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The former South West Local Health Integration Network (SW LHIN) of Ontario, which is in a predominantly rural region, regularly reports the lowest rates of caregiver distress in the province. Caregivers from rural communities regularly face challenges related to the access, applicability, and availability of supports and services, This qualitative case study describes perspectives of caregiving from the region, and explores how role construction and expectations of caregivers might both mitigate distress and influence service support use. Thematic analysis identified five themes: anticipated care, gendered caring, service support assumptions, confidence in community, and the “line in the sand”: care decisions for evolving needs. Using the lens of caregiver identity theory, the findings suggest that these caregivers conceptualize identity as an extension of their primary role, to include caregiving obligations and responsibilities. We also noted a steadfast confidence in community and perceived service support assumptions across the region, with no notable rural–urban divide.
Black Women’s Mothering and Caregiving explores Black women as parental and family caregivers and caregiving as a source of joy and yet burden in Black women’s lives. We discuss contemporary challenges of Black women as caregivers, including their fears and anxieties about present conditions that create risks for Black children and adolescents. Such conditions include stereotypes, institutional biases around educational achievement, violence, police aggression, and the need to juggle professional and domestic responsibilities. Finally, this chapter offers strategies to help Black women manage and balance their caregiving roles and responsibilities.
In March 2020, the Government of Ontario, Canada implemented public health measures, including visitor restrictions in institutional care settings, to protect vulnerable populations, including older adults (> 65 years), against COVID-19 infection. Prior research has shown that visitor restrictions can negatively influence older adults’ physical and mental health and can cause increased stress and anxiety for care partners. This study explores the experiences of care partners separated from the person they care for because of institutional visitor restrictions during the COVID-19 pandemic. We interviewed 14 care partners between the ages of 50 and 89; 11 were female. The main themes that emerged were changing public health and infection prevention and control policies, shifting care partner roles as a result of visitor restrictions, resident isolation and deterioration from the care partner perspective, communication challenges, and reflections on the impacts of visitor restrictions. Findings may be used to inform future health policy and system reforms.
With the tremendous growth of people over age 65—10,000 people a day cross that marker—it is expected that in the next 20 years nearly every middle-aged person will be caregiving someone. Few have any idea what lies ahead. No clear charted course. Takes a toll, mentally and physically. Caregivers need help too. Chapter describes Seven Core Strategies that can provide the support and renewal caregivers need throughout their journey. Look for outside help. Find a support group. Figure out a self-care plan, and do it. Enlist outside help for your loved one’s physical needs. Maintain your own health. Make time to reflect on your situation. Find your team. The greatest comfort you can know is that you have cared, you have invested yourself, and that you have loved.
Older adults who experience social isolation are at as high risk of dying as those who smoke 15 cigarettes daily or drink more than 6 alcoholic drinks per day. Human beings are social creatures who need collaborative groups. But as we age, those groups become smaller in number. Social isolation sneaks up on us over many years. At least ¼ of older adults in US report feeling isolated. Men who are socially isolated die of an accident or suicide at twice the rate of those not socially isolated, and have far greater risk of heart attack and stroke. Both isolated men and women have higher rates of dementia. Chapter outlines seven actions to help prevent social isolation: Seek out social interaction! (Book clubs; Museum docent; volunteer to read to children.) Reach out to cultural and ethnic groups unfamiliar to you. Take advantage of home-based care. Own a pet. Maintain a healthy self-image. Consider co-housing. Reach out and connect with others.
This chapter discusses how time preferences influence the importance of and actions regarding old age health as well as factors behind taking up protective measures against the financial risks of care at old age. We discuss the complexity of planning for old age including the challenges related to our imperfect ability to predict the future or what our preferences for the future will be when making decisions today. We include the role of social norms and family experience in decision-making as well as the cognitive demands required of old age planning. We also incorporate the roles of biases such as optimism and present bias as well as risk denial and procrastination into decision-making about ageing. The chapter finishes with a consideration of nudges appropriate to this context.
