Tuesday, June 11

Session 7 (8:30 – 9:45 a.m.)
Concurrent Sessions

7.1. Paper Session: The Costs of Unpaid Care

East Common Room

  • Moderator: LaShawnDa Pittman, University of Washington
  • Melody Waring, University of Wisconsin Madison, “Is There an Education Gradient in Women’s Time Transfers to Aging Parents?”

Existing research has resulted in conflicting evidence on whether women with low-socioeconomic status (SES) transfer more or less time and money to aging parents. On the one hand, low-SES women may have relatively lower opportunity costs for spending time caring for an aging parent, but they are also less likely to have access to paid leave or a spouse’s income. While recent research in the U.S. relies on a national study of women over retirement age, demographic research shows the accumulating health disadvantage of low-SES adults (relative to high-SES) is most pronounced in middle age—suggesting we should include younger adult daughters to understand caregiving within economically vulnerable families.

In this paper, I contribute to the literature by using a U.S. sample of adult women with a living parent (N=5,238), including working-age women, from the Panel Study of Income Dynamics (PSID)—a household-level, nationally representative survey that oversamples families of color. I examine the relationship between education and time spent assisting parents using logit and Tobit regressions, controlling for demographic characteristics, parents’ needs, caregiver’s competing demands, and resources.

Women with low education (high school or less) are as likely as women with high education (college degree or more) to transfer at least an hour of time to parents, at about 40 percent of the sample. But women with low education are significantly more likely to provide 100 or more hours of time per year, and significantly less likely to receive any time or money from their aging parents. Taken together, this suggests that while many women assist their parents, women with low education are more likely to experience a double burden of unreciprocated care and fewer hours available for non-carework activities.

  • Pilar Gonalons-Pons, University of Pennsylvania, “Reproductive Labor and the Structure of Inequality: Childcare Costs and Family Earnings Inequality, 1984-2014.”

This paper argues that the social organization of care work shapes economic inequalities across families. I develop a conceptual framework to connect the structure of inequality to institutional arrangements of care responsibilities and penalties and offer empirical proof using the rising costs of childcare in the US as my case study. Rising childcare costs have the potential to exacerbate employment inequalities after childbirth between women with high- and low- earnings potential, and to aggravate economic inequality as a result. I investigate this hypothesis using the Survey of Income and Program Participation (SIPP) panel data from 1984 to 2014 and state-level measures of childcare costs. Preliminary results show that post-birth employment gaps between women widen as childcare costs increase and that this polarization in women’s labor force supply is responsible for a 40% increase in economic inequality among first-time parents.

  • Rachel Bennett, University of Gloucestershire, Philippa Waterhouse, The Open University, “Thriving or Surviving? The Wellbeing of Grandchildren and Grandparents in Multigenerational Care Arrangements in South Africa.”

Changing patterns in family structure, migration and female labour force participation have contributed to growing international interest in multigenerational care, particularly the role of grandparents. Research on the impact of such care arrangements have predominantly examined the wellbeing of grandparents or grandchildren in isolation, despite social work professionals emphasising the importance of a holistic approach to family wellbeing. In South Africa, there is an established literature specifically on the wellbeing of AIDS orphans cared for by grandparents but minimal evidence on the broader phenomenon of grandparental care or analyses encompassing the wellbeing of both grandparent and grandchildren. This paper presents a national level analysis of the circumstances under which the wellbeing of grandchildren and grandparents involved care arrangements thrives or suffers, drawing on data from wave 5 of the National Income Dynamics Survey (2017). Logistic regression modelling is employed to explore the association between children’s nutritional status and relationship to primary caregiver and older people’s self-reported health and emotional wellbeing and childcare responsibilities. Moderation analysis is then used to examine how child, parent, grandparent and household level factors influence the direction or strength of these associations. In total 21% of children (<15 years) are primarily cared for by a grandparent, whilst one in six older adults (60+ years) are the primary caregiver for a co-resident grandchild. Preliminary results reveal that children thrive in the care of grandmothers, but grandmothers who are primary caregivers for grandchildren report poorer health than other older women. In comparison, children primarily cared for by grandfathers have comparative wellbeing to those cared for by parents by other relatives, but these grandfathers report poorer emotional wellbeing. These findings highlight the importance of gender sensitive research and policy which does not overlook the role that grandfathers can play in the support of grandchildren.

  • Jennifer Utrata, University of Puget Sound, “’Helping Them Get Ahead’: Intensive Grandmothering and Family Inequality.”

The intensive support which grandparents increasingly routinely provide for their adult children and grandchildren constitutes an important but undertheorized form of social inequality in American family life. How does this “third shift” of carework centered on extended kin support across households reflect social inequality while also serving as a way families manage inequality? Demographic and cultural trends surrounding longevity, paid work after retirement, exorbitant childcare costs, and increasing levels of insecurity and instability in family life have led to an underexplored reliance on grandparents, especially for regular, if often informal, childcare support, with differing effects by race and class.

While some grandparents serve as a true lifeline, and others instead “smooth the edges” of their adult children’s lives, grandparents are frequently motivated not only by “joy” but in helping adult children to get ahead and succeed. In fact, the persistent stereotype that grandparents are motivated mostly by joy in “helping out” adult children has obscured the pressures grandmothers, especially, feel to provide childcare support whenever called upon, especially if adult children’s lives are unsettled. Other grandmothers want to help, but they do so in ways that consolidate the advantages that their relatively affluent adult children already possess. This research explores the cultural meanings of grandparental support across households, using interviews with intergenerational dyads (grandparents providing regular childcare as well as adult children relying upon a grandparent for some regular childcare) to illuminate the extent and nature of childcare and other grandparental supports. Not only is grandparenting more intensive than ever before, but it advances their adult children’s success in our insecure, unequal era. Intensive grandmothering is no longer exceptional; instead it has become routine and sometimes taken-for-granted by adult children.

