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(In)Decent work conditions and quality care: an issue for long-term care policy

Published online by Cambridge University Press:  30 March 2021

Ana Paula Gil*
Affiliation:
Interdisciplinary Centre of Social Sciences (CICS.NOVA), NOVA FCSH, Lisbon, Portugal
*
*Corresponding author. Email: anapgil@fcsh.unl.pt

Abstract

The availability of informal care will remain a key factor influencing future demand for formal services and the analysis cannot be dissociated from formal care. Based on the ‘unpaid care work–paid work–paid care work circle’, proposed by the International Labour Office, this paper focuses on the individual, interpersonal and organisational determinants that most influence quality care. This paper is based on 40 semi-structured interviews with care workers, in 16 Portuguese care homes, in one council in the metropolitan area of Lisbon. In spite of social change processes in the care worker profession in Portuguese nursing homes, in the last decade, in terms of numbers, age and education, the interviews allowed me to unveil qualitatively what the numbers hid: precarious working conditions, insufficient staffing, excessive workloads and long working hours, high rotation and insufficient skills. All these determinants have consequences not only on the quality of the care that these care workers can offer, but also on their physical and mental health, job satisfaction and work environment. The high demand of care needs due to the ageing of the population, calls for continued efforts in improving working conditions, and a national strategy to promote recruitment of a diverse, younger and more-qualified workforce. The professionalisation of care work must be integrated with migration and employment policies (improvement of job quality and working conditions).

Type
Article
Copyright
Copyright © The Author(s), 2021. Published by Cambridge University Press

