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

2011 ◽  
Vol 2 ◽  
Author(s):  
Birgit Pfau-Effinger ◽  
Ralf Och ◽  
Per H. Jensen

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figure of the elderly person in need of care, who was interpreted before these changes as the client or patient, has been replaced by the figure of a ‘consumer' who makes ‘free choices'.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.       

2011 ◽  
Vol 6 (1) ◽  
pp. 104
Author(s):  
Patrícia Peres Oliveira ◽  
Priscilla Sete de Carvalho Onofre ◽  
Paula Bertone Norberto

ABSTRACT Objective: to know the feelings of elderly people living in a long term care institution (ILP) with regard to the death of friends and relatives. Methodology: this is a descriptive and exploratory research with a qualitative approach, using the oral history method through two guiding questions: “Have you ever experienced the death of a friend, relative, or even some close colleague living in this institution? “and” How you face this situation?”. The data collection was carried out by means of recorded interviews, with the signing of Free and Informed Consent Term, help between January and March 2010, with twenty elderly people, from both sexes, aged between 72 and 89 years, living in an institution for elderly care in Sao Paulo city, as approved by the Research Ethics Committee of Universidade Paulista under CAAE 5380.0.000.251/09, obtaining a favorable opinion, under the Protocol 715/09. Results: from analyzing the interviews, four thematic focuses emerged: loss due to withdrawal from family relationships, new friendships, the existence after the death of friends and relatives, reflections on the possibility of one’s own death. Conclusions: it was possible to understand that the death of beloved people brings the elderly person closer to her/his own mortality, turning the grieving process more difficult, but separation is much more difficult to be interpreted because it is the loss of living persons. Therefore, it is essential that the health professionals and caregivers give support to the elderly people in their process of facing the suffering experienced. Descriptors: geriatric nursing; death; qualitative research. RESUMO Objetivo: conhecer os sentimentos dos idosos residentes em uma instituição de longa permanência (ILP) em relação à morte de amigos e familiares. Metodologia: trata-se de pesquisa descritiva e exploratória com abordagem qualitativa, utilizando o método da história oral a partir de duas questões norteadoras: “O senhor já vivenciou a morte de algum amigo, parente ou mesmo algum colega mais próximo residente nesta instituição? “e” “Como foi para o senhor enfrentar essa situação?” A coleta de dados foi realizada por meio de entrevistas gravadas, com assinatura de Termo de Consentimento Livre e Esclarecido, realizadas entre janeiro e março de 2010, com vinte idosos, de ambos os sexos, com idade entre 72 anos e 89 anos, residentes em uma instituição para idosos da cidade de São Paulo, conforme aprovação do Comitê de Ética em Pesquisa da Universidade Paulista sob o CAAE n. 5380.0.000.251/09, tendo obtido parecer favorável, sob o Protocolo nº 715/09. Resultados: a partir das análises das entrevistas emergiram quatro focos temáticos: a perda pela separação do convívio familiar, novas amizades, a existência após a morte dos amigos e familiares, reflexões sobre a possibilidade da própria morte. Conclusões: foi possível compreender que a morte de pessoas queridas aproxima o idoso de sua própria mortalidade, dificultando o processo de luto, mas a separação é muito mais difícil de ser interpretada por ser a perda de pessoas vivas. Portanto é fundamental que os profissionais de saúde e cuidadores deem suporte aos idosos em seu processo de enfrentamento do sofrimento vivenciado. Descritores: enfermagem geriátrica; morte; pesquisa qualitativa. RESUMEN Objetivo: conocer los sentimientos de los ancianos residentes en una institución de larga permanencia (ILP) en relación a la muerte de amigos y familiares. Metodología: esta es una investigación descriptiva y exploratoria con abordaje cualitativo, utilizando el método de la  historia oral, desde das preguntas orientadoras: “¿Usted ya vivenció la muerte de algún amigo, pariente o mismo algún colega más cercano residente en esta institución? “e” ¿Cómo fue para usted hacer frente a esa situación?”. La recogida de datos se realizó por medio de entrevistas grabadas, con firma de Término de Consentimiento Libre Y Esclarecido, realizadas entre enero y marzo de 2010, con veinte ancianos, de ambos sexos, con edades entre 72 y 89 años, residentes en una institución para ancianos en la ciudad de São Paulo, conforme aprobación del Comité de Ética en Investigación de la Universidade Paulista bajo el CAAE 5380.0.000.251/09, teniendo obtenido opinión favorable, bajo el Protocolo 715/09. Resultados: desde los análisis de las entrevistas surgieron cuatro focos temáticos: la pérdida por separación del convivio familiar, nuevas amistades, la existencia después de la muerte de amigos y familiares, reflexiones acerca de la posibilidad de la propia muerte. Conclusiones: fue posible comprender que la muerte de personas queridas aproxima el anciano de su propia mortalidad, dificultando el proceso de luto, pero la separación es mucho más difícil de ser interpretada por ser la pérdida de personas vivas. Por lo tanto, es fundamental que los profesionales de la salud y los cuidadores den soporte a los ancianos en su proceso de enfrentamiento del sufrimiento vivenciado. Descriptores: enfermería geriátrica; muerte; investigación cualitativa.


