gerektiği düşünülmektedir.

IMPACT OF INFORMAL CARE, TRAVEL DISTANCE, AND STRESS ON RETIREMENT DECISION MAKING

AbstractEstablished literature informs us that caring for the elderly living over a distance can be a stressful for the caregivers. We add to this literature by showing the impact of distance on reported physical, emotional and financial stress levels, and further show that this distance can have a negative impact on the retirement decision-making of care providers. Using data from the Caregiving in the United States, 2015 survey conducted by the National Alliance for Caregiving and AARP Public Policy Institute, we find that increased distance between the care-giver and the recipient living outside the household significantly increased the burden of care-giving stress on the provider. This is especially significant for those over fifty years of age and providing care. However, those who are caring for elderly inside their household also report high stress levels.Our findings indicate that among women, those with parents residing within 20 minutes of travel are least likely to be stressed out emotionally and financially, and are less likely to report care-giving as a reason for retirement than those with parents living further away. The likelihood of early retirement among women seems to increase substantially with an increase in their travel-time to elderly care recipients and is negatively related to income levels, possibly due to improved access to transport and paid-care services.

유급 간병서비스 이용 영향요인에 관한 융복합적 연구: Andersen's Behavioral Model

현재 입원환자 및 환자 가족의 사적 고용으로 시행되는 유급 간병서비스 실태를 파악하고, 이를 이용하는데 영향을 미치는 요인을 확인하고자 함을 목적으로 한다. 본 연구는 한국의료패널 자료 (2011-2014)를 활용하였으며, 연간 1회 이상 입원서비스를 이용한 경험이 있는 5,110명을 연구대상으로 선정하였다. 본 연구의 자료처리 및 분석을 위해 STATA 12.0 SE를 활용하였으며, 입원환자들의 기본특징을 확인하기 위해 빈도분석을 수행하였으며, 특성에 따른 유급 간병서비스 이용 현황을 확인하기 위해 교차분석 및 t-test를 시행하였다. 마지막으로, 입원환자들의 유급 간병서비스 이용에 영향을 미치는 요인을 확인하기 위해 Andersen's Behavioral Model의 3 범주를 단계적으로 모형에 투입하는 위계적 로지스틱 회귀분석을 실시했다. 분석결과 유급 간병서비스 이용은 여성, 고연령, 장기입원 및 장애가 있을 경우에 더 많은 것으로 나타났다. 반면, 사적고용에서 중요한 가구소득 변수는 유의한 결과를 보이지 않았다. 이 연구결과는 현재 논의 중에 있는 간호간병통합서비스의 대상자 선정에 있어 기초자료로 활용될 것으로 기대된다. 또한, 향후 대상자 선정에 관한 세부적인 논의가 이루어질 필요가 있다. The purpose of this study is to identify the current state of paid care services and to identify the factors that affect the utilization of private nursing services. This study constructed and utilized the Korean Health Panel data (2011-2014) in the form of panel data, and selected 5,110 patients who had experience using one or more hospitalization services per year. STATA 12.0 SE was used for data processing and analysis of this study. Frequency analysis was performed to confirm basic characteristics of hospitalized patients. Cross-analysis and t-test were conducted to confirm the status of paid care services according to characteristics. Respectively. Finally, panel logistic regression was performed by applying a hierarchical method to stepwise modeling the three categories of Andersen's Behavioral Model to identify factors affecting the use of paid care services for inpatients. The results showed that the use of paid nursing services was higher in women, elderly, long - term hospitalized and disabled. On the other hand, significant household income variables in private employment did not show significant results. The results of this study are expected to be used as basic data for the selection of the nursing care integrated services under discussion. In addition, detailed discussions on the selection of subjects should be made in the future.

Social care and migration policy in Australia: Emerging intersections?

