FOR LOVE AND MONEY: FOR LOVE AND MONEY: PAYING FAMILY PAYING FAMILY

CAREGIVERSCAREGIVERS

Sample oral presentationSample oral presentation

outline

1. key words2. summary and introduction3. supporting details4. conclusion5. commentsQuestions and discussion

Part one: key words

Part One (1): key words and summary

CaregiverCare receiver ObligationAccountabilityEconomicsCare workCompensate/

compensationDirect paymentTax creditUnpaid leave

Cash allowancesConsumer-directionCommunity-basedLong-term careClientIdeologicalEthicalProfessionalPersonal-interpersonal

Part One (2): key words and summary

BeneficenceWell-intentionedPaternalisticHomecareIn-home serviceAgency-based

workersState-contracted

homecare agencySelf-directed careAcid test

Inherent problematic concept

The sense of empowerment

ResponsibilityWorkforce

participationEmpiricalanecdotal

Part Two: Summary and Introduction

Part Two (1): Summary

The debate over the issues for compensating family caregivers involves diverse problems, including economics, public policy questions, family value and the nature of care work. To re-evaluate these issues more comprehensively, the author will compare and inspect the pros and cons under four categories: ideological, ethical, and personal-interpersonal concerns.

Part Two (2):Introductionvery complicated problem

1. policy questions: the intrusion of public systems into family life

2. ethical and ideological issues about obligation and accountability

3. pragmatic concerns about health, safety, and quality of services

4. the definition and distinction of care and work love and money?!

Part Two (3):Introductiontwo sides

Proponents: compensating family caregivers is a way to strengthen, expand, and sustain the natural support system

Critics: compensation for some of the work will erode family obligation, create a strain on the public system, and put older people at greater risk of abuse and poor care

Part Three: Supporting Details

Part Three (1-1): Ideological concerns and empirical realities

The conflicting ideology in USA: the primacy versus a reluctance to legislate supports for family care

Public dollars to support a private and obligatory activity?

Part Three (1-2): Ideological concerns

Concerns

1.Undermine social values2.A major shift from caring as part of normal family responsibility

3.Decrease the quality of the care-giving4.Tremendous burdens on public expenditures

5.Increase in the number of homecare recipients

Part Three (1-3) To address these concerns

The same dollar allocation: hire family member/ traditional service system

All programs paid worker compensation, unemployment insurance, and Social Security taxes.

80 percent of whom hired family members, reported large and consistently rates of satisfaction compared to a randomized control group

No negative effects on the overall relationship between the paid family caregiver and the consumer

Part Three (2-1): Supporting detailEthical Concerns

Concern (1): in-home service recipients would be at greater risk of receiving poor quality care

Concern (2): worker fraud, abuse and neglect were expected to be a much greater problem in the home when compared to the nursing home setting

Part Three (2-2): Supporting detailEthical Concerns and discussion

(1) safety: safety: no significant differences in safety risks between clients receiving agency-based services and those using consumer-directed services.

(2) quality: consumers hiring family members report better care.

(3) fraud: using a social service professional in a support and monitoring role with consumers and a systematic book-keeping system to assist and review expenditures can minimize auditing concerns

Part Three (2-3): Supporting detailEthical Concerns and summary

Paid family workers did not abuse the system, exploit the consumer, or fail to provide good service.

Paying family caregivers provide an “acid test” for the notion that beneficence and lack of harm can only be achieved in a formal, public system.

Part Three (3-1): Personal/ Interpersonal Issues

an inherently problematic concept

Care work?Care= from heart, not for moneyPaid care-giving : paradoxical

Part Three (3-1): Personal/ Interpersonal Issues

for money and for love?

Two issues:

1.how and whether payment changes the relationship between caregiver and receiver?

2.The difficulties old and frail consumers may have in taking on the role of employer of their own family members

Part Three (3-2): Personal/ Interpersonal Issues

changed relationship?

Yet, but not negative!

The sense of empowerment

Hiring their own worker—very often family members—makes them feel more secure and more in charge of their lives.

Part Three (3-3): Personal/ Interpersonal Issues

difficulties?

Learn the roles of employer and employee roles and responsibilities

Key concepts: service, exchange, money, paychecks

Empowered consumers seem to be successful at managing their workers, giving feedback, and making sure their services are being provided in the best way possible.

Part Four: Conclusion

Conclusionthe changing society

Societal changes in such areas as longevity patterns, workforce participation, and family composition suggest that care-giving will grow in both importance and difficulties.

Conclusion (2)paid family care

Anecdotal (not true): neglect, safety, and negative effects

Empirical evidence: recipients of paid family care are more satisfied, as are the caregivers.

Part Five: Comments

My Comments (1): Strengths

1. The way to organize the complicated issues and problems

2. The experiments and journal articles to support the arguments

3. The objective standpoint

My Comments (2): Weaknesses

Do not consider the poor families, Do not consider the poor families, who cannot pay for any care-givers, who cannot pay for any care-givers, even they are family members.even they are family members.

Too many variables are mixed up.Too many variables are mixed up.The radThe comparative studies The radThe comparative studies

My Comments (3): Suggestions for Improvement

Some illustrations and figures are necessary.

e.g. the results of the comparative studies

The focus of each part should be highlighted more.

E.g. ideological empirical

Questions for discussion

Questions for discussion (1)

1. (p. 230) In the broadest sense, financial supports for caregivers can include direct payment for services provided, tax credits, unpaid leave, and cash allowances to cover related to caregiving.

Is there any other method to support both the care givers and care receivers?

Questions for discussion (2)

(p.233) “The care-giver recipient relationship can be emotional, intense, and challenging, whether the individual providing service is a family member or not.”

To hire the family members as caregivers can improve such an intensified relationship?

Questions for discussion (3)

(p.234) “Compensating family workers, and having consumers hire and manage their own workers, can be good for consumers, family members, and the long-term-care system overall.”

What will happen if a consumer (care-recipient) fail to pay the family worker?