The redefinition of the familialist home care model in France: the complex formalization of care through cash payment

Abstract

This article investigates the impact of policy measures on the organisation of home-based care for older people in France, by examining the balance between formal and informal care and the redefinition of the initial familialist model. It focuses on the specific cash for care scheme (the Allocation personnalisée d'autonomie - Personalised allowance for autonomy) which is at the core of the French home-based care policy. The author argues that in a redefined context of 'welfare mix', the French public strategy for supporting home-based care in France is articulated around two major objectives, which can appear contradictory. It aims to formalise a professional care sector, with respect to the employment policy while allowing the development of new forms of informal care, which cannot be considered to be formal employment. The data collection is two-fold. Firstly, a detailed analysis was made of different policy documents and public reports, together with a systematic review of existing studies. Secondly, statistical analysis on home-based care resources were collected, which was not easy, as home-care services for older people in France are part of a larger sector of activity, 'personal services' (services à la personne). The article exposes three main findings. First, it highlights the complexity of the formalisation process related to the introduction of the French care allowance and demonstrates that formalisation, which facilitates the recognition of care as work, does not necessarily mean professionalisation. Second, it outlines the diversity of the resources available: heterogeneous professional care, semi-formal forms of care work with the possibility to employ a relative and informal family care. Finally, the analysis outlines the importance of the regulation of cash payments on the reshaping of formal and informal care and comments on its impact on the redefinition of informal caring activities.

Mapping support policies for informal carers across the European Union

“…As noted by Ungerson, the impact of financial support schemes largely depends on whether the scheme regulates the type of worker who can be employed by care-recipients, whether it enforces social care for these care workers and whether or not the payment of relatives (and especially spouses) is allowed [37]. For instance, the introduction of a regulated cash-for-care scheme in 1997 in France has resulted in the externalisation of the time-consuming tasks -mostly those related to personal care -to professional carers, while informal carers take on the role of care-coordinator [38,39]. On the other hand, in Italy, a less regulated attendance allowance has fostered the development of a broad unregulated care sector, employing between 650,000 and 800,000 immigrant care workers [40][41][42].…”

Anhörigomsorg mot betalning: Biståndshandläggare om sent-i-livet-invandrares önskemål

“…Olika länders system för kontantbidrag riktas i regel till antingen brukare eller omsorgsgivare (Moran et al, 2012 Ökad uppmärksamhet på hur olika kontantstöd landar i ledet hos anhöriga omsorgsgivare har bidragit till att den tidigare väletablerade dikotomin mellan formell och informell omsorg börjat problematiserats, inte minst inom en feministiskt orienterad forskningstradition (Daly & Lewis, 2000;Ungerson, 2004;Cass, 2007;Le Bihan, 2012). Omsorg utgör alltid en form av arbete, omgärdas alltid av normativa uppfattningar och har alltid ett pris för omsorgsgivaren -ofta en kvinna (Daly & Lewis, 2000).…”

Sustainable Care in a Familialist Regime: Coping with Elderly Care in Slovenia

“…The increasing care needs and tighter budgetary constraints are being managed in numerous ways, ranging from a bigger involvement of migrant workers [20][21][22][23] to withdrawal of the state and strengthening the role of the market. Such changes are encouraged, for instance, by cash-for-care schemes, the emergence of semi-formal forms of care work enabled by the possibility of paying a relative for care, privatisation, as well as deinstitutionalisation trends [10,20,21,[24][25][26].…”