7.2. Paper Session: Policy for Care

Debates Room

  • Moderator: Jennifer Zelnick, Touro College
  • Allison Earle, UCLA Fielding School of Public Health, “Global Progress in the Provision of Paid Leave for Family Care.”

While women’s labor force participation globally has risen overall since 1980 when global data first became available, there has been little change in the gender distribution of informal care work or household labor. Across the globe, women continue to have primary responsibility for and spend more hours on the care of children, the elderly and sick and disabled family members. There is evidence that parental leave policies facilitate adult’s attachment to and time in the labor force in the long run, and support infant and parental health. At the same time, there is a small but growing body of research showing that parental and paternity leave policies are associated with more equal sharing of informal care work and unpaid household labor. When benefits provide full or high wage replacement and policies extend coverage to the informal sector, paid family leave also has the potential to support the ability of low-wage workers to balance their paid work and informal care work as well as meet their families’ health needs and economic well-being. Little research has examined the availability of paid leave for family leave for reasons other than infant care. Paid leave to enable informal carework to meet the needs of elderly family members is of growing importance as many countries face a rapidly aging population. In this study, we review national legislation in 193 United Nations member states gathered by the WORLD Policy Analysis Center to examine whether and to what extent progress has been made between 1995 and 2016 in passage and generosity of paid leave to care for children’s health needs and leave to care for adult family members.

  • Randy Albelda, University of Massachusetts Boston, Michael D. Carr, University of Massachusetts Boston, Emily Wiemers, University of Massachusetts Boston, “The Long-Run Impact of Temporary Disability Insurance on Social Security Disability Insurance Claims (SSDI) in the United States.”

Workers facing illness or injury often require time off work to recover or engage in treatment before returning to work. But access to temporary paid medical leave is in the United States is limited. In 2017, only 72% of workers had access to employer-sponsored paid sick leave and 39% had access to short-term disability leave. Moreover, access to paid leave is less common among low-income leave-takers. Five states, however, have had Temporary Disability Insurance programs (TDI) since the late 1960s.

Workers face both short- and long-run employment consequences of adverse health conditions and disability including increased likelihood of job loss, declines in work hours, and reductions in earnings and consumption, which are all likely exacerbated by the lack of access to temporary paid medical leave for a work-limiting disability. Lack of temporary paid medical leave may also affect long-run employment outcomes through the use of the US federal disability program, Social Security Disability Insurance (SSDI), which restricts labor force participation, even during the application process, and discourages returning to the labor force.

These twin problems of limited access to temporary paid medical leave and growing SSDI claims in the United States may be linked to each other. To better understand this relationship, we use current state-level TDI availability to answer the following research questions:

  1. Does the availability of partial wage replacement through TDI programs reduce SSDI claims for these individuals?
  2. Are there groups of workers by education, earnings, gender, or race for whom TDI availability is particularly useful in reducing SSDI claims?

We will present preliminary findings using data from the longitudinal and administrative date linked Survey of Income and Program Participation Synthetic Beta (SIPP SSB) and the SIPP Gold Standard File (SIPP GSF).

  • Rachel Langford, Ryerson University, Alana Powell, Ryerson University, “Low-Wage Work of Early Childhood Educators in Ontario: Are Policy and Advocacy Directions Working?”

In the Canadian province of Ontario, the early childhood education and care (ECEC) workforce continues to be undervalued, underpaid, and burdened with challenging working conditions. The paper will begin with descriptions of three key policy and advocacy directions that seek to address these ECEC workforce issues: (1) The workforce has been increasingly ‘professionalized’ through a self-regulatory body; (2) In 2018, the Liberal government issued a policy document, Growing Together, in which the working conditions of early childhood educators (ECEs) were finally acknowledged and partially addressed by policy recommendations; and (3) ECEs began to advocate in their own right for better working conditions through the Association of Early Childhood Educators Ontario’s ‘Professional Pay and Decent Work’ campaign. Campaign strategies include implementing mobilization forums across the province to establish Decent Work Communities of Practice, developing policy recommendations communicated through reports, videos, and local advocacy actions, and building ECEs’ advocacy capacity and leadership skills with the Institute for Change Leaders. The paper analyses in what ways these policy and advocacy directions are and are not working to advance gender justice and social change for Ontario’s ECEs. Drawing on Fraser (2016) and Tronto (2013) the paper explores factors that constrain change such as the dominance of market thinking for out-of-home childcare and the unequal allocation of the care of young children to a new class of low-wage workers. How these constraints present new risks in the citizenship and social inclusion of ECEs in Ontario is examined. The paper concludes by exploring resistance to constraints particularly in the context of a new Conservative Ontario government.

  • Zitha Mokomane, University of Pretoria, “Balancing Childcare and Work Roles: Views of Parents in the South African Informal Sector.”

A wide and established body of research evidence has consistently shown the critical role of various workplace policies and practices in enhancing the integration of paid work and family care responsibilities. It is noteworthy, however, that in many countries of the Global South where labour markets are characterized by large informal sectors, the majority of workers have limited or no access to the formal workplace measures meant to support the combination of work and care responsibilities. Despite this, the care challenges and coping strategies of workers in the informal sector have remained largely unexplored. With a particular focus on childcare, the aim of this paper is to contribute to closing this research gap by exploring the work-family fit (individuals’ assessment of who well they are able to integrate paid work and family responsibilities) of informal sector workers in South Africa, a country where the informal sector accounts for 17% of total employment. The paper uses data from the “Family and Gender Roles” module fielded in a recent round of the South African Social Attitudes Survey – an annual, nationally representative survey that provides quantitative public opinion data on various socioeconomic and political issues. The results reveal that due, overall, to the precarious nature of their jobs, informal sector workers have relatively poor work-family fit compared to their formal sector counterparts. The key factors that underlie these results are discussed, and the paper concludes that the experiences and views that emerged from the informal sector workers underscore the need for the development of context-specific interventions that cater for all types workers. Examples of plausible policies and programmes for the informal sector are presented.