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References

Abrantes, M (2012) A densidade da sombra: trabalho doméstico, género e imigração [In the depth of shadows: domestic work, gender and immigration]. Sociologia, Problemas e Práticas 70, 91110.Google Scholar
Anderson, A (2012) Europe's care regimes and the role of migrant care workers within them. Population Ageing 5, 135146.CrossRefGoogle Scholar
Bauer, G, Rodrigues, R and Leichsenring, K (2018) Working conditions in long-term care in Austria. The perspective of care professionals. European Centre, Vienna, Policy Brief.Google Scholar
Bettio, F and Verashchangina, A (2012) Elderly Care in Europe. Provisions and Providers in 33 Countries. Luxembourg: Publications Office of the European Union.Google Scholar
Bouget, D, Spasova, S and Vanhercke, B (2016) Work–Life Balance Measures for Persons of Working Age with Dependent Relatives in Europe – A Study of National Policies. Brussels: European Commission.Google Scholar
Cangiano, A and Shutes, I (2010) Ageing, demand for care and the role of migrant care workers in the UK. Journal of Population Ageing 3, 3957.CrossRefGoogle Scholar
Cangiano, A, Shutes, I, Spencer, S and Leeson, G (2009) Migrant Care Workers in Ageing Societies. Oxford: Centre on Migration, Policy and Society, University of Oxford.Google Scholar
Colombo, F, Nozal, AL, Mercier, J and Tjadens, F (2011) Help Wanted? Providing and Paying for Long-term Care (OECD Health Policy Studies). Paris: OECD Publishing, pp. 159187.CrossRefGoogle Scholar
Corbin, J (1992) Le soin: cadre théorique pour un cheminement interactif. Revue internationale d'action communautaire 28, 3949.Google Scholar
Dixon, J, Biggs, S, Tinker, A, Stevens, M and Lee, L (2009) Abuse, Neglect and Loss of Dignity in the Institutional Care of Older People. London: National Centre for Social Research.Google Scholar
Drennan, J, Lafferty, A, Treacy, M, Fealy, G, Phelan, A, Lyons, I and Hall, P (2012) Older People in Residential Care Settings: Results of a National Survey of Staff–Resident Interactions and Conflicts. Dublin: University College Dublin and National Centre for the Protection of Older People.Google Scholar
Dubet, F (1994) Sociologia da Experiência [Sociology of Experience]. Lisbon: Instituto Piaget.Google Scholar
Eurofound (2017) In-work Poverty in the EU. Luxembourg: Publications Office of the European Union.Google Scholar
Eurofound (2019) Quality of Health and Care Services in the EU. Luxembourg: Publications Office of the European Union.Google Scholar
European Commission (2018) Informal Care in Europe – Exploring Formalisation, Availability and Quality. Luxembourg: Publications Office of the European Union.Google Scholar
European Commission, Directorate-General for Economic and Financial Affairs (2018) The 2018 Ageing Report – Economic and Budgetary Projections for the EU Member States (2016–2070). Luxembourg: European Commission.Google Scholar
Eurostat (2015) People in the EU: Who Are We and How Do We Live? – Statistics on an Ageing Society. Luxembourg: Publications Office of the European Union.Google Scholar
Eurostat (2018) Inactive population due to caring responsibilities by sex. Eurostat Home. Luxembourg: Publications Office of the European Union.Google Scholar
Eurostat (2019) Ageing Europe – Looking at the Lives of Older People in the EU – Statistics on an Ageing Society. Luxembourg: Publications Office of the European Union.Google Scholar
Figueiredo, MC, Suleman, F and Botelho, MC (2018) Workplace abuse and harassment: the vulnerability of informal and migrant domestic workers in Portugal. Social Policy & Society 17, 6585.CrossRefGoogle Scholar
Gabinete de Estratégia e Planeamento (2018) Carta Social. Lisbon: Gabinete de Estratégia e Planeamento, Ministério da Solidariedade, Emprego e Segurança Social.Google Scholar
Gil, AP (2010) Heróis do quotidiano: Dinâmicas familiares na dependência [Everyday Heroes: Family Dynamics in Dependency]. Lisbon: Fundação Calouste Gulbenkian and Fundação para a Ciência e para a Tecnologia.Google Scholar
Gil, AP (2018) Care and mistreatment – two sides of the same coin? An exploratory study of three Portuguese care homes. International Journal of Care and Caring 2, 551573.CrossRefGoogle Scholar
Gil, AP (2019) Quality procedures and complaints: nursing homes in Portugal. Journal of Adult Protection 21, 126143.CrossRefGoogle Scholar
Gil, AP (2020) Estruturas residenciais para pessoas idosas: Relação entre qualidade dos cuidados e qualidade do emprego [Residential structures for older people: the relation between care quality and employment quality]. CIDADES, Comunidades e Territórios 40, 6787.Google Scholar
Gil, AP, Moniz, A and São-José, J (2019) Technologies in Care for Older People (EPTA Report 2019), pp. 9098. Available at https://eptanetwork.org/images/documents/minutes/EPTA_report_2019.Google Scholar
