Thematic Panel 18: COVID-19 and Long-term care for older people – international policy responses and learnings

Elena Bogdanova, European University at St.Petersburg (EUSPb)
and Tine Rostgaard, Stockholm University and Roslkilde University

The COVID-19 pandemic took the long-term care systems around the world by surprise. Facing unknown virus, each country developed its own urgent and ad hoc measures of coping with the challenge. Some introduced strict quarantine measures, others avoided such restrictions. Overall, measures were mainly aimed at the nursing home sector, neglecting the home care sector, and measures often did not consider the effect for members of staff. The effect of COVID-19 on long-term care users and staff has varied by countries and may depended on different factors, including institutional features, cultures of care, integration of health and social care etc. Different countries entered the pandemic at different stages of evidence of how it spread, with different resources for coping with the infection, different cultural models of care, and relying upon different organizational modes of care provision. Therefore, the issue of successful resistance to the pandemic in a time pressure situation is an important empirical and theoretical question, which requires broad discussion, sensitive to a variety of circumstances. With this Thematic Panel, we invite single-country and comparative studies about COVID-19 policy responses and learnings from the long-term care sector.

Open Panel

This open session welcomes papers that strongly relate to the Conference theme Time and temporality in care policies and practices – but do not specifically match any thematic panel.

Paper should focus on one or more research areas at the core of the Transforming care Network – early child education and care, care for adults with disabilities and long-term care for older people – and tackle at least one key dimension:

    • Changes in the institutional setting of care systems and in care policy

 

    • Impact and dilemmas of social and policy innovation in care services

 

    • Changes in intergenerational care arrangements and informal care

 

    • Transformations affecting care workers and their working conditions

 

  • Care policies and practices during the Corona pandemic: difficulty in crisis management, social and political impacts, prospects for the future.

Thematic Panel 15: How to measure care? Innovative reflections and proposals with quantitative and qualitative approaches

Karina Batthyany and Natalia Genta, Universidad de la República

In direct connection with the theme of the 5th Transforming Care Conference, related to time, this symposium receives proposals that seek to analyze the different ways of measuring care, with time being one of the most frequent. Surveys of Time Use, a privileged instrument to quantify the time of unpaid work has been used for several decades around the world. These measurements allow the calculation of the overall unpaid workload, including specific care activities.
However, this instrument has limitations to measure care activities, questions already discussed in the literature.

In this thematic panel we focus on presentations on innovative methodologies to measure care, through quantitative and qualitative strategies that allow quantifying the time of care, its distribution between men and women, the differences in the types of care tasks performed, the uses that families do care in institutions and how they combine it with the time provided at home, among others.

In addition to this, there are key elements that allow understanding the time dedicated to care (such as care services in the country as well as family assessments and gender mandates related to care). The incidence of these elements in the time that families spend on care is also a central element, with which we invite proposals in this regard.

Finally, we especially celebrate comparative studies between countries, especially those that compare countries from different regions of the world. In the Latin American region, it is especially important to deepen the comparative view, more present in other regions.

Thematic Panel 14: Negotiating and arranging care during the COVID-19 pandemic and shifting grounds: the effectiveness of policies in shaping a responsive and resilient care system

Shereen Hussein, University of Kent

The COVID-19 pandemic and associated policy and practice responses have profoundly impacted care and time to care across the world. The policy measures taken to control the infection spread have further affected care disproportionately. Evidence is mounting of higher infection and death rates in care settings, and the workforce is at the forefront of negotiating a complex set of challenges. COVID19 pandemic, and measures taken to contain the disease, are having a profound impact on the individuals and health and care systems calling for a consorted recovery policy response. At the individual level, there are significant effects on care recipients, their family and the care workers’ physical, mental and social wellbeing. The care systems have experienced enormous pressures on the organisation and delivery of care, including the workforce. Furthermore, the pandemic has clearly shown the effect of profoundly rooted health inequalities with disproportionate mortality rates among ethnic and less socio-economically advantaged groups.

