Sustainable care: theorising the wellbeing of caregivers to older persons

Abstract

The term ‘care crisis’ is invoked to denote chronic system failures and bad outcomes for the people involved. We present a comprehensive wellbeing framework and illustrate its practicality with evidence of negative outcomes for those who provide care. We find evidence of substantial material and relational wellbeing failures for family carers and for care workers, while there has been little interest in carers’ views of their ability to live the life that they most value. Understanding and improving wellbeing outcomes for carers is an essential component of sustainable care, which requires the wellbeing of the different actors in care arrangements.

Sustainable Social Care: The Potential of Mainstream “Smart” Technologies

“…All expert groups interviewed viewed the use of mainstream digital devices in adult social care largely positively, though with some important caveats. Using a three-dimensional model of wellbeing as the conceptual lens through which to explore mainstream technologies' potential role in adult social care systems [40,41], we now reflect on the implications of this emerging area of practice for each dimension in turn.…”

“…Indeed, subjective wellbeing is central to the Care Act, which states each person is best placed to define their own wellbeing. The Care Act's approach to wellbeing also aligns with research and theory, which has drawn together concepts of wellbeing from across the world to argue that the concept has three dimensions: "what a person has (the material), what they can do through their relationships with others (the relational) and how they feel and evaluate what they have and can do (the subjective)" [41] (p. 4). The relative importance of the dimensions is an area of contestation [38] with Austin [39] (p. 97), who argues for the core importance of relational wellbeing-"sociality" and "good social relationships"-as the "catalyst for overall wellbeing".…”

“…The government-funded WSD randomized control trial also found that while users' and their carers' wellbeing was "enhanced", it was not "transformed" [46][47][48][49], and yet it has been noted that these findings had little bearing on the continued policy enthusiasm for TECS [50,51] (Appendix A, note 3). Following the arguments of Keating et al [41], in which the wellbeing of actors within care systems and the sustainability of said systems are linked, technology that enhances wellbeing should therefore contribute to sustainability. However, the way technologies in care arrangements have traditionally been commissioned and delivered in England appears to be out of step with the wider aims of care legislation focused on wellbeing, and in turn, this could be argued to curb technologies' potential to support sustainable care arrangements.…”

A research framework for the United Nations Decade of Healthy Ageing (2021–2030)

“…This perspective is grounded in human ecological assumptions that people have various capacities to act upon or adapt their environments and that person-environment fit occurs when environmental demands and opportunities are balanced with individual capabilities and resources (Bigonnesse and Chaudhury 2020 ). Two further assumptions illustrate its’ values base: that responsibility for supporting those with limited agency must be shared; and that a goal is to identify and create evidence of those who are rendered invisible by contexts that exclude (Keating et al 2021a , b ).…”

“…Incorporating knowledge of diversity in areas such as ambiguous or exploitive family relations or decreased friend networks in the face of illness and death are examples. A systematic review of wellbeing of family caregivers found that material resources (including labour force participation and care-related out of pocket expenses); and relational resources (including with the cared-for person, other family members, friends and co-workers) are most important (Keating et al 2021a , b ). There is merit in further empirical examination of what are the core resources and relationships in their lives.…”