Hostname: page-component-cd9895bd7-hc48f Total loading time: 0 Render date: 2024-12-27T10:48:25.941Z Has data issue: false hasContentIssue false
  • English
  • Français

To Pay or Not to Pay: Examining Underlying Principles in the Debate on Financial Support for Family Caregivers*

Published online by Cambridge University Press:  31 March 2010

Janice Keefe  and
Beth Rajnovich
Janice Keefe*
Affiliation:
Nova Scotia Centre on Aging
Beth Rajnovich
Affiliation:
Mount Saint Vincent University
*
Requests for offprints should be sent to:/Les demandes de tirés-à-part doivent être adressées à: Janice Keefe, Ph.D., Department of Family Studies and Gerontology, Mount Saint Vincent University, 166 Bedford Highway, Halifax, NS B3M 2J6.
Get access Rights & Permissions [Opens in a new window]

Abstract

In many countries one approach to supporting family-and-friend caregivers is direct financial or monetary support. Debates about the benefits and consequences of such policies pervade the literature. Building on the premise that values underlie public policy, the paper examines four policy paradoxes in the literature and uses selected examples from an international policy analysis to illustrate the underlying objectives and values upon which many of the policies were developed. These include the responsibility to care, economic or social objectives, gender equity, and the autonomy of care receivers. The authors conclude that policy makers need to be cautious about the unintended effects of financial support policy and develop a menu of policies and services to support caregivers. Future policy development in Canada must enable legitimate choice across the life course and ensure that neither the caregiver nor the care receiver will experience short- or long-term financial consequences of his or her choice.

Résumé

De nombreux pays offrent un soutien financier ou monétaire direct aux membres de la famille ou aux amis dispensateurs de soins familiaux. Les débats sur les avantages et les désavantages de cette politique abondent dans la documentation. d'après l'hypothèse voulant que les valeurs sous-tendent les politiques publiques, l'article examine quatre paradoxes politiques relevés dans la documentation et illustre, à l'aide de certains exemples provenant d'une analyse politique internationale, les objectifs et les valeurs sur lesquels repose l'élaboration de nombre des politiques. Il s'agit de la responsabilité des soins, des objectifs économiques ou sociaux, de l'équité de genre, et de l'autonomie des bénéficiaires de soins. Les auteurs mettent en garde les décideurs au sujet des effets pervers d'une politique de soutien financier et proposent des programmes et des services destinés à appuyer les dispensateurs de soins. La politique futur au Canada doit permettre des choix appropriés tout au long de la vie et faire en sorte que ni le dispensateur de soins, ni le bénéficiaire des soins, n'éprouveront de difficultés financières à court ou à long terme en raison de leur choix.

Keywords

agingfamily caregiversgenderpolicypayment for careinternationalvieillissementdispensateurs de soins familiauxgenrepolitiquerétribuer les soinsinternational
Type
Articles
Information
Canadian Journal on Aging / La Revue canadienne du vieillissement , Volume 26 , Issue S1: Hidden Costs/Invisible Contributions of Caregiving / Coûts cachés et contributions invisibles des soins , Winter/Hiver 2007 , pp. 77 - 89
Copyright
Copyright © Canadian Association on Gerontology 2007

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

Footnotes

*

Funding for this paper was received from the Social Sciences and Humanities Research Council as part of the Hidden Costs/Invisible Contributions Project: The Marginalization of Dependent Adults.