Guberman, N, Maheu, P and Maillé, C (1992) Women as family caregivers: why do they care. The Gerontologist 32, 607617.CrossRefGoogle ScholarPubMed
Hayes, LJB (2017) Stories of Care: A Labour of Law – Gender and Class at Work. London: Palgrave.Google Scholar
Hoffmann, F and Rodrigues, R (2010) Informal carers: who takes care of them? European Centre for Social Welfare Policy, Vienna, Policy Brief, April.Google Scholar
Hussein, S (2010) Adult care workers at the upper end of the third age (60–75). England Social Care Workforce Periodical (Issue 5). London: Social Care Workforce Research Unit, King's College.Google Scholar
Hussein, S (2018) Job demand, control and unresolved stress within the emotional work of long-term care in England. International Journal of Care and Caring 2, 89107.Google Scholar
Hussein, S and Manthorpe, J (2010) Attracting young adults (18–25) to work in social care in England, how secondary data analysis may assist policy makers and providers. Diversity in Health and Care 7, 229239.Google Scholar
Hussein, S and Manthorpe, J (2012) The dementia social care workforce in England: secondary analysis of a national workforce data set. Aging and Mental Health 16, 110118.CrossRefGoogle Scholar
Hussein, S, Manthorpe, J and Stevens, M (2011) Social care as first work experience in England: a secondary analysis of the profile of a national sample of migrant workers. Health and Social Care in the Community 19, 8397.CrossRefGoogle ScholarPubMed
Hussein, S, Stevens, S and Manthorpe, J (2013) Migrants’ motivations to work in the care sector: experiences from England within the context of EU enlargement. European Journal of Ageing 10, 101109.CrossRefGoogle ScholarPubMed
Instituto Nacional de Estatística (2011) Recenseamento Geral à População (Database). Lisbon: Instituto Nacional de Estatística.Google Scholar
International Labour Organization (2019) Working conditions in a global perspective. Publications Office of the European Union, Luxembourg, and International Labour Organization, Geneva.Google Scholar
International Labour Organization (ILO) (2018) Care Work and Care Jobs for the Future of Decent Work. Geneva: ILO.Google Scholar
Keating, N, Eales, J, Funk, L, Fast, J and Min, J (2019) Life course trajectories of family care. International Journal of Care and Caring 3, 147163.Google Scholar
King-Dejardin, A (2019) The Social Construction of Migrant Care Work – At the Intersection of Care, Migration and Gender. Geneva: International Labour Organization.Google Scholar
King-Dejardin, A (2019) The social construction of migrant care work - At the intersection of care, migration and gender. Geneva: International Labour Office.Google Scholar
Lopes, A (2017) Long-term care in Portugal – quasi-privatization of a dual system of care. In Greve, B (ed.), Long-term Care for the Elderly in Europe – Development and Prospects, Social Welfare Around the World. London: Routledge, pp. 5974.Google Scholar
Mackenzie, R and Forde, C (2009) The rethoric of the ‘good worker’ versus the realities of employers’ use and the experiences of migrant workers. Work, Employment and Society 23, 142159.CrossRefGoogle Scholar
Melchiorre, M, Penhale, B and Lamura, G (2014) Understanding elder abuse in Italy: perception and prevalence, types and risk factors from a review of the literature. Educational Gerontology 40, 909931.Google Scholar
Miles, M, Huberman, M and Saldana, J (2014) Qualitative Data Analysis – A Methods Source Book, 3rd Edn. Thousand Oaks, CA: Sage.Google Scholar
Ministério do Trabalho, Solidariedade e Segurança Social (2020) Boletim do Trabalho e Emprego, no. 39, Lisbon, Gabinete de Estratégia e Planeamento.Google Scholar
Organisation for Economic Co-operation and Development (OECD) (2013 a) A Good Life in Old Age? Monitoring and Improving Quality in Long-term Care (OECD Health Policy Studies). Paris: OECD Publishing.Google Scholar
Organisation for Economic Co-operation and Development (OECD) (2013 b) International Migration Outlook 2013. Paris: OECD Publishing.Google Scholar
Organisation for Economic Co-operation and Development (OECD) (2014) Unpaid Care Work: The Missing Link in the Analysis of Gender Gaps in Labour Outcomes. Paris: OECD Development Centre.Google Scholar
Organisation for Economic Co-operation and Development (OECD) (2017) Health at a Glance 2017 (OECD Indicators). Paris: OECD Publishing.Google Scholar
Organisation for Economic Co-operation and Development (OECD) (2019 a) Health at a Glance 2019 (OECD Indicators). Paris: OECD Publishing.Google Scholar
Organisation for Economic Co-operation and Development (OECD) (2019 b) International Migration Outlook 2019. Paris: OECD Publishing.Google Scholar
