We adapt the concept of the ‘consumption ensemble’ to capture the nuanced collaborations between actors in the provision and receipt of home care. Data were from a ten-year study of home care clients, family carers and workers in selected Canadian provinces. Using the lens of the ‘ensemble’, we analysed interviews with 24 dyads (carers and clients) and reviewed findings of our previously published research. Evidence of agency as collective endeavour supporting client autonomy and of improvisation in the ensemble informed a revision of our previous interactive model of care, emphasising the bidirectional nature of care relationships.
This chapter looks at rural homecare and how living and working in a rural community can pose certain challenges to the delivery and receipt of homecare services. It shows that in very small places, the home support workers don’t have the same anonymity that workers in larger places have. The discussion determines that it is not unusual for older rural residents to have a home support worker who is the child of a close friend, a neighbour or even a relative. This chapter concludes that while formal home support services may not be as readily available in rural areas as in urban areas, there are issues that are specific to working, living, and receiving services in a rural context. Nevertheless, it is determined that rural places can still be supportive to ageing in a place. The presence or absence of formal services is not the sole indicator of the social vitality of rural communities, nor is it the only indicator of whether rural areas are indeed good places in which to grow old.
Directly funded home care provides funds to individuals to arrange their own services. We ask, what is unique about being a directly funded home care worker? Our qualitative case study in Manitoba, Canada, included an online survey of 95 directly funded workers and interviews with 13 key informants, 24 clients and/or family managers, and 23 workers. Framed by feminist and disability care theories, we found ‘social task shifting’, that is: work that keeps households running and supports socialising; front-line worker involvement in care administration; and blurred relationships. Some directly funded workers are empowered by social task shifting, though the expectations can feel limitless.