7.3. Panel Session: Emotions at Work: The Intersections of Emotion, Care, and Work
Music Room

  • Moderators: Alisa Grigorovich, Toronto Rehabilitation Institute – University Health Network, Laura M. Funk, University of Manitoba
  • Laura M. Funk, University of Manitoba, Rachel Herron, Brandon University, Lisette Dansereau, University of Manitoba, “The Methodological Complexities of Using Interviews to Examine Carers’ Emotion Work.”

Both paid and unpaid care work have been identified in previous scholarly work as involving not only physical tasks of care but the effort involved in supporting a person’s emotional well-being. Care work is also generally recognized as an emotionally challenging experience for many carers. The concept of emotion work addresses the intersection of these two issues, and highlights the influence of feeling rules in the everyday experience of supporting persons with long-term chronic illness or disability. Though emotion work has potential to advance the study of both paid and unpaid care work, there are methodological and epistemological challenges involved in examining the concept (indeed, examining emotions in general) using interview data. In this presentation we reflect on our own experiences analyzing carers’ emotional work in different qualitative datasets. Taking a social constructionist perspective, we identify how carer participants do more than just describe their felt emotions about care work; they simultaneously manage their own emotions and navigate feeling rules during the interaction with the interviewer. This generates considerable analytic complexity, as well as ethical considerations (e.g., Sinding and Aronson, 2003). Drawing on illustrative examples from our datasets, we discuss the potential and limitations of studying emotion work using interview data, and provide several recommendations as to how best to investigate emotions through interviews.

  • Lisette Dansereau, University of Manitoba, “Caring On Your Own: The Emotional Labour of Home Care and Home Support Workers.”

Home care is a vital and irreplaceable service, aligning directly with the international principle of Aging in Place. Older adults come from all walks of life, may be accommodating or abusive, appreciative or entitled, and some will be experiencing cognitive decline and dementia. Workers need emotional skills to foster positive interactions with a diverse group of people, and to manage potentially intense one-on-one relationships. This study explores the emotional of features of care relationships and ways that those experiences are shaped by the context of working for pay in the home of another. Following ethics approval, nine semi-structured interviews lasting an average of one hour and 40 minutes were conducted with participants who shared highly personal stories about their emotional experiences when working with clients in their own homes. Transcriptions included details of emotional cues, tone of voice, and speech patterns, and were analyzed through the theoretical lens of emotional labour, impression management and synesic role-taking. Qualitative techniques included directed content analysis, narrative reconstruction and summarization, followed by reiterative thematic synthesis. The relational and emotional experiences shared by the participants ran the gamut from joy to fear to outrage to grief, and were influenced by gender, ethnicity and newcomer status. Importantly, the structural features of care work—most particularly the uniformity, comprehensiveness and type of workplace policies—strongly influenced workers’ emotional experiences both positively and negatively. The findings from this research suggest that care workers would benefit from training in emotional and relational skills in addition to task-based skills. Additionally, there are areas for improvement in organizational policies, such as providing consistent and comprehensive support and oversight. Such labour practices would better protect the emotional wellbeing of workers, resulting in more positive interactions between workers and the people they care for.

  • Rachel Herron, Brandon University, Laura Funk, University of Manitoba, Dale Spencer, Carleton University, “Responding the ‘Wrong Way’: Examining the Emotion Work Involved in Caring for a Family Member with Dementia.”

Although it is generally acknowledged that the changing actions of some people living with dementia (specifically responsive behaviours) can be emotionally exhausting for family members, there has been little research on how carers actually interpret and manage their emotional responses when interacting with persons with dementia in context and over time. Drawing on the concept of emotion work, we examine when and where carers feel they are responding “the right way” to their kin and when and where they resist normative emotions around family care. We conducted interviews (N= 20) and diaries (N= 11) with family carers in Manitoba, Canada to explore how they negotiate their emotions and emotional displays when caring for a family member whose behaviours are changing. Carers expressed feelings of frustration, anger, and resentment and identified putting on a positive attitude, putting the person with dementia first, protecting the person with dementia, and avoiding conflict and arguing as the ‘right way’ to respond to these negative feelings. They identified challenges responding the ‘right way’ in relation to household chores, lost opportunities, fear, verbal aggression, and fatigue. We suggest that programs and policies must recognize the complex and often gendered emotion work of family carers. Specifically, there is a need for more nuanced education materials, support with household tasks, the inclusion of carers emotional needs in transition planning, and support for carers to exit the caring role.

  • Nicole Dalmer, Trent University, “Tracing Emotion in Family Caregivers’ Information Work.”

Family caregivers contend with large amounts of information from different sources in different formats throughout their everyday and every night care work. Information work saturates families’ care work, providing tools for coping, problem solving, and dealing with uncertainty. Family caregivers’ information work is increasing in quantity and intensity given trends towards aging in place and the informatization of care. Information is often problematically constructed as a neutral resource that caregivers can draw upon, conflating information provision with being informed. Not only does this construction overlook the work needed to find and make sense of information, but it also neglects the emotional work involved in using information and dealing with the implication of information found, including the ways information can shape and change caring relationships. As part of a larger institutional ethnographic study that aimed to look at the social organization of family caregivers’ information work, this study draws on data from 13 interviews and mapping exercises with family caregivers of older adults who are living with dementia and are living at home. As families began to make visible their information work, emotive components emerged in their working and tinkering with information throughout their caregiving trajectory. Findings from these interviews indicate that information is more than a neutral or cognitive resource for families. Families not only articulated the emotion work involved in using, finding, storing, and avoiding information, but also described different emotions that themselves became important sources of information. Drawing attention to families’ emotion work within their information work is in attempt to identify and make known the intricate and workful character of families’ care work, building towards the creation of a language for the work of everyday caring.