Organisation for Economic Co-operation and Development (OECD) (2020) Who Cares? Attracting and Retaining Care Workers for the Elderly (OECD Health Policy Studies). Paris: OECD Publishing.Google Scholar
Peixoto, J and Figueiredo, A (2007) Imigrantes brasileiros e o mercado de trabalho em Portugal [Brazilian immigrants and the labour market in Portugal]. In Malheiros, J (ed.), Imigração Brasileira em Portugal. Lisbon: ACIDI, pp. 87112.Google Scholar
Pordata (2020) Database of Contemporary Portugal. Lisbon: Francisco Manuel dos Santos Foundation.Google Scholar
Reis Oliveira, C and Gomes, N (2014) Monitorizar a integração de imigrantes em Portugal: relatório estatístico decenal [Monitoring the Integration of Immigrants in Portugal: 10-year Statistical Report] (Imigração em Números 1). Lisbon: Alto Comissariado para as Migrações.Google Scholar
Rodrigues, R (2017) Cuidados de longa duração para idosos no contexto europeu: múltiplas soluções para um problema comum? [Long-term care for the elderly in the European context: multiple solutions to a common problem?] In Ferreira, P, Cabral, M and Moreira, A (eds), Envelhecimento na Sociedade Portuguesa – Pensões, Família e Cuidados [Ageing in Portuguese Society – Pensions, Family and Care]. Lisbon: Imprensa de Ciências Sociais, pp. 165179.Google Scholar
Rodrigues, R (2020) Caring relationships and their role in users’ choices: a study of users of Direct Payments in England. Ageing & Society 40, 14691489.CrossRefGoogle Scholar
Rodrigues, R, Huber, M and Lamura, G (2012) Facts and Figures on Healthy Ageing and Long-term Care. Vienna: European Centre for Social Welfare Policy and Research.Google Scholar
Rodrigues, R, Schulmann, K, Schmidt, A, Kalavrezou, N and Matsaganis, M (2013) The Indirect Costs of Long-term Care (Research Note 8). Brussels: DG Employment, Social Affairs & Inclusion.Google Scholar
Rummery, K and Fine, M (2012) Care: a critical review of theory, policy and practice. Social Policy and Administration 46, 321343.CrossRefGoogle Scholar
Salis, E (2014) The governance of labour migration in the long-term care sector. Comparative Migration Studies (CMS) 2, 519545.CrossRefGoogle Scholar
Scheil-Adlung, X (2016) Health workforce: a global supply chain approach. New data on the employment effects of health economies in 185 countries. International Labour Organization, Geneva, Extension of Social Security Working Paper.Google Scholar
Scheil-Adlung X and International Labour Organization (ILO) (2015) Long-term care protection for older persons: a review of coverage deficits in 46 countries. International Labour Organization, Geneva, Extension of Social Security Working Paper.Google Scholar
Shulmann, K, Gasior, K, Fuchs, M and Leichsenring, K (2016) The view from within: ‘good’ care from the perspective of care professionals – lessons from an explorative study. European Centre, Vienna, Policy Brief.Google Scholar
Simonazzi, A (2008) Care regimes and national employment models. Università degli Studi di Roma, Rome, Working Paper.CrossRefGoogle Scholar
Spencer, S, Martin, I, Bourgeault, I and O'Shea, E (2010) The Role of Migrant Care Workers in Ageing Societies: Report on Research Findings in the United Kingdom, Ireland, Canada and the United States. Geneva: International Organization for Migration.Google Scholar
Theobald, H (2017) Care workers with migrant backgrounds in formal care services in Germany: a multi-level intersectional analysis. International Journal of Care and Caring 1, 209226.CrossRefGoogle Scholar
Tronto, J (2010) Creating caring institutions: politics, plurality and purpose. Ethics and Social Welfare 4, 158171.CrossRefGoogle Scholar
United Nations Economic Commission for Europe (2019) The challenging roles of informal carers. United Nations Economic Commission for Europe, Geneva, Policy Brief on Ageing ECE/WG.1/31.Google Scholar
Verbakel, E, Tamlagsrønning, S, Winstone, L, Fjær, EL and Eikemo, TA (2017) Informal care in Europe: findings from the European Social Survey (2014) special module on the social determinants of health. European Journal of Public Health 27, 9095.CrossRefGoogle ScholarPubMed
Wall, K and Nunes, C (2010) Immigration, welfare and care in Portugal: mapping the new plurality of female migration trajectories. Social Policy and Society 9, 397408.CrossRefGoogle Scholar
Wiskow, C, Albreht, T and Pietro, C (2010) How to Create an Attractive and Supportive Working Environment for Health Professionals. Copenhagen: World Health Organization Europe.Google Scholar
Woolham, J, Norrie, C, Samsi, K and Manthorpe, J and (2019) The employment conditions of social care personal assistants in England. Journal of Adult Protection 21, 296306.CrossRefGoogle Scholar
Yeandle, S (2016) Caring for our carers: an international perspective on policy developments in the UK. Juncture 23, 5762.CrossRefGoogle Scholar