The response to the pandemic, especially at the early stages, illustrated the impact of the disparities between health and care systems where discharge, isolation and infection containment guidelines simply did not account for the spill-over across the two systems nor the specific dynamics of each. Furthermore, the UK and Europe are experiencing other forces of change at different policy levels, including Brexit and economic downturn exacerbated by the response to COVID-19, adding immense pressures to existing policy challenges. The full impact of Brexit on the care systems is yet to be realised. However, there are significant implications expected on the workforce, care regulation and supply and cross-border care arrangements, among others.

This session is calling for papers addressing some of the following questions, utilising appropriate policy, qualitative or qualitative research methods and analyses:

How do current policies consider and shape time for care in response to system shocks across the globe?
Comparative analyses of the policy response to COVID-19 and their implications on care arrangements and outcomes?
How Brexit and end of free labour mobility affect different care actors, care professionals, caregivers and care receivers across Europe?
What role, if any, of innovations and technology in responding to long-standing and emerging challenges in arranging and delivering care?
How care delivery and arrangements, especially in low and middle-income countries, have been impacted by the pandemic?

Thematic Panel 16: Comparing long-term care policies in time and space: Historical developments and cross-country variations

Panel convenors:
Johanna Fischer, University of Bremen
Heinz Rothgang, University of Bremen
Discussant:
Lorraine Frisina Doetter, University of Bremen

The extent of state involvement in the field of long-term care (LTC) differs between countries and has changed considerably over time. The historical inception of public programmes concerned with LTC often was rudimentary, fragmented and focused at the most vulnerable population groups. In the last decades, LTC for the old-age population has increasingly become a salient issue in many parts of the world, calling to be politically addressed. For instance, many countries in Europe have established (limited) social protection for LTC rather early and experienced different kinds of reforms since the 1990s. More recently, countries in the Global South like China or Uruguay are increasingly discussing and introducing public policies for LTC as well.

This thematic panel focuses on the varieties of public LTC schemes in different time periods and countries. We aim to address the following questions. In which contexts did first – often rudimentary – LTC policies emerge, which form did they take and how did they develop subsequently? How do past and present LTC arrangements compare across countries and regions? Do we see similarities between early adopters of social protection for LTC in the Global North and recent undertakings in the Global South?

We invite papers addressing one or several of the above questions which focus on long-term care for the elderly and/or adults with disability. Papers should take a macro-perspective on LTC policies, looking at historical developments and/or cross-country variations. We welcome papers dealing with any region of the world and especially encourage submissions that explore more embryonic developments unfolding in recent years in countries of the Global South. Contributions may focus on individual countries or cover a wider set of cases comparatively.

Thematic Panel 17: The changing meaning of informal care

Barbara Da Roit, Ca’ Foscari University of Venice

The balance between public and private care responsibilities in the provision and funding of care for older people is high in the political agenda across Western countries. A long-standing debate exists on the effects of the expansion of formal care on the provision of informal care. More recently, policy makers attempted to “refamilialize” care or to reinforce informal care, while research has started to look at the effects of such policies.
Notwithstanding differences in cross-country policy trajectories, we can detect a number of shared assumptions in these debates: (a) care is seen as a fixed/given set of responsibilities and tasks that can be allocated to different actors; (b) family and community care belong to a common past of Western societies; (c) the welfare state, when able to provide universally accessible care services, reduced or changed the role of family care; (c) family care in weaker welfare states is endangered by socio-demographic developments and is turning to an unprecedented crisis that reverses its traditional strength.
Yet, our knowledge of the extent, nature and forms of informal care and its relationship with formal and market care is more based on comparative research than on historical accounts. Little is known of the practices and experiences of informal caregiving in the past.
This thematic panel welcomes papers with a socio-historical approach to the study of informal care (and of the relationship to other forms of care). It focuses on changes in (elder)care practices, visions, understanding, framing in relation to economic, political, demographic and technological change.
Relevant papers tackle:

