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In Cuba, the number of older people in need of care is increasing rapidly. At the same time, many younger people are leaving the country in search of a better life. This article focuses on these two processes by asking how care for older people is organized when (some) children live abroad. It shows that in the absence of an adequate public old age care infrastructure, a private market for home-based old age care has emerged. This development is linked to the sending of remittances and may potentially exacerbate social inequalities between older people receiving and not receiving money from abroad.
Despite the reported positive impact of informal personal care on the cared for, carers themselves experience a range of adverse health outcomes. In addition, Australian care policies primarily target the cared for, while the needs of carers tend to be disregarded. This article draws on data collected from 36 interviews with carers who were offered an opportunity to engage in a pilot training programme focused on enhancing opportunities. Viewed through the lens of self-determination theory, the training served as a stimulus in supporting carers’ psychological needs, demonstrating that more targeted, nuanced and meaningful supports are required to maintain carers’ motivation and well-being.
Across Western nations, ‘ageing in place’ policies rely on having a sufficient and skilled aged care workforce. In Australia, due to the impact of successive policy reforms, this workforce including the sector that provides community-based services has declined in number and skills. At the same time the need to upskill and sustain this workforce has intensified as the frailty and health needs of consumers have increased. This paper reports on an integrative literature review undertaken during 2021 to describe workforce needs and peer reviewed reports of programs instituted in aged care settings that aimed to address these needs.
The review sought to examine programs implemented in both long-term and community care settings and to draw from these elements that may be utilised in future program design across the sector. It focussed primarily on workforce deficits in the community aged care sector and on the capacity of rurally-based services to meet and respond to growing consumer demand. The findings emphasise current workforce deficits while they also reveal a paucity of peer-reviewed reports of implemented programs across the sector as a whole. Nevertheless, the few programs examined in this review provide examples of the capacity and willingness of workers and providers to trial measures that aim to increase the recruitment, retention, skill and job-satisfaction of direct care workers. We propose that the key elements of the programs identified in this paper provide the foundation for the development of strategically designed programs that address particular workforce needs such as those shaped by rural contexts.
Health and social care services and systems increasingly promote both interprofessional practice and person-centred care. This discussion first examines the clinical and community-based contexts for providing interprofessional practice and person-centred care through the lens of personal, interpersonal, interprofessional and organisational values. Emerging conflicts among values are highlighted using the concept of moral distress, with examples from US and Canadian settings. The comparison then moves to the systems level, examining different US and Canadian contexts for improving the quality and reducing the cost of care. Finally, implications and applications are presented, focusing on interrelationships among the individual, interprofessional team and organisation.
Spinal cord injury paraplegia is a significant health problem in Sri Lanka. This study explores the psychological experiences of family carers of people with such a condition. A descriptive phenomenological study was conducted with 17 parent, sibling, spouse and adult carers. Thematic analysis revealed four themes related to: carer emotions regarding the caring process; feelings related to the family member’s condition; beliefs beyond the physical world; and behaviour changes due to psychological distress. The findings will help develop interventions for the psychological needs of Sri Lankan carers and may provide insight into the experiences of similar Asian communities living globally.
The significance of formal and informal supports and barriers on the company level for combining employment and informal care for older adults has rarely been investigated. This is one of the main findings of a systematic literature review. This systematic literature review elucidates what can be learned from research on practices that have been developed to maintain a sustainable work–care balance. Research indicates that firms have rarely actively addressed the topic and many seem unaware of the challenges employees are facing and the support they need. If firms offer support, they often favour individual, case-based solutions, whereas systematic approaches seem less likely to be put in place. In general, the findings show that better support for companies and for carers would seem important, even urgent, but the knowledge base for offering this support is not well developed.
Many studies have discussed the challenges of reconciling work and care, but few address the role of carers’ voice in advocating for, and facilitating access to, workplace support. Drawing on qualitative case studies of three large UK organisations, we examine the role of working carers’ voice in the development of a carer’s leave policy at work. Findings indicate that working carers’ voice is shaped by various factors, including available voice mechanisms; workers’ perceptions of their care responsibilities; and stigma, work processes and inequalities. Research implications indicate the need for a more effective representation of working carers through voice channels at work.
In a fraught fiscal and post-pandemic context, English adult social care is likely to see further care home closures. To make sure that closures minimise distress and potentially negative outcomes for residents, this article reports findings from an analytical narrative review of the existing research evidence about the process and outcome of such closures in the UK. Despite the importance of these issues, there is little underpinning research to draw on when establishing good practice, with particular gaps in terms of understanding outcomes for older people, the experience of care staff, economic evidence and the perspectives of social care leaders.
Challenges in keeping healthcare affordable make informal care increasingly important. It is essential to understand the context in which people provide informal care and gain insight into their wishes with regard to the division of care responsibilities. A total of 37 interviews and eight focus groups were conducted to investigate how Dutch carers’ care attitudes are shaped. Results show that carers’ intersecting social positions, such as gender, migration background, socio-economic status and stage of life, largely influence their care attitudes. Carers want to provide care but experience challenges in doing so. They request a government that takes the lead and facilitates cooperation with professionals.
This article highlights carers’ information-related work of caring for community-dwelling older adults living with dementia. Within an institutional ethnography method of inquiry, two sets of interviews with 13 carers and five paid dementia care staff map out the social organisation of carers’ information work. Carers’ information work is organised by timescales of past, present and future. Paid dementia care staff’s work reveals the broader institutional agendas that shape and constrain the ways that family caregivers experience their information work. As carers contend with information that is ‘fluid’ and ambiguous, differing supports are required to agentively support carers’ information needs.
