The right to care? Social citizenship and care poverty in developed welfare states

2022 ◽  
Vol ahead-of-print (ahead-of-print) ◽  
Author(s):  
Kirstein Rummery

PurposeThere are clear theoretical, policy and practice tensions in conceptualising social or long-term care as a “right”: an enforceable choice. The purpose of this article is to address the following questions: Do disabled and older citizens have the right to long-term care? What do these rights look like under different care regimes? Do citizens have the right or duty to *provide* long-term care? It is already known that both formal and informal care across all welfare contexts is mainly provided by women and that this has serious implications for gender equality.Design/methodology/approachIn this article, the author takes a conceptual approach to examining the comparative evidence from developed welfare states with formal long-term care provision and the different models of care, to challenge feminist care theory from the perspective of those living in care poverty (i.e. with insufficient access to long-term care and support to meet their citizenship rights).FindingsDrawing on her own comparative research on models of long-term and “personalised” care, the author finds that different models of state provision and different models of personalised care provide differential citizenship outcomes for carers and those needing care. The findings indicate that well-governed personalised long-term care provides the best outcomes in terms of balancing potentially conflicting citizenship claims and addressing care poverty.Originality/valueThe author develops new approaches to care theory based on citizenship and care poverty that have not been published elsewhere, drawing on models that she developed herself.

2020 ◽  
Vol 4 (Supplement_1) ◽  
pp. 711-712
Author(s):  
Katherine Ornstein ◽  
Jennifer Reckrey ◽  
Evan Bollens-Lund ◽  
Katelyn Ferreira ◽  
Mohammed Husain ◽  
...  

Abstract A large and growing population of older adults with multimorbidity, cognitive impairment, and functional disability live in the community but are homebound (never/rarely leave home). While homebound status is associated with decreased access to medical services and poor health outcomes, it is unclear how long individuals remain homebound. We used the National Health and Aging Trends Study (NHATS), a nationally representative sample of Medicare beneficiaries age 65 and over, with survey weighting to assess duration of homebound status in the community. Among the incident homebound in 2016 (n=253) , only 28% remained homebound after 1 year. 21% died, 18% were recovered, and one-third left the home but still reported difficulty. As the locus of long-term care shifts from nursing homes to the community and models of care expand to serve the needs of the homebound, it is critical that we better understand the heterogeneity and transitions of the homebound population.


2017 ◽  
Vol 37 (3/4) ◽  
pp. 134-147 ◽  
Author(s):  
Caroline Murphy ◽  
Thomas Turner

Purpose The undervaluing of care work, whether conducted informally or formally, has long been subject to debate. While much discussion, and indeed reform has centred on childcare, there is a growing need, particularly in countries with ageing populations, to examine how long-term care (LTC) work is valued. The purpose of this paper is to provide an overview of the way in which employment policies (female labour market participation, retirement age, and precarious work) and social policies (care entitlements and benefits/leave for carers) affect both informal carers and formal care workers in a liberal welfare state with a rapidly ageing population. Design/methodology/approach Drawing the adult worker model the authors use the existing literature on ageing care and employment to examine the approach of a liberal welfare state to care work focusing on both supports for informal carers and job quality in the formal care sector. Findings The research suggests that employment policies advocating increased labour participation, delaying retirement and treating informal care as a form of welfare are at odds with LTC strategies which encourage informal care. Furthermore, the latter policy acts to devalue formal care roles in an economic sense and potentially discourages workers from entering the formal care sector. Originality/value To date research investigating the interplay between employment and LTC policies has focused on either informal or formal care workers. In combining both aspects, we view informal and formal care workers as complementary, interdependent agents in the care process. This underlines the need to develop social policy regarding care and employment which encompasses the needs of each group concurrently.


2021 ◽  
Vol ahead-of-print (ahead-of-print) ◽  
Author(s):  
Marie Beaulieu ◽  
Julien Cadieux Genesse ◽  
Kevin St-Martin

Purpose Among the ten Canadian provinces, Quebec has experienced the most significant excess mortality of older persons during COVID-19. This practice paper aims to present the chronology of events leading to this excess mortality in long-term care facilities (LTCFs) and a comprehensive analysis of the phenomenon. Design/methodology/approach Documented content from three official sources: daily briefings by the Quebec Premier, a report from the Canadian Armed Forces and a report produced by Royal Society of Canada experts were analysed. Findings Two findings emerge: the lack of preparation in LTCFs and a critical shortage of staff. Indeed, the massive transfer of older persons from hospitals to LTCFs, combined with human resources management and a critical shortage of permanent staff before and during the crisis, generates unhealthy living conditions in LTCFs. Originality/value To our knowledge, this paper is the first to analyse official Quebec and Canadian statements concerning COVID-19 from the angle of quality of life and protection of older adults in LTCFs.


Author(s):  
Feliciano Villar ◽  
Rodrigo Serrat ◽  
Annette Bilfeldt ◽  
Joe Larragy

AbstractLiving in a long-term care (LTC) institution provides older people experiencing health and social problems with a comprehensive range of support services that address their quality of life. Despite access to such services, challenges arise in relation to their participation in key activities both within and outside the institution. This chapter examines such challenges, reviewing and describing ways to prevent exclusion along various domains, specifically social relationships, civic participation and socio-cultural life. Firstly, we discuss ways in which bio-medical models of care and the quality control systems, which are dominant in LTC services, standardise care, tending to put decisions exclusively in hands of staff, taking away residents’ autonomy, and ultimately curtailing rights and citizenship status. Secondly, we examine how LTC services might prevent such exclusion and promote older people’s participation in at least four respects: (1) prompting and supporting residents’ ability to take decisions on their own care, (2) favouring the maintenance and creation of social relationships, (3) enabling residents’ participation in the activities and management of the institution, and (4) guaranteeing residents’ rights and full access to citizenship. We discuss the impact and limitations of recent initiatives put into practice in these areas of practice.


Author(s):  
Kai Leichsenring ◽  
Jenny Billings ◽  
Henk Nies

2018 ◽  
Vol 2 (suppl_1) ◽  
pp. 396-396
Author(s):  
J Keefe ◽  
D Taylor ◽  
B Parker ◽  
L Tay ◽  
H Cook

2019 ◽  
Vol 37 (2) ◽  
pp. 565-578 ◽  
Author(s):  
Tsu-Wei Yu ◽  
Lu-Ming Tseng

PurposeThe purpose of this paper is to explore the role of commercial long-term care insurance (LTCI) in long-term care (LTC) services, and to elucidate the mediating roles of service quality and relationship satisfaction in the relationship between customization and loyalty. In addition, this study offers important recommendations for policy makers in formulating policy aimed at supporting the industry and regulating its customer relationships in life insurers in Taiwan.Design/methodology/approachStudy participants were policyholders of life insurance in Taiwan with experience in purchasing commercial LTCI. They were investigated through in-depth interviews and surveys. The hypotheses were tested using the structural equation modeling (SEM) analysis of variance.FindingsThe findings of this study are important for policy makers in formulating policy aimed at supporting the industry and regulating its customer relationships.Originality/valueThis study represents the first attempt to investigate the role of LTCI in LTC services in Taiwan. Likewise, this study improves our understanding of the main issues relating to the effect of customization on policyholder loyalty, and the partially mediating role of service quality and relationship satisfaction in the insurance marketing context.


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