Symposium 3

Implementing reablement in home care – what are we talking about?

Conveners:

Silke F. Metzelthin, Assistent Professor, Department of Health Services Research, Care and Public Health Research Institute (CAPHRI), Faculty of Health, Medicine and Life Sciences, Maastricht University and Tine Rostgaard, Professor, VIVE – The Danish Centre for Social Science Research

Discussant:

Tine Rostgaard, Professor, VIVE – The Danish Centre for Social Science Research, Denmark

Living in the community, rather than in residential care, is the expressed preference of the majority of older adults. In addition, policy makers prioritise an ageing‐in‐place policy over more expensive institutionalisation to balance their budget limits. However, to support ageing-in-place innovative home care approaches are needed to assist older adults to stay in their homes as long as possible.

Reablement is an innovation care approach that has been rapidly adopted in many countries such as the US, the UK, New Zealand, Australia, the Netherlands, Denmark, Norway and Sweden. Reablement aims to support frail older adults to maintain, gain or restore their competences so that they can manage their lives as independently as possible. However, there is great variation between and even within countries regarding the conceptual understanding of reablement, which hinders evidence-based policymaking and the pragmatic identification of ‘what works’ in care. Therefore, an international Delphi study was conducted with the aims 1) to reach agreement on the key components, characteristics and aims of reablement; and subsequently (2) to develop an internationally accepted definition of reablement.

After Silke Metzelthin has presented the results of the Delphi study, researchers from four different countries (the Netherlands, New Zealand, Australia and Denmark) will talk about reablement in each their country. The first presentation by Teuni H. Rooijackers will be about the findings of a process evaluation that is conducted alongside a randomised controlled trial investigating the feasibility of a Dutch reablement programme. Matthew Parsons from New Zealand will discuss the findings from four randomised controlled trials of reablement undertaken in New Zealand and highlighting the key learnings. The third presentation by Elissa Burton from Australia will be about utilising physical activity programs within reablement to improve physical function. Tine Rostgaard researcher will present the Danish reablement model including the results from a recent evaluation of the outcomes in community-dwelling frail older adults.

Panel authors:

1. Silke Metzelthin, Assistent Professor, Department of Health Services Research, Care and Public Health Research Institute (CAPHRI), Faculty of Health, Medicine and Life Sciences, Maastricht University, the Netherlands
2. Teuni H. Rooijackers PhD., Department of Health Services Research, Care and Public Health Research Institute (CAPHRI), Faculty of Health, Medicine and Life Sciences, Maastricht University, the Netherlands
3. Prof. dr. Matthew Parsons, School of Nursing, Faculty of Medicine and Health Sciences, The University of Auckland, New Zealand
4. Elissa Burton, Doctor of School of Physiotherapy and Exercise Science, Faculty of Health Sciences, Curtin University, Australia
5. Prof. dr. Tine Rostgaard, VIVE Danish Centre of Applied Social Science, Denmark

Symposium 4

Privatization: The Case of Nursing Homes

Convener and Discussant:

Pat Armstrong, Distinguished Research Professor, York University, Toronto, Canada

Privatization has become a major feature of changing priorities in nursing homecare. For almost a decade, an international, interdisciplinary team of researchers has been reimagining long-term residential care. Organized initially around the four themes of approaches to care, work organization, accountability and financing, our ethnographic studies of nursing homes in Canada, Germany, Norway, Sweden, the US and the UK have made us increasingly aware of the forces driving us in various ways towards privatization. We have come to understand the move away from public provision takes various forms, including more corporate ownership of homes and of services within non-corporate ones, more private payment, more private decision-making, more unpaid care work, and more for-profit approaches to management, which together help to change our shared notions of care. At the same time, we have seen many variations across jurisdictions, demonstrating that context and resistance matter. And the consequences vary as well.

This panel is based on articles we are preparing for an edited collection.

1. Pat Armstrong, Distinguished Research Professor, Department of Sociology, York University, Toronto, Canada
‘Forms of privatization’
2. Gudmund Ågotnes, Postdoctoral Fellow, Centre for Care Research Western Norway University of Applied Sciences Bergen, Norway, presenting author; co-authors Frode Jacobsen, Marta Szebehely
‘Privatization in the Norwegian and Swedish nursing home sector’
3. Hugh Armstrong, Distinguished Research Professor, Professor Emeritus of Social Work and Political Economy, Carleton University Ottawa, Canada
‘Contracting Care’
4. Rachel Barken, Postdoctoral Fellow, Department of Sociology, York University Toronto, Canada
‘Unpaid care in public places’
5. Liz Lloyd, Professor of School for Policy Studies, University of Bristol, United Kingdom
‘Older Residents’ Experiences of Risk in a Market System of Nursing Homes’

Symposium 5

Care arrangements in context of migration

Conveners:

Lenka Formánková, Junior Researcher, Institute of Sociology, Czech Academy of Sciences, Czech Republic, and Monique Kremer, Professor of University of Amsterdam, Netherlands

Discussant:

Monique Kremer, Professor of University of Amsterdam, Netherland

The ever-rising migration flows in Europe make it necessary to address the care needs of families and clients of diverse ethnical and national backgrounds. Our symposium presents four national and regional case studies on care choices for families with migrant backgrounds. Both child care and elderly care arrangements, formal and informal, are covered. Aging migrant populations as well as the rising number of children brought up in families of foreign origin challenge the citizenship/nationality-based welfare provision. Going beyond the single categories of age, gender, disability, ethnicity or nationality when discussing diversity in care provision, we address such questions as whether and how the needs of children or the frail elderly with migration backgrounds are considered in access to care benefits and services. Also, what are the current dilemmas in care provision in the era of ‘super diversity’? By debating different systems of care provision, the symposium adds to the discussion on prioritizing diversity in care policy design and provision in connection with migration.

Panel composition:

1. Monique Kremer, University of Amsterdam, the Netherlands presents a paper entitled: Dealing with super-diversity in care. Dutch home care practices in times of migration. Analysis of Dutch home care policies stems from an in-depth qualitative case study of ‘Kings Care’: a home care organisation based in Hague, established and owned by individuals with a Turkish background, which considers its care provision to be ‘culture-sensitive’. The central questions of this analysis include the following: What are the opportunities and barriers in Dutch care policies in catering to super-diversity? Also: How does a care organisation aimed at dealing with super-diversity fulfil the needs of its diverse clientele? This analysis’ results provide insight into the strategies and challenges of Dutch welfare states in their interactions with ‘super-diversity’.
2. Guðný Björk Eydal, Professor, and Ásdís Arnalds, PhD student, University of Iceland, Iceland present a paper entitled: Polish and Icelandic parents’ division of paid parental leave in Iceland. As Poles are the largest migrant group in Iceland, this study addresses how Polish migrants use parental leave in comparison to parents who are born and raised in Iceland. This study uses mixed methods. A survey and qualitative interviews with parents were used to compare the two groups and to gain insight into the parents’ strategies in dividing parental leave. This study’s findings reveal how parents’ decisions regarding leave use are shaped by their experiences, social networks, work orientation and views towards the roles of men and women in the upbringing of children.
3. Roos Pijpers, Associate Professor, Radboud University, the Netherlands presents a paper entitled: The impact of neighbourhood-based working for access to care of older migrants. In the Netherlands, the neighbourhood is increasingly viewed as an ideal place to organise care and social services. This qualitative study of care services in the city of Nijmegen focuses on the development of practices relevant to older migrants’ access to care. The study’s results indicate that the new service structures are only partially successful in helping these migrants access care. Older migrants search for facilities not in accordance with their function, but rather seek out care professionals with the same cultural background or language. These caregivers are able to bridge the psychological distance between the health care system and the lifeworld of these older migrants.
4. Lenka Formánková, Junior Researcher, Academy of Sciences, Czechoslovakia presents a paper entitled: Negotiated childcare arrangements in the context of migration – case study of Vietnamese and Ukrainian families in the Czech Republic. Based on family and migration policy analysis (analysis of legal documents) and on analysis of interviews conducted with mothers with children under 10 of Vietnamese and Ukrainian origin, this paper aims to fill the gap in social policy research regarding work-life balance within the context of migration. The findings show that the childcare care arrangements in families of migrant background differ in some aspects from the practices of the majority population and are result of gendered pre-migration cultural frameworks same as the institutional environment of the sending and receiving countries, proximal social networks and family composition.

Symposium 6

Care work and change. An across (and within) country comparison of working conditions and job quality in the care sector

Convenor:

Valeria Pulignano, Full Professor, Centre for Sociological Research, KU Leuven, Belgium.

Discussants:

Valeria Pulignano, Full Professor, Centre for Sociological Research, KU Leuven, the Netherlands and Marta Szebehely, Professor of Social Work, Stockholm University, Sweden

The symposium aims at enhancing knowledge on the social impact of policy change in care work under constraints in (welfare and power) resources during economic and financial austerity measures as well as neo-liberal marketization processes and policies in public services, in Europe. The main focus are the working conditions and job quality of workers in contemporary care work. It also discusses the factors, processes and conditions generating these employment outcomes under changing priority in care policy.