  • Megan Nguyen, University of Toronto, “The Bodily Experience of Emotions among Cancer Patients.”

Research demonstrates that conversations between health practitioners and cancer patients about their experiences of emotions alleviate their emotional distress and support their improved quality of life. When practitioners create a safe space for patients to express their emotions, patients are less likely to experience detrimental health outcomes associated with poorly managed emotional distress (e.g. reduced adherence and adaptation to treatment, lower quality of life). Best practice guidelines recommend that practitioners help cancer patients express and explore their feelings, especially during active treatment when they are particularly at risk for increased emotional distress. Despite this, the emotional needs of cancer patients remain largely unmet. This gap in care is fundamentally an effect of the biomedical culture of oncology in which the physical body is prioritized over emotional health and explorations of emotions are limited to screening for and mitigating emotional distress. This biomedical approach does not provide a sufficient means for deeply exploring and understanding patients’ emotions. It behooves us to venture beyond conventional approaches to enable a radical rethinking of emotions in the context of cancer care. In this presentation I will provide an overview of the empirical and theoretical literature regarding cancer patients’ bodily experiences of emotions. I will argue that a phenomenological embodiment approach to exploring emotions is warranted because it can provide insight into the direct experience of emotions through its orientation to the subjective, lived body. This perspective enables an exploration of the bodily dimension of feelings that fundamentally underpins emotion experiences and thus, has the potential to shed light on meanings of emotions that attention to bodily experience can particularly afford. Through the disruption of traditional thought therein lies the possibility for new insight into emotions. This understanding could be applied in practice to foster improvements in the emotional support and care of cancer patients.

  • Alisa Grigorovich, Toronto Rehabilitation Institute – University Health Network, Pia Kontos, Toronto Rehabilitation Institute – University Health Network & University of Toronto, “‘It Could Be A Lot Worse’: The Emotional Work Involved in the Management of Unwanted Sexual Attention from Residents.”

While there is an abundance of research examining emotions in the context of care provision, little research has explored emotions and their management in the context of unwanted sexual attention in nursing homes. We conducted a study to explore the affective practices that are undertaken by health care providers in relation to the management of unwanted sexual attention from older residents living with dementia in these settings. This was an ethnographic study of a nursing home in urban Ontario, Canada. Here we will focus on in-depth interviews conducted with care providers (n=26) across multiple professions (e.g. personal care, nursing) and roles (e.g. frontline, administrative). Our analysis highlights that unwanted sexual attention from residents was common and persistent, and incited in care providers feelings of shame, discomfort, self-blame, and fear. Further, they reported that management and prevention strategies that they endorse are largely unsupportive and ineffective. Yet, despite care providers’ vulnerability to unwanted sexual attention from older residents, and the negative emotional consequences they experience as a result, providers both minimize and tolerate unwanted sexual attention, rather than seek formal redress. Our analysis suggests that such minimization and tolerance is a protective form of coping that is encouraged by professional and organizational mandates and policies that inform providers’ practices. More specifically, organizational policies privilege the safety of residents over that of workers. Further, professional standards and training hold workers responsible for managing and preventing residents’ aggression, while also naturalizing aggression as part of dementia. This structural landscape effectively reproduces care providers’ vulnerability to unwanted sexual attention and may have long-term implications for their well-being.

7.4. Roundtable Session: Neo-liberalism, Inequality and Resistance

Great Hall A

  • Sarah-Louis Ruder, School of Environment, Resources and Sustainability, University of Waterloo, Sophia Sanniti, School of Environment, Resources and Sustainability, University of Waterloo, “Towards Equitable Labour Futures: Reframing Care through an Ecofeminist Ethic.”

As extreme shifts in global climate bring about unprecedented levels of economic, political, and environmental stressors, there is an urgent need for transformative change in the ways humanity lives, eats, works, and interacts [1,2,3,8]. From healthcare and education, to homecare and emotional labour, the nature of care is changing in the face of system shocks and social-ecological crises. Paid and unpaid carework constitute the ‘human infrastructure’ of our communities, and this labour is paramount for societal transformations to equitable, sustainable, and resilient futures [3]. While the social sphere of reproductive labour (i.e., carework) is crucial to community vitality, this anthropocentric emphasis excludes intergenerational and interspecies dynamics of care provisioning, and limits the potential for intersectional understandings of human care. We highlight the fundamental dependency of humans on the care and provisioning of Nature: healthy air, water, and soil. Critically interrogating the meaning of carework, we propose an ecofeminist ethic of care that recognizes social and ecological elements of reproductive labour [4].

Ecofeminists outline a crisis of care, rooted in a false nature-culture dichotomy that justifies domination [5,7,9,10,11]. The discipline traces this dualism from Greek philosophy (soul/body), to the scientific revolution (nature/culture), then culminating in the growth imperative of contemporary market logic (ecology/economy) [6]. The economic production-reproduction division systematically erodes both nature and society’s reproductive capacities, externalities in the growth throughput, culminating in a dual crisis of care for people and the planet [3,6,7]. The radically alternative normative paradigm presented by ecofeminist ethics brings forth elements of kinship, interdependence, and community, while abolishing the institutional structures of oppression at the core of extractivist economics [4,5,10]. In arguing that carework is labour is reproduction, we present limits of the Sustainable Development Goals, as an anthropocentric individualist care ontology, and apply ecofeminist ethics to produce equitable labour futures and communities of care.