Chapter 6 focuses on special treatment stigma—the stigma that accompanies the need for any modifications in the workplace. First, I present evidence that employers are reluctant to accommodate workers regardless of whether the accommodation is needed because of a disability, pregnancy, or caregiving responsibilities. Second, I describe what happens when employers do accommodate workers—both in terms of what workplace consequences flow from those accommodations, and how those accommodations affect the accommodated employees’ relationships with their coworkers.
Chapter 7 first explores the theory behind protecting people with disabilities and workers with caregiving responsibilities. It then explores the practical justifications for protecting these groups of employees. Finally, it explains why my proposals go beyond protecting specific groups of employees and instead protected everyone.
Chapter 2 provides an overview of caregiver discrimination in the workplace. It provides a history of the gendered norms that still affect our workplaces and our lives. It describes the three facets of what I call the “caregiver conundrum”—(1) not enough time; (2) not enough money and opportunities for advancement; and (3) the stereotypes affecting caregivers in the workplace. The chapter then discusses several “lackluster laws” that fail to provide sufficient protection for working caregivers. These include Title VII of the Civil Rights Act of 1964, which protects against sex discrimination; the Pregnancy Discrimination Act, which protects against discrimination based on pregnancy; and the Family and Medical Leave Act, which mandates job-protected leave in certain circumstances. This chapter demonstrates how inadequate the protections are for most workers who are trying to balance work and family, despite these three laws.
Chapter 9 proposes a universal accommodation mandate, which would allow employees to request modifications to the structural norms of the workplace (when and where work is performed) and to request modifications to how the physical tasks of the job are performed. This chapter explains how the mandate would work, discusses various applications of the mandate, briefly addresses logistical issues, and then responds to the anticipated criticisms.
Chapter 1 introduces the concepts and ideas I discuss throughout this book. First, I provide a summary of the experiences of both individuals with disabilities and workers with caregiving responsibilities in the workplace. This summary exposes the difficulties these two groups have when trying to meet the expectations of their employers. Second, I introduce some of the laws and legal concepts that are discussed throughout the book—the Americans with Disabilities Act, reasonable accommodations, sex discrimination under Title VII, the Pregnancy Discrimination Act, and the Family and Medical Leave Act. Third, I briefly explain my proposal for reform. Finally, this chapter provides a brief outline of the structure of the rest of the book.
In the wake of the pandemic, many employers continue to allow their employees to work from home, but much of the workplace remains governed by strict structural norms such as shifts, schedules, attendance, and leave-of-absence policies that determine when and where work is performed. In The Workplace Reimagined, Nicole Buonocore Porter explores how these workplace norms marginalize people with disabilities and workers with caregiving responsibilities. Using COVID-19 as a lens to illustrate how entrenched workplace norms are often not inevitable or necessary, Porter theoretically and practically reconceptualizes the workplace to end the stigmatization of these employees and helps readers understand the value of accommodating all workers. The Workplace Reimagined is timely, eye-opening, and will help us realize a workplace in which we account for the reality, the precarity, and the diversity of all our lives and bodies.
Despite becoming increasingly represented in academic departments, women scholars face a critical lack of support as they navigate demands pertaining to pregnancy, motherhood, and child caregiving. In addition, cultural norms surrounding how faculty and academic leaders discuss and talk about tenure, promotion, and career success have created pressure for women who wish to grow their family and care for their children, leading to questions about whether it is possible for these women to have a family and an academic career. This paper is a call to action for academia to build structures that support professors who are women as they navigate the complexities of pregnancy, the postpartum period, and the caregiving demands of their children. We specifically call on those of us in I-O psychology, management, and related departments to lead the way. In making this call, we first present the realistic, moral, and financial cases for why this issue needs to be at the forefront of discussions surrounding success in the academy. We then discuss how, in the U.S. and elsewhere, an absence of policies supporting women places two groups of academics—department heads (as the leaders of departments who have discretion outside of formal policies to make work better for women) and other faculty members (as potential allies both in the department and within our professional organizations)—in a critical position to enact support and change. We conclude with our boldest call—to make a cultural shift that shatters the assumption that having a family is not compatible with academic success. Combined, we seek to launch a discussion that leads directly to necessary and overdue changes in how women scholars are supported in academia.