  • The changing organization of informal care and its relationship to formal care provision
    The changing visions of care by formal care professions and professionals
    The changing narratives of informal care and intergenerational support by caregivers and people cared
    The changing media accounts and representations of informal care and intergenerational support
    The changing representations of care in the arts

Research should preferably consider eldercare, but contributions on intergenerational relations and care at large will be considered.
The historical time(s) taken into account may vary according to the specific research question/hypothesis and the social, political, economic development of the context considered.
Cross-disciplinary approaches (history, sociology, literature, art and media studies) are welcome. Historical accounts of western and non-western contexts are of interest for the thematic panel.

Thematic Panel 13: Time to care: critical perspectives on “fast policy regimes” and anticipatory techniques in care policy

Carlotta Mozzana, Università degli Studi di Milano-Bicocca
Davide Caselli, Università degli Studi di Torino

The session aims to tackle the issue of time in care by focusing on two trends: a) the increasing speed by which policy frames and policy tools are elaborated and circulate globally; b) the policy-makers’ ambition to shape and control the future through the use of anticipative tools based on quantitative data and knowledge (e.g. social impact metrics).
Contemporary public action is embedded into a complex global fast policy regime (Theodore, Peck 2015), based on increasingly globally interconnected policy communities that create a complex temporality of policy transfer. This regime is made on the one hand of fast circulation and adoption of policy frames and tools through the widespread reference to international best practices and benchmarking; and on the other of slow, gradual and path-dependent adaptations to the local socio- institutional context. This is true also for care policies and services, where new actors (with their policy frames and the informational bases upon which they rely) have emerged and contribute to reshape policies and practices.
But time is important here not only for qualifying the speed of such circulation but also as a specific dimension embedded into the policies and practices themselves. In order to reduce uncertainty and to justify public spending in the field of welfare, care policies are increasingly based on predictive and anticipative techniques such as assessment and evaluation metrics that project actual actions in the future.
The session invites empirical and theoretical papers dealing with these two specific problems of temporality in the field of care policies. Interesting contributions may include (but are not limited to):
• Analysis of the elaboration and circulation of policy frames and policy tools in specific policy areas (e.g. active ageing; home care; social impact assessment): who are the actors involved in the process and what kind of temporality does this circulation involve?
• the making of a global Fast Policy Regime in the field of care (e.g. analysis of specific policy and epistemic communities operating at the global level; analysis of local and national networks of expertise mediating global trends, etc);
• the analysis of the logics of care that are promoted through the use of anticipatory, pre- visional, impact-oriented tools in the realm of care policy. How do such tools promote specific logics of action? How do they modify existing logics and practices of care?
• Analysis of the conflicts taking place into the Fast (care) policy regime: emerging forms resistance and elaboration of alternative/new/different paradigms and informational bases for care policies and services.

Thematic Panel 12: Transforming what? Unpaid carers and family care of children and adults in systems in transition

Agnes Turnpenny, TÁRKI and University of Kent
Gábor Petri, TÁRKI

Although the institutionalisation of children and adults with intellectual and developmental disabilities has received considerable attention in policy and research across the world, the majority of people with intellectual disabilities live with their families in the community, often with little or no formal support and experiencing high levels of social exclusion and deprivation. This panel aims to bring together empirical and policy research that explores how care practices and policies have changed across historical time and future directions. We welcome analytical and descriptive papers that address any of the following topics from a historical or longitudinal/life-course perspective:

– How policies supporting family caregiving have changed over time?

– What are the current policies supporting family caregiving and unpaid carers for people with intellectual and developmental disabilities? What are the implications of these for their socio-economic status at different stages of the life-course?

– How do family carers mobilise formal and informal resources to support the person with intellectual and developmental disabilities across the life course? What are the lived experiences of unpaid family caregiving? How has this changed over time?

