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Welfare Reform on the Web (June 2012): Care of the elderly - overseas

Collective regulation of wages and conditions in aged care: beyond labour law

S. Kaine

Journal of Industrial Relations, vol. 54, 2012, p. 204-220

The residential aged care workforce in Australia is largely female and low paid. Improvements in pay and conditions are mainly dependent on bargaining power, either individual or collective. Neither of these bargaining frameworks has resulted in significantly improved outcomes for women working in aged care. This article argues that the regulatory architecture in aged care provides an opening for lifting labour standards. The Productivity Commission's 2011 report champions 'responsive regulation' and its recommendations open the way for a responsive regulatory framework to be applied to labour standards in aged care using existing consultative mechanisms and the accreditation standards. Such an approach would allow for the development of a Code of Practice by key parties with the potential to lift labour standards above statutory minima.

From person-centred to relational care: expanding the focus in residential care facilities

J. Rockwell

Journal of Gerontological Social Work, vol. 55, 2012, p. 233-248

Long-term residential care homes for older people in Canada currently espouse a philosophy of person-centred care. However, these facilities operate according to a medical model with highly structured administration and regulation, resulting in tensions between the priorities of the residents and those of the organisation. This article presents the results of a qualitative study of four social workers employed in residential care homes in one Health Authority in British Columbia. Findings suggest important insights into the reality of practicing person-centred care within a highly institutional structure, as well as the role of multidirectional relationships in fostering meaningful engagement for residents and staff. The final section presents some suggestions on how social workers and care facilities might overcome the tendency for large organisations to prioritise administrative goals and procedures over resident preferences by focusing on the therapeutic potential of relationships and relational care.

Reforming home care in ageing societies

T. Rostgaard, V. Timonen and C. Glendinning (guest editors)

Health and Social Care in the Community, vol. 20, 2012, p. 225-327

In the context of ageing societies, the importance of home-based care is growing in all OECD countries. This special issue focuses on how various countries have responded to the growing needs for home care, the challenges encountered in the course of reform, and the relative success of different reform strategies. It documents the responses of nine European countries to the challenges of providing greater volumes and intensity of home-based care for older and disabled people. The contributions show that new governance mechanisms have been introduced in all of the countries, accompanied by targeting and decentralisation processes and by shifting divisions of work in a mixed welfare economy. Modernisation of the modalities of organisation and governance of home care systems is evident in all countries, although unique political, historical and cultural contexts shape each country's approach, as do the different configurations of key actors, such as providers, users and public authorities. Thus countries differ in the division of competencies and responsibilities between different levels of government; in the types of entitlement that govern access to care; and in the ways in which the delivery of home care services is organised. The articles all focus on identifying the drivers of change and countries' responses to them, with regard to the organisation, provision, regulation and quality of home care. Each article analyses national policies and experiences of reforming home care for older people, and identifies some of the resulting tensions that characterise the country in question.

Sustaining low pay in aged care work

E. Palmer and J. Eveline

Gender, Work and Organization, vol.19, 2012, p. 254-275

Care work undertaken by women inside and outside the home has always been undervalued. There is, however, little research on how this devaluing is sustained at the level of the organisation. In addressing this gap in the literature, this article shows links between paid and unpaid care and the role of the employer in specific organisational processes. It draws on a study which used in-depth interviews to explore employer responses to shortages of frontline workers in Western Australian aged care. It shows that employers actively reproduce a familial logic of care that represents paid aged care work as unskilled and natural to women and therefore not deserving of higher pay. At the same time, they strive to represent their institutions as providing both good quality employment opportunities for mothers returning to the labour market and good quality care for recipients.

Why does institutionalised care not appeal to Indian families? Legislative and social answers from urban India

B. Brijnath

Ageing and Society, vol. 32, 2012, p. 697-717

Currently in India there remains a preference for elder care to occur within the family setting. Cultural concepts of care and joint family structures have constructed elder care as critical to family functioning and family cohesion. Such cultural practices are supported by a legal environment that places primary responsibility for care of older people on the family and rewards or penalises families which do or do not fulfil these responsibilities. However, as forces such as rapid economic development, migration, urbanisation and changing family structures impact on Indian society, care arrangements and preferences may change. Drawing on in-depth interviews, this qualitative study explores families' perceptions of and experiences with institutional care facilities within the context of the Senior Citizens Act 2007.

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