AbstractMigrants are important both as providers and users of paid care services in Australia, yet migration has rarely featured in Australian strategies to grow and sustain the paid care workforce. Correspondingly, Australia is rarely mentioned in the international scholarship on care and migration that has burgeoned since the 1990s. This article shows the ways that service providers, consumer advocates, unions and scholars have begun to bring migration into debates about workforce growth in two of Australia's most significant areas of paid care: aged care and childcare. Drawing on submissions to national enquiries in both areas, we identify the actors who have sought to adjust Australia's migration settings to respond to growing demand for care, and explain the rationales – which differ between the sectors – underlying their advocacy for change.

Characteristics of care-givers and care recipients influencing the impact of paid care services on family care-giver burdens

ABSTRACTIn the last few decades, a number of researchers have attempted to identify the effects of paid care services on alleviating the sense of burden of family care-givers, especially care-givers to people with dementia. However, few researchers have considered the possibility that paid care services alleviate the sense of burden only among those care-givers who possess specific characteristics. Without considering this point, the impact of paid care services would be averaged over an entire sample, and one might overlook the effects on these specific care-givers. With this background, this study examines the relationship between family care-givers' sense of burden and the amount of paid care services in Japan and identifies groups of care-givers among whom these services are significantly associated with a lesser sense of burden. The sense of burden of 339 family care-givers to older care recipients with dementia was measured using a modified version of the Caregiver Burden Inventory. In order to examine their association with the amount of paid care services received, logistic regression analysis was individually applied to groups of care-givers who exhibit specific characteristics. The results suggested that paid care services alleviated two out of five components of burden, provided the groups to which the analyses are applied are appropriately defined. In particular, two subsets of the entire sample, comprising young care-givers aged 49 or below, and including male care-givers, indicated that their overall sense of social and emotional burden were alleviated by the use of paid care services. The practical implications for policy makers are discussed.

Association between components of family caregivers’ sense of burden and types of paid care services provided in Japan

Objectives: The aim was to identify significant relationships between the 21 components of caregivers’ sense of burden in the Zarit Burden Interview and specific paid care services provided in Japan's long-term care insurance system. Method: We defined a service utilization level (SUL) that represents the amount of care services that caregivers were consuming. We calculated the ratios of people, among those with the same SUL value, whose sense of burden was weaker than a specific level. Finally, we conducted regression analysis and checked how this ratio varied compared to the change in SUL values. Results: For 12 among 22 components, the use of paid care services in general were significantly and linearly related with a smaller number of people having the strongest sense of burden. Several pairs of burden components and care service types were identified indicating that the type of care services effectively alleviated that burden component. Conclusions: (1) Paid care services do relieve caregivers’ sense of burden. (2) Measures to increase the ratio of people with the weakest sense of burden by encouraging the use of care services do not necessarily match those that decrease the ratio of people feeling the heaviest burden. (3) Policies that encourage caregivers to use more care services can be more effective if policy makers know which type of care service is related with a burden component.

Demanding Quality: Worker/Consumer Coalitions and “High Road” Strategies in the Care Sector

Paid care services such as child care, elder care, teaching, and nursing are vulnerable to competitive pressures that often generate low-pay/low-quality outcomes. Both workers and consumers suffer as a result. This article develops an economic analysis of the “care sector” that emphasizes the potential to build political coalitions that could push for a high-pay/high-quality alternative.

Offre de travail féminine et garde des jeunes enfants

Nous estimons un modèle de décision des mères de jeunes enfants en matière de recours à une garde extérieure payante et d ’ offre de travail (participation et heures de travail sous la forme mi-temps , 80 %, plein temps ), sur des données microéconomiques françaises . Nos résultats suggèrent que le coût de la garde influe sur le recours à une garde payante , mais peu sur la décision d ’ activité féminine . La suppression de l ’ APE (Allocation Parentale d ’ Éducation ) ferait augmenter le taux de recours à une garde payante de 2 points et le taux d ’ emploi féminin de 4 points , au sein des couples mariés avec au moins un enfant de moins de 3 ans . Le temps partiel féminin est fortement sensible aux incitations financières de l ’ APE . Mots-clés : offre de travail des femmes , garde des enfants , effets de politiques publiques