2020 ◽  
Vol 30 (Supplement_5) ◽  
Author(s):  
H Vinarski ◽  
D Halperin

Abstract An aging population, attended by an increase in chronic diseases and disability, together with decrements in health among the elderly, require considerable health care resources being expended on long-term care needs in the home environment at the community level. Increase in life expectancy, and more substantially, the disproportionate increment within the very oldest age groups and in the number of elderly whose activities are limited by some sort of physical or cognitive disability have significantly increased family care needs. Such demographic shift and socioeconomic changes throughout the developed world are making elderly care an increasingly important public policy issue. Particularly, one of the principal foci of policy makers should be supporting and nurturing family care. This paper focuses on the case of Israel. Like many industrialized countries, Israel faces the challenge of caring for a growing number of vulnerable older people while advancing adequate policies to support both elderly and their informal caregivers. Currently, the demands for family caregivers has increased drastically, and, studies predict that the personal, social, and economic costs of caregiving, which have risen dramatically over the last three decades, will only continue to increase. This paper focuses on the extent to which current legislation supports primary informal caregivers in Israel. A review of the legislation and benefits has indicated that the aid supplied is limited mainly because their application is relevant only in extreme cases where the elderly need constant supervision or care in institutions. Their contribution to most elderly and their families is only partial. The rights afforded to the informal caregivers are relatively few, are limited and are all concentrated in the domain of occupational support, and this also in a restricted manner. Key message Family caregiving in an aging society: Key policy questions.


2018 ◽  
Vol 28 (2) ◽  
pp. 571-574
Author(s):  
Ivanka Stambolova ◽  
Stefan Stambolov

In outpatient care the home care, including hospices, is recognized as a model for providing quality, cost-effective and charitable care. The focus is mainly on the care that helps everyday lifeof the patient as well as the relatives, rather than on treatment, and in most cases it takes place in the patients' home. In Europe, in recent years there has been a real "boom" in home care due to demographic processes linked to increased needs for elderly care and chronically ill under the conditions of limited financial resources.In outpatient medical care in our country by means of a national framework contract there are regulated visits to the patient's home by a doctor, as well as visits by medical staff employed by him - nurse, midwife, medical assistant / paramedic / for manipulation, counseling and monitoring. At the same time there is no regulated legal activity in the Republic of Bulgaria, which is essentially the subject of home care.Since 1994 „Caritas“ has carried out the "Home Care" service, which provides a complex - health and social care for over 360 sick adults in a place where the elderly person feels the most comfortable - in their own home. „Caritas Home Care“ is provided by mobile teams of nurses and social assistants who visit the elderly at home and provide them with the necessary care according to their health and social needs.With the establishment of the first „Home Care Center“ in Lozenets region, Sofia, with the support of the PHARE ACCESS program in 2003, the Bulgarian Red Cross introduces in Bulgaria an integrated model for provision of health care and social services in the home of adults, chronically ill and people with permanent disabilities. To date, there are a number of problems in home care related to the realization of home care for patients in need in out-of-hospital settings: lack of legal regulation for home care, lack of qualified staff in outpatient care; lack of organization and structures for care; unsettled funding and the inability of the part of the population that is most in need of care to pay for it, there is no regulation to control the activity. Although home care began over 20 years ago, our country is yet to make its way to the European program called „Home care in Europe“.