Cette recherche qualitative traite de la situation des proches aidants des aînés composant avec une problématique d’accumulation (trouble d’accumulation compulsive, autonégligence, syndrome de Diogène). Il s’agit d’un contexte de la proche aidance qui a été jusqu’à maintenant peu étudié, où les réalités du vieillissement et de la santé mentale sont en interaction. Onze proches aidants et huit intervenants sociaux des régions de la Capitale-Nationale et de Chaudière-Appalaches ont participé à des entretiens semi-dirigés, lesquels ont été soumis à une analyse thématique de contenu. Nos résultats indiquent que malgré l’interaction du vieillissement et de problématiques de santé mentale, ce sont les enjeux liés au vieillissement qui déclenchent le début de la proche aidance, puis le maintien de cet engagement dans la durée. Ils nous montrent aussi que des efforts de concertation et de coordination devraient être déployés afin que les différents acteurs interpellés prévoient des trajectoires de services pour la personne âgée et les proches avant que le problème d’accumulation engendre des enjeux de sécurité importants. Dans ces trajectoires, les organisations sociosanitaires gagneraient à davantage reconnaître les savoirs des proches et à mettre à leur disposition les services requis pour répondre à leurs besoins spécifiques.
Chapter 5 highlights that a large share of the singlehood scholarship draws little attention to the race or class dimensions of this demographic shift of the rise in singlehood. Collectively, Chapter 5 argues that the singlehood scholarship overlooks how systemic inequalities, including racism and gendered racism, shape singlehood among Black adults – especially Black women. Such shortcomings are particularly relevant when it comes to looking at whether Black individuals are single through choice or circumstance (or both), and what the implications of this are for the Love Jones Cohort particularly and the Black middle-class more generally. Chapter 5 looks at the degree to whether the women and men of the Love Jones Cohort chose their SALA status, and how systemic inequalities, institutional constraints, and societal pressures play a role in such decision-making (or lack thereof), particularly among the Cohort’s women. Chapter 5 suggests that while many hope or anticipate that they will one day marry and so leave the Cohort, this is not something they are willing to pay any price to achieve – and introduces the term “respectability singleness.”
Increasingly diverse caregiver populations have prompted studies examining culture and caregiver outcomes. Still, little is known about the influence of sociocultural factors and how they interact with caregiving context variables to influence psychological health. We explored the role of caregiving and acculturation factors on psychological distress among a diverse sample of adults.
Secondary data analysis of the California Health Interview Survey (CHIS).
The 2009 CHIS surveyed 47,613 adults representative of the population of California. This study included Latino and Asian American Pacific Islander (AAPI) caregivers and non-caregivers (n = 13,161).
Multivariate weighted regression analyses examined caregiver status and acculturation variables (generational status, language of interview, and English language proficiency) and their associations with psychological distress (Kessler-6 scale). Covariates included caregiving context (e.g., support and neighborhood factors) and demographic variables.
First generation caregivers had more distress than first-generation non-caregivers (β=0.92, 95% CI: (0.18, 1.65)); the difference in distress between caregivers and non-caregivers was smaller in the third than first generation (β=-1.21, 95% CI: (-2.24, -0.17)). Among those who did not interview in English (β=1.17, 95% CI: (0.13, 2.22)) and with low English proficiency (β=2.60, 95% CI: (1.21, 3.98)), caregivers reported more distress than non-caregivers.