Works Cited

  1. Eriksen, C. (2013). Gender and wildfire: Landscapes of uncertainty. New York: Routledge.
  2. Floro, M. S. (2012). ‘The Crises of Environment and Social Reproduction: Understanding their Linkages’. Journal of Gender Studies, 15, 13–31.
  3. Gibson, C., Head, L., & Carr, C. (2015). From Incremental Change to Radical Disjuncture: Rethinking Everyday Household Sustainability Practices as Survival Skills. Annals of the Association of American Geographers, 105 (2): 416–424.
  4. Kates, R. W., Travis, W. R., & Wilbanks, T. J. (2012). Transformational adaptation when incremental adaptations to climate change are insufficient. Proceedings of the National Academy of Sciences, 109(19), 7156–7161.
  5. Lee, A. (2018). ‘An ecofeminist perspective on new food technologies’. Canadian Food Studies 5 (1): 62-89.
  6. Mellor, M. (1997). Feminism and Ecology. New York, NY: New York University Press
  7. Merchant, C. (1980). The Death of Nature: Women, Ecology, and the Scientific Revolution. HarperOne.
  8. Mies, M. and Shiva, V. (2014). Ecofeminism. New York, NY: Zed Books.
  9. Park, S. E., Marshall, N. A., Jakku, E., Dowd, A. M., Howden, S. M., Mendham, E., & Fleming, A. (2012). Informing adaptation responses to climate change through theories of transformation. Global Environmental Change, 22(1), 115–126.
  10. Plumwood, V. (1994). Feminism and the mastery of nature. London, UK: Routledge.
  11. Salleh, A. (2017) Ecofeminism as Politics: Nature, Marx, and the Postmodern - Second Edition. London: Zed Books Ltd.
  12. Warren, K. (2000). Ecofeminist Philosophy. Lanham, MD: Rowman & Littlefield
  • Adwoa Onuora, University of the West Indies, “The Intersectionality of Carework, Reproductive Justice, and Gender Inequality in Jamaica.”

In Jamaica, the state deems it unlawful for women to exercise their right to an abortion except in cases of medical emergencies. Poorer Jamaican women—unlike their economically privileged counterparts with contraceptive choices outside of the public healthcare system—are left with very limited reproductive options, and are therefore forced into motherhood. This has a knock-on effect on their increasing care burden and time poverty because they are becoming mothers in a context of severe economic austerity with no social support systems in place. This paper presents the findings of the first time use survey conducted in Jamaica as part of the first step towards alleviating women’s unpaid care burden highlighted as a key area of concern in Jamaica’s National Policy for Gender Equality. It discusses how Jamaicans spend their time, highlights the disparity in unpaid carework undertaken by men and women of varying socio-economic backgrounds, and examines why advocacy and legislative changes around women’s reproductive rights is important in the context of discussions on women’s unpaid carework.

  • Anna Rosinska, University of Massachusetts Lowell, “Dimensions of Inequality and Privilege - White Non-Hispanic American Women in Paid Domestic Work in the USA.”

Paid domestic and care work (PDCW) as a labor sector employs at least 67 million people globally (ILO, 2018) and an estimated two million people in the USA. Scholarship on this topic focuses on workers with racial minority or migrant backgrounds. Despite ethnicization and racialization of PDCW, workers who are white working-class women citizens continue to perform domestic and care tasks for private households (ILO, 2017). M.Duffy’s analysis revealed 49.2% participation of White non-Hispanic women, while in the sub-type of care work characterized by personal contact (nurturance) the ratio was even higher, 57.4% (2005). In a European context, employment of white citizens was strengthened by the recent economic crisis (Di Bartolomeo, Marchetti 2016; EPRS 2015, see also Kofman, Raghuram 2015)).

The aims of this paper are twofold. Firstly, to explore data relating to the overlooked group (in decennial censuses and American Community Surveys) – who are they, what are their basic characteristics, what is regional variability of their incidence among domestic workers? Secondly, to situate the facts within the framework of discussions and narratives on whiteness, race, class and gender inequalities.

Some of the questions I will ask include: Who are white non-Hispanic domestic workers in terms of age, education level, and socioeconomic position? What specific care and domestic jobs do they perform? How is their gender, whiteness, class, and citizenship enacted? What is the experience of being a white non-migrant person in a sector associated with racial minorities and migrants? Are we missing any dimensions of inequality or privilege? The proposed paper is part of a larger project funded by the European Commission: “Intersections of class and ethnicity in paid domestic and care work: theoretical development and policy recommendations based on the study of 'majority workers' in Italy and in the USA”.

7.5. Roundtable Session: Care Work Trajectories

Great Hall B

  • Miao Wang, University of Toronto, Weiguo Zhang, University of Toronto, Jia Yongfang, Inner Mongolia University of Technology “Love, Money, Autonomy and Self-Development: Becoming Care Workers in China.”

This study seeks to understand what motivate people to become careworkers. Within the context of ageing and economic restructuring in China, it aims to understand the intrinsic and extrinsic motivation of individuals who become care workers. Based on thematic analysis of interviews of 42 care workers in Beijing and Hebei, this study demonstrates that underlying motivations of becoming a care worker are complex and multidimensional. Differentiated by gender, some become home-based care workers, while others work in institutional settings of nursing homes or hospitals. A variety of motivations go beyond economic and emotional rewards of money and love. They may also include exploration, learning, and pursuit of autonomy, freedom, and actualization of their dreams.

  • Brittany Campbell, Brock University, “Strengthening the Bond: Understanding Interspecies Care Work Among Veterinarians, Low-Income Individuals, and their Companion Animals.”

