Privatization of home care

According to Mullaly (2007), "neo-conservatives have called for a return to the economic values of the private marketplace" (p. 72). This includes a strong trend to the privatization of functions normally considered a state responsibility. One of these areas is home care.

A recent report by the Canadian Healthcare Association indicates that private spending on home care now outstrips public spending. There is an increasing trend to shifting the responsibility for home care to the the private sector. One of the many impacts is that for older people who can't afford to pay for care, informal caregivers (mostly women) have to carry much more of the care.

Having worked in a Quebec CLSC specializing in the development and provision of services to older people, I observed the superiority of public home care services over most for-profit services. Our workers, who had to fulfill certain educational requirements to be hired, were paid a fair wage, unionized, received benefits, and were properly trained. Private sector workers are paid much less (for example, an Ontario study shows they are paid $6 per hour less in that province).

In my Quebec CLSC, our home care workers were part of the multidisciplinary health care team. They are the professionals who see the older person on a day-to-day basis. Often it was the home care worker who drew our attention to serious problems such as elder abuse and they were often an important part of the solution. When home care services are privatized, they no longer have this connection with the larger health care team and it is the older person who often suffers.

I suspect this trend to privatizing home care and health care will continue under a Conservative government, even though there is some evidence that privatizing home care does not save money in the long run (Shapiro, 2006) and a Winnipeg experiment to do so was deemed a failure (Shapiro, 2000). The Romanow Commission called for a National Strategy on home care and we are still waiting for it -- a strategy that will ensure that every older person has equal access to the services they need.

Infantilization of older adults by professionals

Infantilization is considered a form of elder abuse. It's when older adults are treated like children by the people around them. In our society, adulthood is equated with autonomy and independence. Anyone who is dependent on others is considered to be childlike. Not too long ago, that included women. And very often it happens to older adults.

I gave my students a reading by Zauszniewski et al (2004) for this week on reminiscence groups, which are considered to be a positive activity at many long term care homes and community settings. Here is how the article describes the six sessions for older adults without dementia:

The theme for this session was called, “Those Were the Days,” and the elders recalled early childhood memories through schooldays. Pictures such as a pencil sharpener, a school bus, a typewriter, a graduation cap, chalk, and a microscope were presented. The theme for session two was “All Creatures Great and Small,” and participants recalled past experiences involving animals (e.g., pets, farm animals, zoo animals). The focus of session three was

“Food for Thoughts,” and elders recalled favorite and least favorite foods, mealtime habits, and food categories (e.g., vegetables, fruits, fish and meats, and beverages). Session four was called, “Red Letter Days.” It involved recollection of holidays and special occasions. Colored pictures reflecting Valentine’s Day, Christmas, Mother’s Day, Groundhog Day, and Halloween were presented. The theme of session five was “That’s Entertainment,” and it focused on leisure activities and favorite pastimes such as fishing, dice, car racing, puzzles, and the circus. Finally, session six was called, “Away We Go,” and elders talked about means of transportation they had used and places to which they had traveled.

This sounds like primary school, doesn't it? And I wonder if my students are going to see it as infantilizing or not.

What do you think?

Silvia

Welcome to Field Focus Aging and this blog!

This is the first year I am using blogging as a major means of communication for a course. For many of you, it will be your first ever venture into the world of blogging. Knowing that most of you are Facebook users, you will see that it's not too big a stretch, since both blogs and Facebook are different types of social media.

I will be setting this blog up over the next week with lots of resources and links to help you with the course material. I will also be accompanying you in your reflections and blogging on course content by doing the same in my own blog here.

So welcome... and I hope you enjoy the course!

Silvia