Non-caregivers exhibited the "healthy immigrant effect," where less acculturated individuals reported less distress. In contrast, caregivers who were less acculturated reported more distress.
As the aging population continues to grow, the issue of caregiving has increasingly moved into the public spotlight. Caregiving is defined as “assistance provided to individuals who are in need of support because of a disability, mental illness, chronic condition, terminal illness or who are frail.” More recently, the COVID-19 pandemic has added an additional spotlight on the issue of how we are caring for older patients in the midst of societal shutdowns, increasing social isolation, and economic impacts that affect patient and caregiver alike. This chapter focuses on the informal caregivers who care for chronically ill older adults. It also broadens the toolset of the primary care provider to include a more systematic approach when assessing the degree of caregiver burden. Recognizing caregiver needs and burden can then inform the primary care provider to counsel caregivers about common stresses, suggest practical interventions, and provide additional resources.
This chapter discusses ‘Wollstonecraft’s dilemma’ – the quandary facing feminists concerned with social provisioning in terms of whether to pursue women’s equality through support for their unpaid caregiving roles or through support for their paid work participation. Each option is based on (and assesses women against) the male norm of citizenship and social participation, with policy either supporting women’s ‘difference’ from men in unpaid caring or treating women ‘like’ men in paid work. Care-supportive and work-supportive policies in liberal welfare states have had both advantages and disadvantages for women. Policies that support women’s unpaid care for children or adults offer some recognition and remuneration of such roles but limit women’s ability to participate in the public sphere. Policies that support or require women to engage in paid work may offer economic autonomy but do not generally recognize or address women’s disproportionate responsibility for care. This chapter also discusses the neoliberal trend away from support for care and maternalism toward ‘employment for all’ regardless of care and support responsibilities.
In this chapter, we identify how recent trends combine to increase instability and uncertainty among low-wage workers, discuss the effects of instability and uncertainty on workers and families, and consider potential policy solutions. Several trends in demographics and in the US labor market have combined to increase instability and uncertainty among low-wage workers since the 1970s: first, the long-run move of low-skilled employment demand toward the service sector, which is lower paying and less stable than manufacturing; second, the related rise of both dual-earner and single-headed households, which has led to an increase in caregiver-breadwinners, or workers who are their family’s primary care provider as well as the primary or sole income earner; third, the growth of the elderly population in the context of our societal dependence on informal caregiving; and fourth, decreasing schedule and earnings stability within service employment, which increases income volatility and decreases family well-being for caregiver-breadwinners. High-skilled workers can address these challenges through paid help, insurance, and other forms of consumption smoothing, while the increasing stress on low-skilled workers represents another, insidious form of inequality. We demonstrate how all these forms of instability can inhibit children’s human capital development, transmitting this inequality to future generations. Finally, we identify and evaluate the evidence regarding a number of policy solutions, including schedule stability legislation, universal care supports, and paid family leave, aimed at alleviating strain on low-skilled workers, particularly the growing group of such workers who combine caregiving and breadwinning, and highlight the legislative pathways for positive policy change.
The relationships infants and young children have with their caregivers are fundamental to their survival and well-being. Theorists and researchers across disciplines have attempted to describe and assess the variation in these relationships, leading to a general acceptance that caregiving is critical to understanding child functioning, including developmental psychopathology. At the same time, we lack consensus on how to assess these fundamental relationships. In the present paper, we first review research documenting the importance of the caregiver–child relationship in understanding environmental risk for psychopathology. Second, we propose that the National Institute of Mental Health's Research Domain Criteria (RDoC) initiative provides a useful framework for extending the study of children's risk for psychopathology by assessing their caregivers’ social processes. Third, we describe the units of analysis for caregiver social processes, documenting how the specific subconstructs in the domain of social processes are relevant to the goal of enhancing knowledge of developmental psychopathology. Lastly, we highlight how past research can inform new directions in the study of caregiving and the parent–child relationship through this innovative extension of the RDoC initiative.