Domiciliary Care: The Formal and Informal Labour Process

Bolton, Sharon C.; Wibberley, Gemma

doi:10.1177/0038038513500098

Cited by 43 publications

(58 citation statements)

References 36 publications

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“…Time management has split caring for and caring about, the former a legitimate part of a care package, the latter rarely so (Cohen, 2015). And yet, many carers find (often unpaid) time to be compassionate, to sit and chat with the service user, their emotional labour neither contractually recognised nor financially rewarded (Bolton & Wibberley, 2014;England & Dyck, 2011).…”

Section: Practicementioning

confidence: 99%

Choice and compassion at the end of life: A critical analysis of recent English policy discourse

Borgstrom

Walter

2015

Social Science & Medicine

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End of life care in England has recently been framed by two very different discourses. One (connected to advance care planning) promotes personal choice, the other promotes compassionate care; both are prominent in professional, policy and media settings. The article outlines the history of who promoted each discourse from 2008 to early 2015, when, why and how and this was done.Each discourse is then critically analysed from a standpoint that takes account of bodily decline, structural constraints, and human relationality. We focus on the biggest group of those nearing the end of their life, namely frail very old people suffering multiple conditions. In their care within contemporary healthcare organisations, choice becomes a tick box and compassion a commodity.Informed choice, whether at the end of life or in advance of it, does not guarantee the death the person wants, especially for those dying of conditions other than cancer and in the absence of universally available skilled and compassionate care. Enabling healthcare staff to provide compassionate, relational care, however, implies reversing the philosophical, political and financial direction of healthcare in the UK and most other Anglophone countries. KeywordsEngland, end of life care, choice, compassion, discourse, old age, relational ethics, governmentality 2 Research Highlights• The 'choice' agenda arises out of (cancer) palliative care.• The 'compassion' agenda arises out of elder care scandals.• Compassion signifies care as a relationship rather than a commodity.• Compassion can be undermined by an overemphasis on autonomous individuals.

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Section: Practicementioning

confidence: 99%

Choice and compassion at the end of life: A critical analysis of recent English policy discourse

Borgstrom

Walter

2015

Social Science & Medicine

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“…A substantial body of work depicts aged care work as hidden and gendered, and workers as poorly remunerated [4][5][6][7][8][9] . The 'lot' of workers is linked to the often casual and insecure terms of employment and industrial powerlessness 5 .…”

mentioning

confidence: 99%

“…The moral dimensions of care work, which rest on worker virtue and passivity, are discursively privileged over technical skill to counter justification for higher rates of pay 13 . Such exploitation is especially apparent in the case of low socioeconomic workers, including migrant and refugee women, whose employment opportunities are narrow 7,[14][15][16][17] .…”

mentioning

confidence: 99%

Challenges to the provision of community aged care services across rural Australia: perceptions of service managers

Savy¹,

Warburton²,

Hodgkin³

2017

Rural Remote Health

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A B S T R A C TIntroduction: The Australian community aged care sector is facing a growing workforce crisis, particularly in rural and regional areas. Its predominantly female workforce is ageing, and recruiting younger, skilled workers is proving difficult. The service sector, too, is proving highly complex and diverse as a result of contemporary aged care service reforms as well as ongoing difficulties in providing services to the growing numbers of older people living in Australia's rural areas. Despite these multiple challenges, there is a gap in research that explores how rural aged care services manage their day-to-day requirements for skilled workers across the diverse service sector. To address this gap, this article reports on the experiences and perceptions of a small sample of service managers whose organisations represent this diversity, and who are accountable for care provision in regional and rural locations. In such areas, recruitment and skill needs are contoured by disproportionate aged populations, distance and reduced service availability. Methods: Eleven service managers were interviewed as part of a larger project that examined the skill and training needs of community aged care workers within the Riverina, a rural region in New South Wales. Qualitative data drawn from semi-structured interviews were thematically analysed to identify the managers' individual needs for workers and skills in the context of location, service parameters and availability of other health and community services. Results: Thematic analysis of the interview data elicited three themes: services, roles and skill deployment; older workers and gendered roles; and barriers to recruitment. The findings illustrate the complexities that characterise the community aged care sector as a whole and the impact of these on individual services located in regional and rural parts of Australia. The participants © P Savy, J Warburton, S Hodgkin, 2017. A Licence to publish this material has been given to James Cook University, http://www.jcu.edu.au 2 reported diverse needs for worker skills in keeping with the particular level of service they provide. Significantly, their varying perceptions and practices reflect their preference for older, female workers; their reluctance to take on younger workers is negatively skewed by a lack of capacity to compete for, recruit and retain such workers and to offer incentives in the form of enhanced roles and career development. Conclusions: The findings highlight the conceptual ambiguities inherent in definitions of community aged care work as broadly skilled and uniformly sought across the sector. On the one hand, demands for more and better trained workers to meet growing client complexity locate care work as skilled. On the other, managers of narrowly defined service activities may rely on a diminishing workforce whose skills they downplay in gendered and lay terms. This contradiction corresponds with long-held conclusions about the gendered, exploitative reputation of care work, a characterisa...

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“…In a study done in Ireland (Timonen and Doyle, 2007) home care staff complained that there was no time allocated for companionship or compassion. Care is now a tradable commodity and domiciliary carers have to continually reconcile the tensions inherent in a care plan that offers no time to care (Bolton and Wibberley, 2014).…”

Section: The Product Element: Care As a Commoditymentioning

confidence: 99%

The Commodification of Care: a Critical Exploration of the Marketing Mix for Domiciliary Care at the End-of-Life

Lolich

2017

DBSBR

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Domiciliary Care: The Formal and Informal Labour Process

Cited by 43 publications

References 36 publications

Choice and compassion at the end of life: A critical analysis of recent English policy discourse

Choice and compassion at the end of life: A critical analysis of recent English policy discourse

Challenges to the provision of community aged care services across rural Australia: perceptions of service managers

The Commodification of Care: a Critical Exploration of the Marketing Mix for Domiciliary Care at the End-of-Life

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