Bringing the Family in through the Back Door: the Stealthy Expansion of Family Care in Asian and European Long-Term Care Policy
Tóm tắt
In the era of global ageing, amid political concerns about increasing care needs and long-term sustainability of current care regimes, most high-income economies are seeking to minimise the use of institutional care and to expand formal home care for their older populations. In long-term care reforms, concerns about public funding, formal providers and the paid care workforce are foremost. However, an integral yet hidden part of all these reforms is the stealthily growing role of family carers. This article aims to identify and spell out how developments in formal home care bring about different modes of increasing, encouraging and necessitating family care inputs, across welfare states. Using secondary sources, three different modes were identified, and the article outlines the logic of each mechanism, drawing on illustrative examples of policy dynamics in both European and Asian countries. Family care inputs have increased through policy changes that are not explicitly or primarily about family care, but rather about expansion or changes in formal care. In some cases, this is explicit, in other cases something that happens 'through the back door'. Nonetheless, in all cases there are implications for the family caregivers' time, health and employment options. Future studies are needed to examine longitudinal trends from a comparative perspective to confirm our findings and elucidate how government commitments to formal home care provision and financing interact with the changing nature and volume of family caregiving.
Tài liệu tham khảo
Asato, W. (2009). ‘Higashi Ajia ni okeru kea no kazokuka seisaku to gaikokujin rōdōsha’ (“Familialisation policy” of care and foreign domestic workers in East Asia). Fukushi Shakaigaku Kenkyū (Journal of Welfare Sociology), 6, 10–25.
Asato, W. (2014). Incorporating foreign domestic workers as providers of family care: Case studies of Hong Kong, Taiwan and Singapore. In E. Ochiai & H. L. Aoi (Eds.), Transformation of the intimate and the public in Asian modernity (pp. 190–233). Brill: Leiden.
Bowlby, S., McKie, L., Gregory, S., & MacPherson, I. (2010). Interdependency and care over the life course. London: Routledge.
Campbell, J. C. (2002). How policies differ: Long-term care insurance in Japan and Germany. In R. Luetzeler & H. Conrad (Eds.), Aging and social policy: A German-Japanese comparison (pp. 157–187). Ludicium: Munich.
Campbell, J. C., Ikegami, N., & Kwon, S. (2009). Policy learning and cross-national diffusion in social long-term care insurance: Germany, Japan, and the Republic of Korea. International Social Security Review., 62(4), 63–80.
Campbell, J. C., Ikegami, N., & Gibson, M. J. (2010). Lessons from public long-term care insurance in Germany and Japan. Health Affairs, 29(1), 87–95.
Chen, H.L. (2014) ‘Meeting the care needs of older people: Long-term care practice in England, the Netherlands, and Taiwan, in Merviö, M.M. Contemporary social issues in East Asian societies: Examining the spectrum of public and private spheres. Herhsye, PA: IGI global.
Chou, Y. C., & Kröger, T. (2004). Community care in Taiwan: Mere talk, no policy. Social Work and Mental Health, 2, 139–156.
Costa, G. (2013). Long term care Italian policies: A case of inertial institutional change. In C. Ranci & E. Pavolini (Eds.), Reforms in long-term care policies in Europe: Investigating institutional change and social impacts (pp. 221–241). New York: Springer.
Courtin, E., Jemiai, N., & Mossialos, E. (2014). Mapping support policies for informal carers across the European Union. Health Policy, 118, 84–94.
Da Roit, B. (2012). The Netherlands: The struggle between universalism and cost containment. Health and Social Care in the Community, 20(3), 228–237.
Daly, M. (2011). What adult worker model? A critical look at recent social policy reform in Europe from a gender and family perspective. Social Politics, 18(1), 1–23.
Fujisawa, R. & Colombo, F. (2009) The long-term care workforce: Overview and strategies to adapt supply to a growing demand. OECD health working paper no. 44. Paris: OECD.
Glendinning, C. (2012). Home care in England: Markets in the context of under-funding. Health and Social Care in the Community, 20(3), 292–299.
Gori, C. (2012). Home care in Italy: A system on the move, in the opposite direction to what we expect. Health and Social Care in the Community, 20(3), 255–264.
Hashizume, Y. (2000). Gender issues and Japanese family-centered caregiving for frail elderly parents or parents-in-law in modern Japan: From the sociocultural and historical perspectives. Public Health Nursing, 17(1), 25–31.
Hayashi, M. (2015). Japan’s long-term care policy for older people: The emergence of innovative “mobilisation” initiatives following the 2005 reforms. Journal of Aging Studies, 33, 11–21.
Jang, S.-N., Avedano, M., & Kawachi, I. (2012). Informal caregiving patterns in Korea and European countries: A cross-national comparison. Asian Nursing Research., 6, 19–26.
Koh, E. K., & Koh, C. K. (2008). Caring for older adults: The parables in Confucian texts. Nursing Science Quarterly, 21, 365–368.
Kröger, T. (2011). Defamilisation, dedomestication and care policy: Comparing childcare service provisions of welfare states. International Journal of Sociology and Social Policy, 31(7/8), 424–440.
Kröger, T., & Leinonen, A. (2012). Transformation by stealth: The re-targeting of home care services in Finland. Health and Social Care in the Community, 20(3), 319–327.
Lan, P.-C. (2006). Global Cinderellas. Durham: Duke University Press.
Lee, E. (2015) Maintenance of parents, repairing of family relationships. Institute of Policy Studies, IPS Commons. http://www.ipscommons.sg/maintenance-of-parents-repairing-of-family-relationships/ Accessed: 7 November 2015.
Lee, Y., & Ku, Y. (2007). East Asian welfare regimes: Testing the hypothesis of the developmental welfare state. Social Policy & Administration, 41(2), 197–212.