2019 ◽  
Vol 2 (2) ◽  
pp. 146
Author(s):  
Mohd. Suhaimi Mohamad

<div class="WordSection1"><p><em>In many traditional societies, women play an important role  as informal caregiver. They take care of small children, family members who are disabled, old and frail.  They perform their role within the private family sphere without much complaints. However when many women enter labour force outside their family many of them can no longer become family care giver. The  seperation between nuclear familes and extended families due to rural urban migration makes older women like mothers and mothers in-law can no longer available to provide help. As an alternative, many urban families opt for domestic help to look after their young children, disabled family members and the elderly.  Domestic helpers continue their domestic chores as instructed by the lady of the house an at the same time perform caregiving role. The important issue  related to having domestic maid to perform care giving role especially in Muslim family is regarding physical contact.  Most of the activities in caregiving roles involves physical contact especially during cleaning patients body, changing their clothes, prepare their bed, feeding them, holding their hands and body for therapy. However Islamic paractice do not allow physical contact like touching between two people who are not close family relations or mahram.  Since most of domestic maid who also perform the role as caregiver are women, therefore the issue of empowering men to become caregiver is very important  because the needs of male caregivers to care for male patients is increasing. Based onwhat is stated in the Quran and hadith and related documents, this paper will outline the need for informal care in families and communities that need to be addressed, particularly those who are Syariah-compliant. Cases from research in the relevant field will be presented to highlight the issues why men should be encourage to consider role as informal caregivers.</em><em></em></p><p>Dalam banyak masyarakat tradisional, perempuan memainkan peran penting sebagai pengasuh informal. Mereka merawat anak-anak kecil, anggota keluarga yang cacat, tua dan lemah. Mereka melakukan peran mereka dalam ruang keluarga pribadi tanpa banyak keluhan. Namun ketika banyak perempuan memasuki angkatan kerja di luar keluarga mereka, banyak dari mereka tidak bisa lagi menjadi pemberi perawatan keluarga. Pemisahan antara keluarga inti nuklir dan keluarga besar karena migrasi perkotaan pedesaan membuat perempuan yang lebih tua seperti ibu dan ibu mertua tidak lagi dapat menyediakan bantuan. Sebagai alternatif, banyak keluarga perkotaan memilih bantuan rumah tangga untuk menjaga anak-anak mereka, anggota keluarga yang cacat dan orang tua. Pembantu rumah tangga melanjutkan pekerjaan rumah tangga mereka seperti yang diperintahkan oleh nyonya rumah dan pada saat yang sama melakukan peran pengasuhan. Masalah penting terkait dengan memiliki pembantu rumah tangga untuk melakukan peran memberi perawatan terutama dalam keluarga Muslim adalah tentang kontak fisik. Sebagian besar kegiatan dalam peran pengasuhan melibatkan kontak fisik terutama selama membersihkan tubuh pasien, mengganti pakaian, menyiapkan tempat tidur, memberi makan, memegang tangan dan tubuh untuk terapi. Namun paraktek Islam tidak mengizinkan kontak fisik seperti menyentuh antara dua orang yang tidak memiliki hubungan keluarga atau mahram. Karena sebagian besar pembantu rumah tangga yang juga berperan sebagai pengasuh adalah perempuan, maka masalah pemberdayaan laki-laki untuk menjadi pengasuh sangat penting karena kebutuhan pengasuh laki-laki untuk merawat pasien laki-laki semakin meningkat. Berdasarkan apa yang dinyatakan dalam Al-Quran dan hadits dan dokumen terkait, makalah ini akan menguraikan kebutuhan untuk perawatan informal dalam keluarga dan masyarakat yang perlu ditangani, terutama mereka yang mematuhi Syariah. Kasus-kasus dari penelitian di bidang yang relevan akan disajikan untuk menyoroti masalah mengapa laki-laki harus didorong untuk mempertimbangkan peran sebagai pengasuh informal.</p></div><p align="left"> <strong><em>Keywords:</em></strong><em> gender, informal care giver, care giving, family.</em></p>