This presentation considers care work and its multi-species implications for companion animal ownership of low-income individuals. Using the lenses of feminist political economy and interspecies solidarity, I examine the cycle of care work among and between veterinarians, companion animals, as well as their owners. As pets are now considered members of the family and a form emotional support in many households, both companion animal owners and their pets engage in various forms interspecies care work to take care of one another. Additionally, low-income and/or vulnerably housed individuals share a unique bond with their animals as they often serve as a central, if not the only source of love, companionship, and especially for women, a form of protection. However, due to larger social stigmas, some people question and criticize the ability of economically marginalized people to take proper care of their pets. In this regard, the veterinary field, which is increasingly feminized, plays a key role in expanding, maintaining, and strengthening multi-species care work. Drawing from core findings in existing literature as well as my current thesis work, I will discuss venues for access to veterinary care for precariously housed humans and their animals, as well as introduce and explore areas of potential for access to such care. This analysis will thus address the gendered and interspecies facets of care work that exist throughout these relationships and offer suggestions that seek to strengthen the human-animal bond.

  • Jielan Xu, University of Toronto, “Gender Differences and Gender Relations in Unpaid Care Work: A Time-Use Analysis of Canadian Data.”

The work of care is highly gendered. It also tends to be invisible, as it is often composed of unpaid small tasks. Moreover, the emotional labour of care work as not been well identified or measured. To understand the invisible unpaid care work, and to analyze its gender differences and embedded gender relations over the life course, this study conducts a time-use analysis and measures (1) the time spent on different types of care work and simultaneous care activities, which captures the scattered physical tasks of care, and (2) time spent with social contacts such as children and older parents, which is linked with an invisible form of care – sustained attention. The results confirm the hypothesis that women still undertake more unpaid care work than their male counterparts over the life course, and a majority of unpaid childcare is carried out by working-age women. Different from previous theories that emphasize factors such as time availability or gender power dynamics on gendered care work, this study suggests that hours of unpaid care work are more strongly influenced by the demand of care rather than availability of time or financial resource. With other socioeconomic factors controlled, time spent on unpaid care is not significantly different between middle-income and high-income women and men, yet low-income women as well as men and women in low-income households tend to undertake more unpaid care work. Also, influenced by traditional gender roles, very few men undertake workloads that are low in paid work but high in unpaid care work in dual-earner households. In contrast, women have more flexible coping strategies. Some of them take high workload in unpaid care but low workload in paid job, and some condense unpaid care work in fewer hours by multitasking.

Session 8 (10 – 11:15 a.m.)
Concurrent Sessions and Book Panel

8.1. Book Panel

East Common Room

  • Author: Christine Kelly
  • Book: Disability Politics and Care: The Challenge of Direct Funding. University of British Columbia Press, 2016.
  • Respondents: Akemi Nishida, University of Illinois, Chicago
  • Laura Mauldin, University of Connecticut

“We do not need care!” is a rallying cry for disability movements. It is informed by a recognition that a lack of choice over life decisions – from relationships and employment, to what to wear or eat – is a subtle yet pervasive form of violence endured by many people with disabilities as part of their “care.”

Disability Politics and Care examines a provincial direct-funding program to illuminate what happens when people with disabilities are given autonomy over their own care arrangements. In addition to investigating responses from a wide range of stakeholders, Christine Kelly reflects on the broader social and political implications of these sorts of programs. She probes the divide that exists between rejections of care by disability activists, on the one hand, and attempts by feminists to value gendered forms of labour, on the other. Rather than trying to forge common ground, Kelly explores how maintaining a tension between them could positively transform the understanding and practice of care.

Enlivened by the voices of disabled people, attendants, informal supports, and others, this book uses one independent living program as a starting point for untangling much larger philosophical, theoretical, and material questions about (self) determination, (inter)dependence, governance, and justice.

This engaging book will interest scholars and practitioners working in disability studies, social work, women’s and gender studies, sociology, and policy studies, as well as advocates and activists working in the areas of disability and care. (UBC Press)

8.2. Paper Session: Care and Neoliberalism
Debates Room

  • Moderator: Louise Oldridge, Nottingham Trent University
  • Fiona Macdonald, RMIT University, “Emerging Risks in Paid Carework: Individualisation, Insecurity and the Gig Economy.”

The massive and rapid transformation of Australia’s system of support for people with disability is reshaping employment relationships, work arrangements and job quality for paid care workers in multiple ways. Under the new personalised and marketised system of supports the goals of power, flexibility and control for care ‘consumers’ are to be achieved, at least in part, through commodification of support relationships, including via direct employment and brokered arrangements. New markets for disability services are being formed and digital platforms are playing a role in shaping market structures and transforming employment relations. The consequences of these changes for paid care workers are the focus of this presentation, which reports on some of the findings of a three-year qualitative case study of the consequences of the Australia’s new National Disability Insurance Scheme for the disability support workforce in comparative perspective. Drawing on findings of analyses of interviews with workers, employers and other labor market actors, and on worker time diaries and organizational and public policy documents the presentation examines how labour market and business risks are being individualised and privatised in the newly forming commodified care market, and the role of platform or ‘gig’ economy businesses in this. It focuses on impacts on the low-paid and highly feminised paid care workforce and the ways in which contemporary changes are informalizing paid care work, placing it beyond the reach of traditional forms of regulation.

  • Louise Oldridge, Nottingham Trent University, “A Discourse Analysis of Social Care Policies in the UK and their Impact on Mid-Life Women’s Informal Caring Careers.”

Informal/unpaid care provision has increased at a rate higher than population growth (Pickard, 2015). The UK care system relies on informal carers, saving the state £132 billion per year (Carers UK, 2016). The greater pressure on families and friends to care for their loved ones and continued reductions in formal support (Grierson, 2017), means that women aged 50 – 64 now provide the highest amount of informal care for dependent adults at 23.5 per cent (ONS, 2013).

