Welcome to Volume 6, Issue 4 of the International Journal of Care and Caring (IJCC). Our November 2022 issue includes nine peer-reviewed articles, two ‘Debates and issues’ items and three reviews by authors based in, or writing about, Canada, Finland, The Netherlands, Portugal, Sweden and the UK. We begin with three articles that engage with crucial conceptual issues and policy ideas in care and caring.

In ‘Care ensembles: examining relational aspects of care in the context of home care’, Anne Martin-Matthews and María-José Torrejón (2022) (University of British Columbia, Canada) use data from a ten-year study of home care clients, family carers and workers in Canada to examine collaborations between actors engaged in providing and receiving home care. Using the lens of the ‘ensemble’ to analyse their interviews with carer and client dyads, adapting the ‘consumption ensemble’ concept and drawing on a review of their previously published research, they find evidence of both agency and improvisation in the collective endeavour of supporting client autonomy. This results in a revision of their previous interactive model of care that places more emphasis on the bidirectional nature of caring relationships.

Next, Antti Hämäläinen (2022) (University of Jyväskylä, Finland), discusses ‘The epistemological complexity of ideal care: long-term care professionals’ perspectives’. In the article, he presents a thematic analysis of semi-structured interviews with eldercare workers in Finland that explores the epistemological basis of care. Hämäläinen focuses on the knowledge that workers describe regarding their everyday care practices and identifies four aspects of knowledge in this work: ‘objective/objectifying’, ‘particular’, ‘corporeal’ and ‘tacit’. The author finds that where complex and fluid care relations are concerned, rational-technical epistemological approaches are insufficient; he emphasises the need for ongoing research that takes account of cognitive impairments and other particularities of eldercare.

Fiona Morgan (University of Wolverhampton, UK) and Minna Zechner (University of Lapland, Finland) (2022) then explore the ‘cash-for-care’ schemes that support older people with health-related social care needs and their carers in England and Finland. In ‘Uncovering familialism: cash-for-care schemes in England and Finland’, they present a meso-level comparative policy analysis of the governance arrangements that underpin these schemes, considering their eligibility criteria, generosity and territorial variations. Their article considers implicit and explicit intentions, functions and effects, and pays particular attention to their defamilialising, familialising or refamilialising impacts on family caring. They find inconsistencies in these effects linked to individuals’ characteristics and choices, as well as policy limitations, and note an overarching tendency, exacerbated by austerity-related politics, to familialise or refamilialise caring for older people.

All six of our other articles in this section focus on carers. In ‘“Living the life of the other”: carers’ perspectives on changes in carer strain during the rehabilitation trajectory’, Chantal Hillebregt, Margo Trappenburg and Evelien Tonkens (2022) (University of Humanistic Studies, the Netherlands) focus on the needs of carers supporting someone receiving medical rehabilitation support following a brain or spinal cord injury. Based on in-depth interviews with couples in the Netherlands, their article explores carers’ experiences and the adverse effects of caring over the rehabilitation trajectory. The findings show how carers’ needs vary during different phases of rehabilitation, using the concepts of ‘personal time’ and ‘personal space’, with the aim of contributing to improvements in rehabilitation treatment practices.

The experience of parents in Portugal caring for a child with chronic kidney disease is the focus of our next article, ‘Material and relational challenges of home-based renal care: a parental perspective on child chronic kidney disease’, by Andréa Bruno de Sousa and Anette Wickström (2022) (Linköping University, Sweden). Based on interviews with parents, they find that they need both to reorganise their everyday routines and to develop advanced technical skills. They conclude that the strategies parents employ to do this need greater understanding; home-based care, they find, leads to worsened social inequities, even when parents use available financial and human resources to manage the situation and create normality. Parents in the study not only described feeling confined, with close relationships strained, but also revealed that their families found hope and meaning in everyday practices and in the social relations of care.

Our next article, ‘Advocating for carers: a qualitative study exploring the needs of UK carers of patients with an acoustic neuroma’, by Katie Gilchrist and Cecilia Vindrola-Padros (2022) (University College London, UK), considers another under-researched group of carers. Based on a small study of carers of patients with acoustic neuroma, the article highlights life disruption, support, well-being, the carer role, lessons learned and the impact of COVID-19. The authors conclude that, from diagnosis to recovery, carers need more practical information and emotional support, and propose that this should include routine carer assessments, early signposting to other services and information about recovery.

In a further UK-based qualitative study of a subgroup of carers, Lorna Chesterton (Manchester Metropolitan University), Anthea Innes (University of Salford), Sarah K. Smith (Sheffield Hallam University) and Lydia Morris (University of Manchester) (2022) discuss ‘Self-reported benefits for care partners of attending a person-centred dementia cafe’. They note that such carers, often referred to as the ‘invisible patient’, can experience the physical, mental and emotional responsibilities of caring for someone with dementia as both rewarding and challenging. Their study explores how attending a co-designed dementia cafe affected carers’ well-being, finding that the cafe adopted a person-centred approach that valued their unique abilities and contributions. Results were positive: the cafe offered a safe environment where individuals could be themselves, find a sense of belonging and friendship, and maintain their selfhood and dignity in ways that enhanced their well-being.

In ‘(How) Will it end? A qualitative analysis of free-text survey data on informal care endings’, based on a collaboration in Australia between University of New South Wales Sydney and Carers NSW, Emma Kirby, Giselle Newton, Lukas Hofstätter, Sarah Judd-Lam, Iva Strnadová and Christy Newman (2022) focus on another under-researched area. Their study analyses 1,746 qualitative free-text responses in a national survey of Australian carers, focusing on current and former carers’ concerns, opportunities and preferences about ‘care endings’. Their thematic analysis produces findings about: carers’ anticipation and fears for the care recipient; their own prospects for life after caring; and issues of responsibility, recognition and loss. Drawing on scholarship on the moralities of caring, the authors discuss carers’ precarious relational and social positions, as well as their uncertainties about how caring ends.

Our final peer-reviewed article in this issue is by Klara Raiber, Ellen Verbakel and Mark Visser (2022) (Radboud University, the Netherlands): ‘Helping helpers? The role of monetary transfers in combining unpaid care and paid work’. Using multiple waves over 12 years of the German Labour Market and Social Security panel study, they apply fixed-effects models to explore how unpaid caring changes labour supply and if monthly monetary transfers from the care recipient to the carer motivate a reduction in labour supply. They find that for women and men, starting high-intensity caring increases the likelihood of becoming non-employed. Women were also likely to reduce working hours when starting non-intensive caring, which was not the case for men. They conclude that the (low) monetary transfers available were a higher motivation to become non-employed for men, while for women, receiving such transfers only reduced their working hours.