International Women’s Day: Who cares?
An older working carer reviews her experience in a changing world by Maria Parsons
Friday, March 8, 2013
12:44 AM
Maria Parsons looks at the issue of carers in her essay for The International Longevity Centre-UK (ILC-UK).
Maria Parsons is committed to improving services for older people and their carers. A social worker, academic and policy lead with health, social care and housing, formerly Director of Oxford and London Dementia Services Development Centres, she is now Director of the Creative Dementia Arts Network (CDAN).
International Women’s Day offers a rare opportunity to formally recognise women’s care of older people and to place ‘who cares’ firmly back onto the political agenda. For amidst the policy debates and government responses to Dilnot, scant attention, if any, has being paid to the ‘who’ of care funding; specifically on ‘whom’ and ‘what’ will the funds made available be spent?
So lest it be forgotten, the unpaid work of family carers, many of them old and frail ‘saves’ the economy £87billion per annum, replacing health and social services through, essentially, voluntarism. The ‘who’ in this scenario is largely women caring for other women in the private sphere of the home where care work’s economic dimensions and contributions are hidden, whilst in the public sphere, a vast low paid and undervalued female workforce is engaged in a similar labour of love. As for ‘care’ – let’s be honest
– it’s often relentless, routinised physically draining toil, in fact, read “housework, with its endless repetition: the clean becomes soiled, the soiled is made clean, over and over, day after day.” Few (male) job specs include these skills.
Yet the issue of who cares or rather who will care is far larger than the UK and Europe. By 2050, of almost 2b people on the planet aged 60 years or over, 80 per cent will live in developing countries. In East Asia and Latin America, where the process of population ageing is already more rapid than that undergone in the past by today’s developed countries, traditional family care is being dismantled and the ‘solution’ of institutional care being pursued.
In the UK there are 10.3million people aged 65. Some 1.4m are over 85, a group forecasted to double in the next 20 years. As in the rest of the world, women aged 65+ outnumber men by almost four to three and by almost two to one in the 80+ age group. Black and minority ethnic (BME) groups make up over 16 per cent of the population of England, but only 8 per cent of people in England aged 60 and over. Nevertheless especially in large urban areas, these are significant groups with specific care needs.
Despite improved life expectancy, an estimated 4m older people in the UK, including 48 per cent of those aged 75+, have a chronic disease or other type of limiting longstanding illness that causes disability. Disability is a crucial factor in considering need for long term care, as it is disability rather than age which influences need for care. A growing older female population with disability is more likely to experience poverty given care-giving roles in earlier life.
Society cannot be complacent as a care gap beckons. In the UK, intergenerational care by women, projected to constitute 60 per cent of people providing intense care to 2041, will ail to keep pace with a forecasted 90 per cent increase in numbers of disabled older people cared for by their adult children, as family size decreases and more women work. Despite a heavy reliance on family care in developing countries and more use of formal care in developed countries, both are experiencing socio-economic change that will shift this care balance and over the coming decades, carer shortages will become a global problem.
In drawing attention to the priority for greatly improved support for informal carers enabling those who want to and have to offer care by family, I reflect on the recent admission to care of my dear 86-year-old Polish-born mother who has lived with me for the best part of three years. Notwithstanding the fact that each care situation is unique, what helped and hindered chimes with many others.
“Money and the lack of worry about it; mum worried that I worried about my ‘flexible employment’ and the costs of reducing my workload when taking on care responsibilities – replacement carer income would offer cost savings in health and care. Local day centres were a godsend but the hours (9.30 – 3.30) were not. Respite (my daughters, a neighbour, a sibling, a paid carer) helped but the absence of easily online bookable weekend or evening respite meant honing my care co-ordination skills, planning ahead, forgetting spontaneity. Holiday care in a care home that was a community hub was a joy, pity it was so far away. Living in an age-friendly neighbourhood where services, shops and staff are geared up for disability with ample seating, clear signage and level paving made a difference to mum’s independence and later her zimmer-aided excursions. We became reliant on the car and our mobility badge. Familiar with the care system, yet the regular local Age UK carers information constantly surprised me but not as much as my (female) GP who, whilst checking out my carer health, secured a one-off carers grant that gave me ‘permission’ to have a break, in this case in New York. Where would mum and I be without Care Managers clearly and competently explaining Personal Budgets (we were not eligible), a Community OT who promptly sorted out aids and adaptations, 14 months of twice weekly District Nurses visits dealing with mum’s massive leg ulcer. My daughters, who also cooked for and showered mum, and friends who handed me white wine (mum prefers red) and listened to my carer tales were perhaps the most treasured of my carer resources.”
I felt that if I could multi-task as a working mother, I would do so as a working carer. Besides, my love and sense of obligation to my mother was huge: how else could I have managed three children, academic and professional roles, spouse support and my home without mum arriving on the coach from Leicester every fortnight? The answer of course was that I could but in the end even I could not. A salutary experience coming to many more of us over this decade and beyond but perhaps where there is political will and community engagement, better, customised and imaginative support will be forthcoming.