Each paper in the stream deals with the overarching theme of changing working conditions and job quality in care work. In particular, they assess their social effects and consider their theoretical and policy implications for labour markets segmentation and social change in the context of comparative studies (e.g. Beynon et al., 2002) by encompassing macro and micro perspectives (Pulignano and Doerflinger, 2018). Drawing from the sociological tradition in employment studies (e.g. Gallie 2013, 2007), combining working conditions and job quality offers an encompassing framework for research and theory development when examining employment under changing policy priority. This is because whereas working conditions deal with objective (contractual) conditions of work (e.g. atypical work, hours of work, education and training, wages), within specific institutional-regulatory contexts (i.e. ‘employment regimes’, Gallie, 2007), job quality engages also with the subjective experiences of work (e.g. health and well-being, career prospects, skills development, reconciliation work-life, job autonomy, job rotation, support, task complexity)

In the light of the aforementioned aims and objectives the stream will consist of four papers addressing the main topic of study in different EU (United Kingdom, Belgium, Germany, and Italy.)

Panel composition:

1. Dorien Frans, Doctoral Researcher, Nadja Doerflinger, Postdoctoral Researcher and Full Professor Valeria Pulignano, Centre for Sociological Research (Ceso), Faculty of Social Science, Belgium
“The (changing) landscape of elderly care in Belgium: challenges and outcomes for quality of working life.”
2. Matthew Johnson, Senior Lecturer In Organisation Studies, Alliance Manchester Business School United Kingdom, Associate Professor Arista Koukiadaki, Alliance Manchester Business School, United Kingdom and Núria Sánchez-Mira, Postdoctoral fellow, Swiss National Centre of Competence in Research LIVES, Institut des Sciences Sociales Quartier UNIL- University of Lausanne, Switzerland
“Different means to the same end? The value (and limits) of socially responsible procurement in older people’s care in the UK and Spain in a context of austerity”
3. Nadja Doerflinger, Postdoctoral Researcher and Full Professor Valeria Pulignano, Centre for Sociological Research (Ceso), Faculty of Social Science, Belgium
‘Labour of love’ versus profit maximization? Comparing working conditions in charitable and for-profit nursing homes in Germany
4. Andrea Ciarini, Assistant Professor. Department of Social and Economic Sciences (DiSSE), Sapienza University of Rome, Italy
“The marketisation of care in Italy. The intended» and «unintended consequences of the “aziende speciali”

Symposium 7

Combining work and care: Workplace support and its contribution to sustainable care arrangements

Conveners:

Jason Heyes, Professor of Employment Relations, Management School, University of Sheffield, and Sue Yeandle, Professor of Sociology, University of Sheffield, United Kingdom

Discussants:

Kate O’Loughlin, Associate Professor of Ageing, Work and Health, CEPAR/University of Sydney, Australia
Teppo Kröger, Professor of Social and Public Policy, University of Jyväskylä, Finland

Family carers provide the majority of care for older and disabled people who need support around the world, and are central to the sustainability of care systems. They are growing in number; most are of working age and many are employed full-time in addition to providing vital, usually unpaid, care.
This proposed symposium includes papers from Canada, Europe, Japan and Taiwan, with contributions from major research programmes in these countries, where researchers are studying policy and practice developments in support for ‘working carers’. These span a spectrum of interventions and modifications to working practices and cultures. They range from flexible work schemes, innovative advocacy and support arrangements for employees, and different forms of care leave. Some measures have been proposed and supported by workers, trade unions or carers’ organisations; others were introduced by employers. Some are legislated policies, requiring employers to support working carers in specific ways, or entitling employees to vary their employment patterns, or take leave from work to manage a caring role (sometimes with compensation for foregone earnings). In Taiwan, the policy enables families to employ a migrant care worker.
Papers in the session are highly relevant to the conference theme. They focus on how policies are made and implemented, discuss new evidence and analyses – highlighting innovations, convergence, diversity, and advantages/disadvantages – and they distinguish policy rhetoric and ambition from working carers’ lived realities. The discussants will draw on their expertise in this field to critique and contextualise the presenters’ analyses, and to encourage discussion and debate.
The convenors, discussants and presenters are members of an international network linked to the UK ESRC-funded programme: Sustainable Care: connecting people and systems (PI Yeandle), within which Heyes is a team leader responsible for the project, Combining work and care: workplace support and its contribution to sustainable care arrangements.

Panel composition:

1. Kate Hamblin, Research Fellow in Sustainable Care, University of Sheffield, UK and Katja Knauthe, researcher and doctoral student, University of Applied Sciences Zittau-Görlitz, Germany
‘Progress and regression in the compatibility of care and work in the 21st century: an Anglo-German comparison’
2. Allison Williams, Professor & CIHR Research Chair, McMaster University, Hamilton, Canada
‘Achieving a caregiver-friendly workplace standard for Canadian working carers: A partnership approach’
3. Shingou Ikeda, Vice-Senior Researcher, Japan Institute of Labor Policy and Training, Japan
‘Statutory care leave in Japan: policy changes, rationales and their consequences’
4. Li-Fang Liang, A/Professor, Institute of Health & Welfare Policy, National Yang-Ming University, Taiwan
‘Managing work and care without workplace support: does employing a live-in worker fill the gap? The example of Taiwan’