| AGEING - Turning the age pyramid on its head
When are you ‘old’? Nowadays, this is becoming at an increasingly advanced age. The terminology reflects the nuances of a changing reality: ‘active ageing’, senior citizens, the elderly and the very elderly. But whatever the words that are used, Europe is greying and it is a phenomenon that poses major challenges for the public finances (health care, pensions), the economy (shrinking workforce) and, at the human level, for the families and social organisations whose support is so vital in the twilight years. Researchers on the Soccare and Care Work projects are investigating all of these issues.
This ‘double front’ responsibility can prove testing, tiring and stressful and has very real consequences for family life. Researchers on the Soccare project found that “relationships between partners are transformed, not only by the symbolic and material weight of finding oneself having to care for somebody, but also by the effort of learning new skills. They discover that they have to invent a new role for themselves in their relationship.” It is easier to arrange for somebody to look after children than to send someone to care for grandparents – engendering an understandable sense of guilt. These new roles are not necessarily easy to assume in regard to the elderly either. The child becomes the responsible parent and vice versa. “The quality of the original relationship can be decisive. If it has always been positive, there is more likelihood that the child’s gratitude to the parent will alleviate the weight of the responsibility of providing care in old age.” (2)
Be that as it may, the reality is that this is a task often accepted due to the lack of an alternative. The elderly person refuses to go into an institution and most families understand this.
The solutions found for the care of elderly people vary across Europe due to cultural traditions, as well as to the efficiency of the social systems. Finland is a country where, thanks to efficient home help, many elderly people are autonomous and live alone (42% of men and 80% of women aged over 75). Portugal, on the other hand, is where elderly people have the least autonomy (16% and 33% respectively). There, as in Italy, families are often aided by people active in the informal economy. In France, specific public aid (Allocation personnalisée autonomie) provides various types of assistance (with housework, for health care, etc.) that allows people to remain in their own homes.
Most European families have recourse to a mix of public aid, which is often well organised, and other alternatives, which can take the form of free services set up by volunteer groups. This growing reliance on professionals “can be seen as a response to needs that are not met by public social aid, but also as a desire to find more flexible and personalised solutions. Such systems have the advantage of leaving management of the care in the hands of the families themselves.”
One of the working groups of the Care Work in Europe project looked at the situation of elderly people in Sweden, Spain and the United Kingdom (3). The aim was to compare the different types of aid offered, the training and working conditions of the carers, and the wishes of families and elderly people. These three countries with their different economic and socio-cultural conditions offer interesting contrasts.
Public responsibility is a major factor in Sweden, where local paid services developed during the 1960s. Over time, this social work has become increasingly structured and hierarchal. The highly trained staff are backed up by a support team with genuine managerial status.
Spain relies more on family solidarity, but has recently developed care services that meet national norms and are able to supplement the support given by families in cases where more demanding or complex care is needed. In the United Kingdom, people with a range of qualifications – although the general level of training is improving – provide a variety of services in both the residential and home care sector. Much of this work is undertaken by associations of voluntary workers.
In all three countries, the typical profile of the care worker is a woman of about 40 years of age whose children are old enough to look after themselves. Most of the professionals interviewed by the researchers say they have good relations with the elderly people they look after, as well as with their families, in fact often seeing support for the family as among their responsibilities. When speaking of their work, the British highlight the importance of communication, empathy, patience, the ability to listen, a sense of responsibility and the ability to give of one’s time. The Spanish also focus on ‘affective values’ and the quality of relations, while the Swedes place a premium on know-how and abilities in the field of health care, on “experience based on knowledge”.
Many of them stress the complexity of a job which often presents a number of dilemmas: the need to be efficient, while paying attention to the requests of the elderly person, combining administrative and practical tasks, and trying to establish personal relations, despite the pressure on their time. Many also feel that their work is not recognised by society. There are many reasons for this: it is invisible and is associated with a low level of qualifications, and is not seen as a priority because it is an activity without tangible results. It no doubt also suffers from the generally negative image associated with old age. There is also the fact that – except in Sweden – wages are low for these jobs which are psychologically and physically demanding and offer little scope for promotion.
Despite all this, while the public services have generally assumed responsibility in the child care sector, in the future they are going to have to intervene more concretely in providing care for elderly people, whatever the cost.
(1) Four research groups worked in five countries (Finland, France, Italy, Portugal and the United Kingdom) on issues facing, in particular, single-parent families, couples with two working partners, immigrant families and multi-generational families.
(2) Final report of one of the project groups: Trifiletti Simoni e Pratesi - Care arrangements in double front carer families.
(3) Other Care Work teams looked at the care of young children and disabled people in the United Kingdom, Denmark, the Netherlands, Spain, Sweden and Hungary.