Gender and Paid Care Work in Modern Welfare States: issues of worklife balance

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Gender and Paid Care Work in Modern Welfare
States issues of work-life balance

• Clare Ungerson and
• Sue Yeandle

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Study The Shifting Boundaries of Paid Unpaid
Care Work Future of Work phase 2 project

• International study of paid and unpaid work in
  the domiciliary care of older people.
• Focus on new forms of care work where, through
  state subsidy, older people become direct
  employers of their caring labour, in their own
  homes.
• National studies in the UK, France, Netherlands,
  Austria and Italy.
• Methods qualitative 10 interviews with elderly
  care users in each country, and up to 2 of their
  current carers leading to approximately 20
  interviews with caregiver/workers in each country

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Aims of the research

• To explore the concept of the commodification of
  care using comparative empirical data drawn, in
  part, from countries where care users can employ
  their relatives to care, and/or where there is no
  regulation of careworkers position
• to assess the impact of 'cash for care' policies
  on the labour market for care work on
  employer/employee relations in the home
• to explore whether these policies maintain or
  improve the social rights of care workers
• to contribute to debates on the management
  organisation of these systems
• to consider how far devolved employer / employee
  relations into the household can be, or should
  be, regulated by the state.

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Commodification of care and work/life balance

• Work/Life balance dichotomy makes little sense
  in this context
• If relatives can be employed, then life
  becomes work.
• Affect and contract move into hybridity.
  Particular impact on the use and ownership of
  time.
• If long-term relationships and co-residence
  encouraged through low payments to live-in
  undocumented care workers, then work becomes
  life.
• Emotions engage, privacy becomes problematic.

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Figure 1 The Cross of Routed Wages
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Figure 2 Carers
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Figure 3 Schemes for Organising Routed Wages
Type of Payment and Time Availability
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Life becomes work (1)

• Where relatives can be paid, this can transform
  unrecognised, unremunerated, uncompensated care
  into full status employment as seen from the
  public domain

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Austrian woman caring for her mother-in-law,
employed by Caritas(1)

• You can only say that I simply felt as if I had
  been promoted. Society also saw it totally
  different then. Suddenly it was Aha, youre
  doing a job. Although I didnt do anything
  differently before, it was suddenly seen as
  self-evident..as soon as youre in employment
  and can say to the doctor that you have your own
  health insurance, it appears you are a better
  type of person. From the point of view of
  society, this type of employment is very good for
  women.

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Life becomes work(2)

• But, in the domestic domain, life can never
  quite become work
• If relatives are paid, work always remains a
  hybrid of affect and contract
• It can mean that work intrudes into every
  aspect of life

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Austrian woman caring for her mother, employed by
Caritas (2)

• I earn more than I did in the factory. I was
  very surprised. On top of that I am in a proper
  employee relationship here and, in the factory, I
  was just another poorly paid worker.
• The minus side is that I never have any free
  time. I cant go out in the evenings if I want
  to.I can go out once a month, and then I have to
  be home by 3am because Ive got to work to a
  prescribed time. Ill be 39 this year, but I
  have to be home by 3am. She doesnt like it.

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Where cash payments to users are low

• Users make trade offs between time and wages
• Where there is a very low wage care labour market
  (typically grey or informal economic
  activity) users can pay for 24/7 care with a mix
  of low wage and in kind accommodation and
  subsistence
• Where there is a credentialised care labour
  market, users can pay qualified workers for short
  bursts of care time
• Each type of trade off has its own impact on
  work/life balance

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Low cash for care employing grey labour

• Work can take over life
• Living in this ladys house helps us
  enormously. However, its not like living in
  your own house.you never have a moment free as
  you do when youre at home, not even when youre
  sleeping. It is not a normal job. A normal job
  is when you know what time you start and what
  time you finish". (Italian care worker)
• Or work is so important, life takes place
  elsewhere
• I would like to have my children here and
  living with me within five years, working in a
  rest home during the day and going home to them
  in the evening (Italian care worker)

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Low cash for care employing credentialised labour

• Work is rushed
• Careworkers want to spend more time, through
  affect, but cannot
• I asked, Until what time are we to work in the
  evening? I was told,Usually you should be home
  by 7.30 at the latest. Yes, but when I have both
  clients. Like this evening I have Mr M. first.
  Friday is griddle cake night, the night on which
  he eats best. So the griddle cakes have to be
  heated up, the egg has to be placed on top and
  everything. I dont know where he puts it all! He
  eats 3 of them! But it makes him happy. On Friday
  he treats himself. You cannot do it in 5 minutes!
  Afterwards there is the washing up, and then he
  has to be undressed. As I have shopping to do
  this evening I will take 1/4 of an hour to go to
  the nearest grocers, its more expensive but what
  can you do? On Fridays, instead of ½ an hour it
  takes a good 3/4 of an hour, plus 1/4 of an hour
  for shopping, that makes 1 hour. (French care
  worker, working for an agency)

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Work in the private home of an elderly care user

• There are problems over the ownership of time,
  privacy, and private space.
• The work involved often involves intimacy and
  bodily care, and this engages emotions.
• Employment can come to an abrupt end or be
  unexpectedly interrupted

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• Austrian woman caring for her mother with
  cash-for-care support
• " A really close friend of mine actually said
  to my face that she wouldn't come to see me
  because my father is always there. It puts an
  enormous strain on friendships you are simply
  more isolated and not so free."
• UK care workers employed through Direct
  Payments
• " She is quite apprehensive at night because
  she doesn't know who's coming in. It must be
  daunting, because she goes to bed and these
  people are left in her home."
• " Its just across the road, and he rings me up
  a lot. 'Oh, can you just do this and that, like
  out of my time.'