References

Adamek, M.E. (1992). Should the government pay? Caregiver views of government responsibility and feelings of stigma about financial support. Journal of Applied Gerontology, 11, 283–297.CrossRefGoogle ScholarPubMed
Armstrong, P., & Kits, O. (2001). One hundred years of caregiving. Ottawa: Law Commission of Canada.Google Scholar
Aronson, J., & Neysmith, S. (2001). Manufacturing social exclusion in the home care market. Canadian Public Policy, 27(2), 151–165.CrossRefGoogle Scholar
Blasser, J. (1998). The case against paid family caregivers: Ethical and practical issues. Generations, 22(3), 65–69.Google Scholar
British Columbia Supreme Court (2005). HMTQ v. Hutchinson et al. Retrieved 28 October 2005 from http://www.courts.gov.bc.ca/Jdb-txt/SC/05/14/2005BCSC1421err1.htm.Google Scholar
Canadian Caregiver Coalition (2005). Working paper for a Canadian caregiver strategy. Retrieved 15 December 2005 from http://www.ccc-ccan.ca/pdf/policyPaper3Eng.pdf.Google Scholar
Carrière, Y., Keefe, J., Légaré, J., Lin, X., & Rowe, G. (In press). Population aging and immediate family composition: Implications for future home care services. Genus.Google Scholar
Colepaugh, J.H. (2004). Lessons to be learned: A gender-based analysis of direct compensation policies for informal caregivers in Australia, Germany and the United Kingdom. Unpublished master's thesis, Mount Saint Vincent University, NS.Google Scholar
Evers, A. (1994). Payments for care: A small but significant part of a wider debate. In Evers, A., Pijl, M., & Ungerson, C. (Eds.), Payments for care: A comparative overview (pp. 19–42). Brookfield: Avebury.Google Scholar
Evers, A. (1998). The new long term care insurance program in Germany. Journal of Aging and Social Policy, 10(1), 77–98.CrossRefGoogle ScholarPubMed
Fast, J., Eales, J., & Keating, N. (2001). Economic impact of health, income security and labour policies on informal caregivers of frail seniors. Ottawa: Status of Women Canada.Google Scholar
Fast, J., Williamson, D., & Keating, N. (1999). The hidden costs of informal elder care. Journal of Family and Economic Issues, 20(3), 301–326.CrossRefGoogle Scholar
Glendinning, C., & McLaughlin, E. (1993). Paying for care: Lessons from Europe. Social Security Advisory Committee Research Paper No. 5. London: HMSO.Google Scholar
Guberman, N. (2003). La remuneration des soins aux proches: enjeux pour les femmes. Nouvelles pratiques sociales, 16(1), 186–206.CrossRefGoogle Scholar
Hammer, E., & Osterle, A. (2003). Welfare state policy and informal long-term care giving in Austria: Old gender divisions and new stratification processes among women. Journal of Social Policy, 32, 37–53.CrossRefGoogle Scholar
Holstein, M., & Mitze, P. (1998). Paid family caregiving: A practical and ethical conundrum. Generations, 22(3), 64–65.Google Scholar
Ingebretsen, R., & Erikson, J. (2004). Services for supporting family carers of elderly people in Europe: Characteristics, coverage and usage – National background report for Norway. Retrieved 14 September 2004 from EUROFAMCARE. website http://www.uke.uni-hamburg.de/extern/eurofamcare/presentations.html.Google Scholar
Jani-Le Bris, H. (2005). Services for supporting family carers of elderly people in Europe: Characteristics, coverage and usage – National background report for France. EUROFAMCARE. Retrieved 14 September 2005 from http://www.uke.uni-hamburg.de/extern/eurofamcare/documents/nabare_france_rc1_a4.pdf.Google Scholar
Jegermalm, M. (2002). Direct and indirect support for carers: Patterns of support for informal caregivers to elderly people in Sweden. Journal of Gerontological Social Work, 38(4), 67–84.CrossRefGoogle Scholar
Jenson, J. (2004). Canada's new social risks: Directions for a new social architecture. CPRN Social Architecture Papers, Research Report F/43, Family Network. Ottawa: Canadian Policy Research Networks.Google Scholar
Jenson, J., & Jacobzone, S. (2002). Care allowances for the frail elderly and their impact on women care-givers. Labour Market and Social Policy, No. 41. Paris: Organisation for Economic Co-operation and Development.Google Scholar
Joel, M.E., Martin, C. (1994). France. In Evers, A., Pijl, M., & Ungerson, C. (Eds.), Payments for care: A comparative overview (pp. 165–190). Brookfield: Avebury.Google Scholar
Johansson, L. (2004). Services for supporting family carers of elderly people in Europe: Characteristics, coverage and usage – National background report for Sweden. Retrieved 14 September 2004 from from EUROFAMCARE Website http://www.uke.uni-hamburg.de/extern/eurofamcare/presentations.html.Google Scholar
Keefe, J. (2004). Policy profiles for compensating family caregivers: Australia, Canada, France, Germany, Israel, Netherlands, Norway, Sweden, United Kingdom, United States. Retrieved 1 May 2005 from http://www.msvu.ca/mdcaging/policyprofiles.asp.Google Scholar
Keefe, J., & Fancey, P. (1997). Financial compensation or home care services: Examining differences among program recipients. Canadian Journal on Aging, 16(2), 254–277.CrossRefGoogle Scholar