Using critical discourse analysis (Fairclough, 2010) of social care policies, this paper explores the UK’s adoption of neoliberal ideologies, with their emphasis on the importance of family as a mechanism of care and reliance on informal care as a policy initiative by successive governments (Gilbert and Powell, 2005). This is reflected in the language utilized, forcing carers to establish their roles and identities (Harris, 2002). Indeed, the National Carers Strategy in 2008 detailed, ‘The role of the individual is to recognize that caring for a family member, friend or partner is one of the responsibilities we all potentially face as part of family life’, (HM Government, 2008:39). The impact of such ideologies are reflected in the findings of empirical research conducted in 2016 presented here. Furthering the work of Aneshensel and colleagues (1995), and developing concepts of work (Glucksmann, 1995; Taylor, 2004), the paper explores the construction of women’s informal caring careers in response. As a result, it provides a typology taking account of ‘emerging’, ‘uncertain’, ‘focused’, ‘declining’, and ‘former’ careers. These categories bring together the experiences of participants with existing literature to encapsulate length of caring and transitions; caring activities; carer identity; and considerations of skills development. With the majority of participants demonstrating ‘focused’ caring careers, they identify themselves as carers and have significant caring responsibilities with little or no training and support.

  • Eleanor Johnson, University of Bristol, Ailsa Cameron, University of Bristol, “Exploring the Role of Volunteers in Care Settings for Older People.”

In England, the voluntary sector, and volunteering as a distinct activity, has always played a role in the provision of personal welfare services. Faced with rising demand for services, cuts to health and social care funding, and recruitment difficulties, however, social care services are becoming more dependent on the use of volunteers in the provision of care to older people. Drawing upon findings from a study of the roles and experiences of volunteers in social care settings in England, this paper considers the implications which this practice has for paid care workers and care provision. Our findings indicate that volunteers are making a substantial contribution to the provision of care and support services for older people and, moreover, that social care organizations recognize the value of this contribution, particularly in terms of alleviating loneliness and isolation amongst the older population. The study found that working with volunteers in social care settings is most successful when it is formalised in terms of recruitment and training and when there are clear boundaries between the volunteer role and that of paid care workers. Those organizations where the boundaries between paid care work and volunteer roles were more clearly defined tended to be larger and had dedicated resources and paid members of staff to oversee the recruitment, training and management of volunteers. In other settings, the boundaries between paid care work and the volunteer role were poorly delineated and appeared at risk of becoming increasingly blurred. In this presentation we explore some of the questions which this blurring of the roles of paid care workers and volunteers raises concerning the equity and quality of service provision, professionalism, and the remuneration of and regard for caring work.

  • Kim England, University of Washington, Caitlin Alcorn, University of Washington, “Home Care Workers, Precarity and the U.S. Fair Labor Standards Act.”

Home care workers will be among the fastest growing jobs in the U.S. in the next ten years, linked to the growing numbers of people aged over 65. Located at the intersection of health care, social policy and the U.S. state, home care work is notable for its low pay, job insecurity, and irregular hours. As most of the funding comes from federal, state and local governments (Medicaid and Medicare are especially important), home care is a version of public sector employment. In broad terms, the contemporary state has retreated from funding and directly providing public services associated with social reproduction, while introducing apparatus that increases market-oriented, for-profit delivery mechanisms. The current legal and economic precarity of contemporary home care workers has roots in the New Deal and the passing of the 1938 Fair Labor Standards Act. We focus on the origins of the FLSA and trace forward to recent amendments that cover most (but not all) home care workers. We use our analysis as a vehicle for exploring American state intervention into caregiving. The contemporary home care industry is marked by the emergence of both for-profit agencies and independent contractors with fewer labor rights (part of a growing set of business strategies that essentially shift market risk to individual workers). We locate these recent trends in the context of neoliberalized policies and politics underscoring the continued retreat of the state from direct welfare provision. Interwoven with these trends is the legacy of raced, classed and gendered discourses about home care. They continue to shape the debates and boundaries of political possibilities, and thus the parameters of social and economic policy that directly impact the working conditions of home care workers which, even with the 2015 extension of FLSA to cover minimum wage and overtime protections, remains a precarious occupation.

8.3. Panel Session: What Constitutes as High Quality in Early Childhood Education and Care Settings? A Synthesis of Three Review and Meta-Analyses
Music Room

  • Moderator: Nellie Kamkar
  • Nellie Kamkar, Michal Perlman, Olesya Falenchuk, Evelyn McMullen, Brooke Fletcher, Ashley Brunsek, Gabriella Nocita, Prakeshkumar Shah, “Is Early Childhood Educator Experience Associated with Child Outcomes? A Systematic Review and Meta-Analysis.”

Purpose. Across the United States, Canada and elsewhere, a significant number of young children are cared for in Early Childhood Education and Care (ECEC) programs1,2. An important element that is associated with positive outcomes in early care settings is the quality of care3,4. One quality indicator that has received research attention is how experienced the educators are5,6. There is little consensus, however, about the extent to which educator experience is associated with children’s academic, socioemotional, or behavioural outcomes. Despite this, many ECEC accountability and other policy initiatives currently assess educator years of experience as part of their quality assessments7. Furthermore, many localities require certain levels of experience from the educators who work in ECEC settings. Thus, the goal of the current review was to comprehensively review the literature on educator’s years of experience and various child outcomes. Methods. Three electronic databases (Medline, ERIC, and PsycINFO), large electronic datasets, and reference sections of eligible papers were exhaustively searched for studies published until February 5th, 2018. Two independent raters screened titles, abstracts, and full papers for relevance and extracted data from all eligible studies. Results. A total of 33 studies (N = 28,195 children) were included in the systematic review. There was considerable variability in how educator’s experience was operationalized across studies as well as the child outcomes measured. Results of both the systematic review and meta-analysis reveal few and weak associations between educator’s years of experience and child outcomes. Scholarly Significance. Educator years of experience does not appear to be a promising avenue for quality improvement initiatives or for use as a mechanism for oversight of ECEC settings. These findings highlight the need to explore other indicators of ECEC quality that are more fruitful in improving childhood care environments and facilitating the selection of good quality childcare.

