Contextualising everyday ethics in social care work based on two case studies of Norwegian long-term care

Author(s):  
Karen Christensen ◽  
Mariya Bikova

The ageing population and long-term care policies of the Organisation for Economic Co-operation and Development countries have put pressure on social care work, creating patterns of difficult ethical situations. This article contributes to contextualising such situations by applying a ‘micro-ethics’ perspective and a theoretical framework that connects micro-ethics to macro-sociological contexts, and combines the concept of ‘moral distress’ (of healthcare professionals) with feminist ethics. Based on two case studies from an ethnographic study of Norway’s long-term care, findings demonstrate how ethically difficult moments connect with structural factors, including bureaucratic, managerialist and de-professionalised models of social care work, and new relationships between older people and their families.

2005 ◽  
Vol 48 (5) ◽  
pp. 643-653 ◽  
Author(s):  
Chris Holden

Internationalized providers of care services face competing incentives and pressures relating to profit and quality. Case studies of corporate providers of long-term care in the UK demonstrate that their mode of organization has important implications for both user choice and the organization of care work. French Les fournisseurs internationalisés sont soumis à des pressions et à des incitatifs concurrentiels pour produire des profits et de la qualité. Des études de cas portant sur les fournisseurs institutionnels d'assistance à long terme au Royaume-Uni révèlent que leur mode d'organisation a d'importantes répercussions tant au niveau du choix des bénéficiaires qu'au niveau de l'organisation du travail d'assistance. Spanish Los prestadores transnacionales de servicios se enfrentan con incentivos que compiten entre sí y con la tensión entre calidad y ganancia. Se estudian unoscasos de prestadores de cuidados de larga duración en el Reino Unido. Estos demuestran que el modo de organización tiene consecuencias importantes, tanto para opciones abiertas al usuario como para la organización de los cuidados.


2014 ◽  
Vol 33 (2) ◽  
pp. 177-192 ◽  
Author(s):  
Shereen Hussein ◽  
Jill Manthorpe ◽  
Mohamed Ismail

Purpose – The aim of this paper is to explore the effect of ethnicity and separate this from the other dynamics associated with migration among members of the long-term care workforce in England focusing on the nature and structure of their jobs. The analysis examines interactions between ethnicity, gender, and age, and their relations with “meso” factors related to job and organizational characteristics and “macro” level factors related to local area characteristics. Design/methodology/approach – The paper analyses new national workforce data, the National Minimum Data Set for Social Care (NMDS-SC), n=357,869. The paper employs descriptive statistical analysis and a set of logistic regression models. Findings – The results indicate that labour participation of British black and minority ethnic (BME) groups in long-term care work is much lower than previously believed. There are variations in nature of work and possibly job security by ethnicity. Research limitations/implications – While the national sample is large, the data were not purposively collected to examine differentials in reasons to work in the care sector by different ethnicity. Practical implications – The analysis highlights the potential to actively promote social care work among British BME groups to meet workforce shortages, especially at a time where immigration policies are restricting the recruitment of non-European Economic Area nationals. Originality/value – The analysis provides a unique insight into the participation of British BME workers in the long-term care sector, separate from that of migrant workers.


2020 ◽  
Vol 4 (Supplement_1) ◽  
pp. 575-575
Author(s):  
Pamela Saunders

Abstract Sociolinguistics and discourse analysis provide tools through which to examine how friendship is socially constructed through language and communication. Research on social isolation and loneliness reveals the importance of social interaction on the psychological and physical health of older adults. Given that linguistic, communicative, and functional abilities decline as dementia progresses, it is challenging to identify markers of friendship. The Friendship Project is an ethnographic study of social interaction among persons with dementia living in a long-term care setting. The data are from transcripts and field-notes of social interactions among residents with a range of cognitive impairments over a six-month time period. Results reveal that persons with dementia employ specific linguistic features such as narrative, evaluation, evidentials, and pronominal reference to make meaning and create relationships over time. Practical implications will be discussed.


Author(s):  
He Chen ◽  
Jing Ning

Abstract Long-term care insurance (LTCI) is one of the important institutional responses to the growing care needs of the ageing population. Although previous studies have evaluated the impacts of LTCI on health care utilization and expenditure in developed countries, whether such impacts exist in developing countries is unknown. The Chinese government has initiated policy experimentation on LTCI to cope with the growing and unmet need for aged care. Employing a quasi-experiment design, this study aims to examine the policy treatment effect of LTCI on health care utilization and out-of-pocket health expenditure in China. The Propensity Score Matching with Difference-in-difference approach was used to analyse the data obtained from four waves of China Health and Retirement Longitudinal Study (CHARLS). Our findings indicated that, in the aspect of health care utilization, the introduction of LTCI significantly reduced the number of outpatient visits by 0.322 times (p<0.05), the number of hospitalizations by 0.158 times (p<0.01), and the length of inpatient stay during last year by 1.441 days (p<0.01). In the aspect of out-of-pocket health expenditure, we found that LTCI significantly reduced the inpatient out-of-pocket health expenditure during last year by 533.47 yuan (p<0.01), but it did not exhibit an impact on the outpatient out-of-pocket health expenditure during last year. LTCI also had a significantly negative impact on the total out-of-pocket health expenditure by 512.56 yuan. These results are stable in the robustness tests. Considering the evident policy treatment effect of LTCI on health care utilization and out-of-pocket health expenditure, the expansion of LTCI could help reduce the needs for health care services and contain the increases in out-of-pocket health care expenditure in China.


2013 ◽  
Vol 14 (2) ◽  
pp. 343-375 ◽  
Author(s):  
Luigi Siciliani

Abstract Long-term care expenditure is expected to rise, driven by an ageing population. Given that public long-term care expenditure is high in many OECD countries, governments are increasingly concerned about its future growth. This study focuses on three relevant issues. First, we discuss factors that affect the growth of long-term expenditure and its projections. These include demographics, the balance in provision between informal and formal care, whether higher life expectancy translates into higher disability, the interrelation between health and long-term care, and whether long-term care suffers from Baumol’s disease. Second, given that a significant proportion of long-term care expenditure is nursing- and care-home expenditure, we discuss the role of government regulation aimed at ensuring that individuals receive appropriate quality of care in such institutions. We focus in particular on price regulation, competition, and the non-profit sector; these have been the subject of considerable empirical work (mainly in the United States). Third, we discuss the relative merits of public and private insurance. Countries differ greatly in their approach. Some countries have nearly exclusively public insurance but in others this is small. We consider the conditions under which public insurance can overcome the limitations of a private insurance market.


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.


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