Keefe, J., & Fancey, P. (1998). Financial compensation versus community supports: An analysis of the effects on caregivers and care receivers. Ottawa: Health Canada.Google Scholar
Keefe, J., Fancey, P., & White, S. (2005). Consultation on financial compensation initiatives for family caregivers of dependent adults: Final report. Halifax: Mount Saint Vincent University.Google Scholar
Keefe, J., Glendinning, C., Fancey, P. (In press). Financial support for family carers: Policy approaches and debates. In Martin Matthews, A., & Philips, J. (Eds.), Ageing at the intersection of work and home life: Blurring the boundaries.Google Scholar
Keigher, S. (1987). Point/counterpoint: Paid family caregiving for the elderly – Good for the poor? Market Mechanisms gone awry. Health and Social Work Winter 64–65.Google Scholar
Keigher, S. (1991). Wages or welfare? Compensating caregiving in two conservative social welfare states. Journal of Aging & Social Policy, 3(3), 83–104.CrossRefGoogle ScholarPubMed
Keigher, S.M., & Murphy, C. (1992). A consumer view of a family care compensation program for the elderly. Social Service Review, 66, 256–277.CrossRefGoogle Scholar
Kenny, N. (2004). What's fair? Ethical decision-making in an aging society. Ottawa: Canadian Policy Research Networks and the Change Foundation.Google Scholar
Kremer, M. (2004, October 7 & 8). Where are we going to when consumers are in the driver's seat? The Dutch Personal Budget (PGB) and its impact on the market, professionals and the family. Second draft. Paper presented at Professionals between People and Policy Transformations in Care and Welfare in Europe, Amsterdam, Utrecht.Google Scholar
Kunkel, S.R., Applebaun, R.A., & Nelson, I.M. (2003–2004). For love and money: Paying family caregivers. Generations, Winter, 74–80.Google Scholar
Ministry of Health Services, BC (2002). Government policy on payment to family members. Retrieved 28 February 2005 from http://www.healthservices.gov.bc.ca/hcc/pdf/policy2.pdf.Google Scholar
Osterbusch, S.E., & Linsk, N.L. (1987). Point/counterpoint: Paid family caregiving for the elderly – Good for the poor? A call for gender justice. Health and Social Work, Winter, 66–71.Google Scholar
Pederson, A., & Huggan, P. (2001, November 8–10). The objective is care: Proceedings of the national think tank on gender and unpaid caregiving. National Think Tank on Gender and Unpaid Caregiving, Charlottetown, PEI.Google Scholar
Pestieau, C. (2003). Evaluating policy research (CPRN Research Paper W|22 Work Network). Ottawa: Canadian Policy Research Networks. Retrieved 9 July 2005 from http://www.cprn.org/en/doc.cfm?doc=495.Google Scholar
Pijl, M. (1994). When private care goes public: An analysis of concepts and principles concerning payments for care. In Evers, A., Pijl, M., & Ungerson, C. (Eds.), Payments for care: A comparative overview (pp. 3–18). Brookfield: Avebury.Google Scholar
Pijl, M., & Johansson, L. (2003, September 23–27). Filling the care gap: A critical analysis of the support of carers of older persons. First draft. Presented at ESA Conference, Murcia, Spain.Google Scholar
Pijl, M., & Ramakers, C. (n.d.). Contracting one's family members: The Dutch care allowance.Google Scholar
Schreuder Goedheijt, T., Visser-Jansen, G., & Pijl, M. (2004). Mantelzorg in the Netherlands: Family care – Characteristics, care policies, support and research. Retrieved 1 May 2005 from http://www.eiz.nl/eiz/docs/word/mz%20in%20Nl%20paper.doc.Google Scholar
Schneider, U. (1999). Germany's Social Long Term Care Insurance: Design, implementation and evaluation. International Social Security Review, 52(2), 31–74.CrossRefGoogle Scholar
Shillington, R. (2004). Policy options to support dependent care: The tax/transfer system. Halifax: Healthy Balance Research Program.Google Scholar
Simon-Rusinowitz, L., Mahoney, K.J., & Benjamin, A.E. (1998). Payments to families who provide care: An option that should be available. Generations, 22(3), 69–75.Google Scholar
Stone, D. (2001). Policy paradox: The art of political decision-making. New York: Norton.Google Scholar
Ungerson, C. (2004). Whose empowerment and independence? A cross-national perspective on “cash for care” schemes. Aging & Society, 24, 189–212.CrossRefGoogle Scholar
Ungerson, C. (1995). Gender, cash and informal care: European perspectives and dilemmas. Journal of Social Policy, 24(1), 31–52.CrossRefGoogle Scholar
Ungerson, C. (1997). Give them money: Is cash a route to empowerment? Social Policy and Administration, 31, 45–53.CrossRefGoogle Scholar
United Kingdom, Department for Work and Pensions (2004). Disabled people and carers Services and benefits. Retrieved 12 July 2007 from http://www.dwp.gov.uk/lifeevent/discare/.Google Scholar
University of Maryland Center on Aging (2002). Cash and Counseling Demonstration. Retrieved 28 February 2005 from http://www.hhp.umd.edu/AGING/CCDemo.Google Scholar
Visser-Jansen, G., & Knipscheer, C.P.M. (2004). Services for supporting family carers of elderly people in Europe: Characteristics, coverage and usage – National background report for the Netherlands. Retrieved 14 September 2004 from EUROFAMCARE. Website http://www.uke.uni-hamburg.de/extern/eurofamcare/presentations.html.Google Scholar