We welcome papers from any region or context; however, we are particularly interested in submissions that focus on systems in transition, the ‘former communist bloc countries’ in Eastern Europe and the Global South, as well as comparative research.

Thematic Panel 11: Family Foster vs Institutional Care: The Achilles Heel of Out-of-Home Care for Children?

Teresa Martín García, Spanish National Research Council (CSIC)

An adverse childhood often results in children being placed in state custody, and these children are generally named as children in out-of-home care. Residential care is typically known as a group home or institutional care in which professional caregivers are responsible for the day-to- day care and well-being of these children. In contrast, family foster care encompasses figures of parents in private families who are entrusted with the care of these children (Li, Chng & Chu 2019). One or another care choice will permeate, in different forms and meanings, the entire life course of these children in out-of-home care. In general, foster care is found to benefit some children and be more beneficial for children than institutional care. In fact, it is a well-stylized fact that foster care is a crucial intervention to reduce the adverse effects following early deprivation and that children placed in family foster care show better-off later life behavioral and psychosocial outcomes as compared to those in residential homes.

While there is abundant social care and care policy research focusing on early childhood education and childcare, we know very little about children in out-of-home care. For instance, how practice and policy concerning substitute care for children have changed across historical time? How can they be foreseen in the future? We may be seeing evidence for a transition from systems being clearly dominated by residential care to others almost exclusively or heavily reliant on family placement (Ireland). Yet, the majority of the countries are in development and some even take a step back: in Spain, institutionalized children overcome those entering foster care since 2018.

Linked with the Conference theme (time and temporality), the aim of this panel is to critically analyze state custody in varying societal contexts and change across time with respect to the potentially (un)equal outcomes for children. We encourage contributions from around the world that investigate care practice and policy for children in out-of-home care, a question that has received scarce attention in care regimes analyses. Which placement type best serves a child as well as who is best suited to take care of a child? We encourage contributions that identify which aspects of residential care carry benefits and which carry risks. Special attention will also be paid to the associations between placement and child outcomes, which can vary as a function of the timing and duration of placement(s) and movements between them. We appreciate papers addressing care-related risks, policies and intervention over the life course to account for the accumulation of (dis)advantages and the specific needs of children in substitute care. Studies that compare short vs. medium and long-term outcomes for children who live in family foster and residential care settings are very welcome. So are those comparing their opportunities and outcomes to family-reared children.

Thematic Panel 10: Care Work in the Household under Time Pressure: Coping Strategies and Precarious Time Frames?

Tanja Carstensen and Almut Peukert, University of Hamburg

Conditions for care work at home – the everyday formal, semi-formal and informal practices by which support is provided within the household for children, elderly, partners, and oneself in order to maintaining livelihood – have changed fundamentally in recent years. Reasons among others are increased women’s employment rates, deliminiation of ‘paid work’ and  ‘life’, work intensification, higher mobility, new gender arrangements, and the higher need to elderly care. These transformations have a clear temporal dimension, they are connected with the organization and perception of time within families closely: Time pressure has become a key issue in the everyday life of balancing between paid work and the demands caused by childcare, elder care, care for partners and oneself. In the proposed session, we seek to analyze the question how time for care around and within the home is negotiated within different (gendered) familial arrangements and invite contributions addressing this question from intersectional perspectives, different levels (micro, meso, macro), different stages of life (childcare, care for disabled, elder care) as well as different strategies and their effects (politics, organizational or individual level). This may include, for example, the analysis of workplace arrangements, digital offers (platforms, apps), policy developments (e.g. care policies, social investment), as well as familial negotiations and strategies from intersectional perspectives connected to care provision within domestic settings. Potential questions are: (How) is the problem of time pressure framed by different actors? Who is addressed, who is excluded? What kind of transformations can be observed? Which strategies, measures, practices can be identified? What is their time frame? How is time pressure managed, which strategies are chosen and how are they legitimized? Which viable and organizational strategies offer opportunities and are used to cope with the time pressure?