Leitner, S. (2003). Varieties of familialism: The caring function of the family in comparative perspective. European Societies, 5(4), 353–375.
Lewis, J. (2001). The decline of the male breadwinner model: Implications for work and care. Social Politics, 8(2), 152–169.
Ministry of Health, Labour and Welfare (Japan) (2014) Comprehensive survey of living conditions of the people on health and welfare. Statistics and Information, Department Minister's secretariat. (in Japanese) [http://www.mhlw.go.jp/toukei/saikin/hw/k-tyosa/k-tyosa14/] (Accessed: 6 November 2015).
Ochiai, E. (2004). 21 seiki kazoku he: Kazoku no sengotaisei no mikata, koekata (towards the 21 st century family: The postwar family system and its transformation). Tokyo: Yuhikaku.
Ochiai, E. (2009). Care diamonds and welfare regimes in East and southeast Asian societies: Bridging family and welfare sociology. The International Journal of Japanese Sociology, 18, 60–78.
Ochiai, E. (2010). Reconstruction of intimate and public spheres in Asian modernity: Familialism and beyond. Journal of Intimate and Public Spheres, 0, 2–22.
Ochiai, E., Aya, A., Uzuhashi, T., Tamiya, Y., & Shikata, M. (2010). Nihon ni okeru kea daiamondo no saihensei. Kaigo hoken ha ‘kazokushugi’ wo kaetaka. (realignment of ‘care diamonds’ in Japan: Has long-term care insurance changed ‘familism’?). Kaigai Shakai Hoshō Kenkyū (The Review of Comparative Social Security Research), 170, 4–19.
OECD. (2011). Help wanted? Providing and paying for long-term care. Paris: OECD.
Peng, I. (2012). Social and political economy of care in Japan and South Korea. International Journal of Sociology and Social Policy., 32(11/12), 636–649.
Pfau-Effinger, B., & Rostgaard, T. (2011). Care between work and welfare in European societies. New York: Palgrave.
Ranci, C., & Pavolini, E. (2015). Not all that glitters is gold: Long-term care reforms in the last two decades in Europe. Journal of European Social Policy, 25(3), 270–285.
Rhee, J. C., Done, N., & Anderson, G. F. (2015). Considering long-term care insurance for middle-income countries: Comparing South Korea with Japan and Germany. Health Policy, 119, 1319–1329.
Rostgaard, T. (2015) ‘failing ageing? Risk management in the active ageing society’, in Larsen, J.E, Frederiksen, M. And Bengtsson, T. (Eds) Risk and the modern welfare state - Sociological investigations of the Danish case. New York; Palgrave MacMillan.
Rostgaard, T., Timonen, V., & Glendinning, C. (2012). Comparing home care policies across Europe. Health and Social Care in the Community, 20(3), 225–227.
Rozario, P. A., & Rosetti, A. L. (2012). “Many helping hands”: A Review and analysis of long-term care policies, programs, and practices in Singapore. Journal of Gerontological Social Work, 55(7), 641–658.
Schmähl, W., Augurzky, B., & Mennilen, R. (2012). ASISP annual national report 2012: Germany. Brussels: European Commission.
Tamiya, N., Noguchi, H., Nishi, A., Reich, M. R., Ikegami, N., Hashimoto, H., et al. (2011). Population ageing and wellbeing: Lessons from Japan’s long-term care insurance policy. The Lancet, 378, 1183–1192.
Tamura, K. (2009). ‘Policy measures in Singapore and their implications for Japan’, Cabinet Office of Japan, Gender equality policies and women’s participation in decision making processes in the Netherlands, Norway, Singapore and the United States, 138–148.
Teo, P., Mehta, K., Thang, L. L., & Chan, A. (2006). Ageing in Singapore: Service needs and the state. London, UK: Routledge.
Theobald, H. (2012). Home-based care provision within the German welfare mix. Health and Social Care in the Community, 20(3), 274–282.
Timonen, V. (2005). Policy paradigms and long-term care: Convergence or continuing differences? In P. Taylor-Gooby (Ed.), Ideas and welfare state reform in Western Europe (pp. 30–53). Basingstoke: Palgrave Macmillan.
Timonen, V. (2009) ‘Toward an integrative theory of care: Formal and informal intersections.’ In: Roberto, Karen A. and Mancini, Jay A. (Eds.) (2009) Human development and the lifespan: Antecedents, processes and consequences of change. Lanham, MD: Lexington, pp. 307–326.
Timonen, V. (2016). Beyond successful and active ageing: A theory of model ageing. Bristol: Policy Press, forthcoming.
Van Hooren, F. (2012). Varieties of migrant care work: Comparing patterns of migrant labour in social care. Journal of European Social Policy, 22, 133–147.
Walker, A., & Wong, C. K. (2005) ‘Introduction: East Asian welfare regimes’, In Walker, A., & Wong, C. K. (Eds.). East Asian welfare regimes in transition: From Confucianism to Globalisation (pp. 3–20). Bristol: The Policy Press.
Yamashita, J., Soma, N., & Chan, R. K. H. (2013). ‘Re-examining family-centred care arrangements in East Asia’, In Izuhara, M. Handbook on East Asian Social Policy (pp. 472–490). Cheltenham: Edward Elgar.
Yeoh, B. S., & Huang, S. (2010). Foreign domestic workers and home-based care for elders in Singapore. Journal of Aging and Social Policy, 22(1), 69–88.
Yu, S., Chau, C.M., & Lee, K.M. (2015) ‘Using defamilisation typologies to study the Confucian welfare regime’, Journal of International and Comparative Social Policy, 31, 1–20.