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• Peruvian migrant worker, living in with an
  elderly care user in Milan " The woman could
  not walk unaided, and then could not sleep at
  night, she wanted to go to the toilet every two
  minutes, shouted, said she wanted to go out. It
  was tough, helping her day and night, because I
  never managed to get a rest."
• Spanish care worker, referring to her
  employer of 26 years
• "It was a job with no fixed timetable for a
  fixed payment I was obliged to stay with her for
  2 hours a day which could be more or less
  according to the situation.. In practice,
  sometimes in the morning, sometimes in the
  afternoon and I had to keep myself free to go
  to her immediately. ... At a certain point we
  didn't understand each other. This all happened
  because she became jealous of my little
  grandchild. One time I said that I could not come
  to her house for a week because I had to take
  care of my grandson, and she got very angry. We
  quarrelled and I decided to go. Now I feel great
  remorse in having done so, because I really am
  very fond of her."

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• UK Care worker, employed through Direct
  Payments
• "It is a very bad thing actually, because you
  do get clients ringing in suddenly and saying,
  'We don't need the service today', or maybe they
  just get taken into hospital - that happens a lot
  actually - because then you lose that work then,
  don't you? Sometimes it can be for 2 or 3 weeks.
  I've lost out a lot. Just recently, actually,
  because 2 of my clients have died. And another
  one was in respite, and a 4th one we had to
  suspend the service for some time because the
  person had had a stroke and needed 2 people to
  handle her. I couldn't handle her by myself, she
  was so heavy. So I've sort of lost 4 clients in
  one week, which worked out at 16 hours, which is
  a lot to me."

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What happens when cash-for-care payments are
unregulated?

• Informal carers can replace some of their own
  care work by employing others, giving them
  freedom and space
• For the carers they employ, these caring jobs may
  jeopardise work-life balance
• Informal carers do not always see the cash as
  turning their care into work
• Care workers can feel exploited or 'bought'

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• Italian woman, 57, caring for her 67 year old
  husband following a stroke
• "I do not put my husband's (cash for care)
  money in my pocket, but I use it to pay the
  person who looks after him while I am at work.
  Every so often I tell my husband that if he had
  to pay me for my work in caring for him the whole
  of his pension would not be enough, considering
  that I look after him day and night, except for
  the 24 hours that I go to work weekly."

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• Migrant mother and daughter caring for an
  elderly woman in Milan
• "Sometimes I manage to sleep some hours in a
  row at night. It depends on how she is. Some
  nights she doesn't sleep, but screams, and is
  always asking for help. There is an armchair near
  her bed. I put myself there and every so often go
  to sleep for a bit, but I don't always manage
  to." (Daughter)
• The son and daughter-in-law tell me, 'We cannot
  change over to another person, you must stay here
  as long as mother survives.' I have committed
  myself. .. I got ill but I live here, so I
  stay and work as usual. (Mother)

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85 year old Italian woman, mainly cared for by
her son, but employing a man to clean for 4 hours
pw

• " I have not employed (the cleaner) in the
  strict meaning of the word. He simply does me a
  favour, gives me a hand, and I pay him 50,000
  lire a week for this favour. Sometimes I also
  give him a little present, so he thinks I am fair
  and does the cleaning better. For me, this person
  is already a friend. Even when he doesn't have to
  come to me to do the cleaning, every so often he
  comes to the door to ask me how I am, if
  everything is well, if I need anything. I've
  already known him for a very long time. (He
  calls me) Signora, even though I would like him
  to use 'tu' to me."

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Peruvian care worker living in with her elderly
client in Milan

• "When she watches television in the afternoon,
  seeing that she ... doesn't need me, I want to
  take the opportunity to write a letter to my
  family, but she does not want that. She wants me
  to stay always by her side, and watch television
  seated next to her, so if she sees me going away,
  she says 'Where are you? What are you doing? I
  pay you to stay with me and keep me company. I
  don't pay you to wander about the house.'
  However, she has got to understand that she has
  not bought me with that little salary she pays
  me."

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Conclusions

• This project demonstrates how policy can
  profoundly influence work/life balance but in
  unexpected and unintentional ways
• We have presented some extremes
• The impact on illegal labour markets and
  undocumented labour, where work/life balance
  disappears altogether
• The impact on previously unpaid informal carers
  who, through payment, acquire self esteem and
  respect from others when life becomes work

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Conclusions

• The implications for UK policy are complex
• Direct Payments are high on the agenda, and the
  regulations are changing in future relatives can
  be employed to care under discretion
• The level at which DP are funded and their
  regulation will have profound impacts on the
  organisation of
• Labour markets
• The public and private lives of the
  careworker/givers who participate in those labour
  markets