1988 ◽  
Vol 69 (8) ◽  
pp. 518-524 ◽  
Author(s):  
Beth Burstein

Elderly people often reject help despite their apparent suffering. Family members may react to a client's pain or deterioration by imposing change on the elderly person. The author discusses the causes for these phenomena and suggests treatment techniques.


2002 ◽  
Vol 54 (3) ◽  
pp. 205-231 ◽  
Author(s):  
Joseph E. Gaugler ◽  
Robert L. Kane ◽  
Rosalie A. Kane

Family care of the elderly is key to the long-term care system, and its importance has led to an abundance of research over the past two decades. Several methodological and substantive issues, if addressed, could create even more targeted and interpretable research. The present review critically examines methodological topics (i.e., definitions of family caregiving, measurement of caregiving inputs) and conceptual issues (i.e., family involvement in long-term residential settings, and the care receiver's perspective on care) that have received insufficient attention in the caregiving literature. Throughout this review recommendations are offered to improve these areas and advance the state of the art.


2020 ◽  
Vol 17 (7) ◽  
pp. 3032-3035
Author(s):  
Rihmaningtyas ◽  
Elida Ulfiana ◽  
Sylvia Dwi Wahyuni

Elderly with frailty syndrome experience a disturbance on physical condition, psychology, social, and financial of the family caregivers. This is due to the long-term care. The nurture will be hampered if the burden is not well handled. This study aims to determine the effect of psychoeducation on families who provide care to the elderly with frailty syndrome. Useable design is a non-experimental one group pre post-test. The number of samples is 15 respondents who provide care to family members who have frailty syndrome. Psychoeducation is given five sessions in three meetings. Lastly, one extra meeting for re-measuring the caregiver burden after intervention. The results of pre-test level of caregiver burden before intervention was 20% severe and 80% moderate. After the intervention, the results changed into the 53.3% average and 46.7% mild. Statistical analysis showed p = 0.001 (significance p < 0.05) on the impact of caregiver burden and psychological impact as much as 53%, physical 27%, social 12% and economic 8%. Psychoeducation affects the level of caregiver burden on caregivers who nurture the elderly with frailty syndrome. The impact of caregiver burden is mostly on the psychological aspects.


Author(s):  
Patience E. Ukiri Mudiare

In Nigeria, it is expected that children take care of their parents in their old age. However, it is increasingly becoming more difficult for children to cater for their aged parents who are not economically buoyant. Because of filial piety, the idea of putting one’s parents in an institution like old people’s home is an anathema for most people. Yet the need for such homes and other specialized care for the elderly is obvious in the light of the burden being experienced by women who are the major primary caregivers. This study of an Old People’s Home in Kano revealed that other than the accommodation and feeding provided, there are no specialized programmes and facilities to cater for the physical, mental and social needs of the elderly. Gender segregation is enforced but no consideration is given to differences in age, physical and developmental challenges. This highlights the urgent need for the Nigerian government to take more proactive measures in its policy on ageing by making provisions for long-term care facilities, residential arrangements with assisted living facilities, and adult day care centres with competent personnel.


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