References

  1. Kamerman, S. B., & Gatenio-Gabel, S. (2007). Early childhood education and care in the United States: An overview of the current policy picture. International Journal of Child Care and Education Policy, 1(1), 23-34. doi:10.1007/2288-6729-1-1-23.
  2. Sinha M. (2014). Childcare in Canada: Spotlight on Canadians: Results from the General Social Survey. Ottawa, Ontario. Statistics Canada, Catalogue no. 89-652-X - No. 005; Release date October 30, 2014. http://www.statcan.gc.ca/pub/89-652-x/89-652-x2014005-eng.pdf.
  3. Côté, S. M., Mongeau, C., Japel, C., Xu, Q., Séguin, J. R., & Tremblay, R. E. (2013). Child care quality and cognitive development: Trajectories leading to better preacademic skills. Child Development, 84(2), 752-766. doi:10.1111/cdev.12007.
  4. Phillips, D., Mekos, D., Scarr, S., McCartney, K., & Abbott–Shim, M. (2000). Within and beyond the classroom door: assessing quality in child care centers. Early Childhood Research Quarterly, 15(4), 475-496. doi:10.1016/S0885-2006(01)00077-1.
  5. Brown, E. T., Molfese, V. J., & Molfese, P. (2008). Preschool student learning in literacy and mathematics: Impact of teacher experience, qualifications, and beliefs on an at-risk sample. Journal of Education for Students Placed at Risk (JESPAR), 13(1), 106-126. doi:10.1080/10824660701860474.
  6. Connor, C. M., Son, S-H., Hindman, A. H., & Morrison, F. J. (2005). Teacher qualifications, classroom practices, family characteristics, and preschool experience: Complex effects on first graders’ vocabulary and early reading outcomes. Journal of School Psychology, 43, 343-375. doi:10.1016/j.jsp.2005.06.001.
  7. Isner, T., Tout, K., Zaslow, M., Soli, M., Quinn, K., Rothenberg, L., & Burkhauser, M. (2011). Coaching in Early Care and Education Programs and Quality Rating and Improvement Systems (QRIS): Identifying Promising Features. Washington, DC: Children’s Services Council of Palm Beach County.
  • Gabriella Nocita, Michal Perlman, Evelyn McMullen, Olesya Falenchuk, Ashley Brunsek, Brooke Fletcher, Nellie Kamkar, Prakeshkumar Shah, “Early Childhood Training of Educators and Preschool Children’s Outcomes: A Systematic Review and Meta-Analysis.”

Purpose: Nearly half of young children in North America are cared for in early childhood education and care (ECEC) settings1, 2. Given the number of children attending ECEC settings and the amount of time they spend in such settings, it is critical to explore the quality of care they receive and the influence of such care on their development. Early childhood training of educators (ECT) is one quality indicator that has received considerable attention. ECT refers to specialized early childhood training of educators in ECEC programs. Although ECT is used frequently in ECEC quality improvement initiatives3, the literature linking ECT to child outcomes is limited and has yielded mixed findings. To address this mixed literature, we conducted a systematic review and several meta-analyses that evaluate associations between educator ECT and children’s cognitive, academic, physical, social, emotional, and behavioral outcomes. Methods: Searches of PsycINFO, ERIC, Medline, large datasets, and reference sections of all included studies were conducted up to February 5, 2018. Title, abstract, and paper reviews were conducted by two independent raters for all studies that met eligibility. Seventeen eligible studies (n = 15,236 children) were included. Results: Studies varied widely in how ECT was conceptualized and measured. Results from the systematic review revealed very few significant associations between ECT and various child outcomes. Results from the meta- analyses yielded weak positive associations between ECT and children’s language and social skills and no significant associations for children’s mathematics, vocabulary, or letter identification skills. Scholarly Significance: Our findings suggest that ECT is not a key driver of children’s outcomes, prompting a call to action to revisit the content, amount, and method of delivery of ECT.

References

  1. Child Care Aware. (2017). Checking In: A Snapshot of the Child Care Landscape – 2017 State Fact Sheets. Retrieved from http://usa.childcareaware.org/advocacy-public- policy/resources/research/statefactsheets
  2. Sinha, M. (2014). “Childcare in Canada” Spotlight on Canadians: Results from the general social survey. Statistics Canada (Catalogue no. 89-652 – No. 005). Retrieved from: http://www.statcan.gc.ca/pub/89-652-x/89-652-x2014005-eng.pdf
  3. Quality Compendium. (2018). A catalog and comparison of quality initiatives like Quality Rating and Improvement Systems (QRIS). Retrieved from: https://qualitycompendium.org/
  4. Early, D. M., Bryant, D. M., Pianta, R. C., Clifford, R. M., Burchinal, M. R., Ritchie, S., . . . Barbarin, O. (2006). Are teachers' education, major, and credentials related to classroom quality and children's academic gains in pre-kindergarten? Early Childhood Research Quarterly, 21(2), 174-195. doi:10.1016/j.ecresq.2006.04.004
  5. Kim, S., Chang, M., & Kim, H. (2011). Does teacher educational training help the early math skills of English language learners in Head Start? Children and Youth Services Review, 33, 732-740. doi:10.1016/j.childyouth.2010.11.019
  6. NICHD Early Childcare Research Network [NICHD]. (1999). Child outcomes when Child care center classes meet recommended standards for quality. American Journal of Public Health, 89(7), 1072-1077
  7. Wasik, B. A., Hindman, A. H., & Jusczyk, A. (2009). Using curriculum-specific progress monitoring to access Head Start children’s vocabulary development. NSHA Dialog, 12(3), 257-275. doi: 10.1080/15240750903075289
  8. Hindman, A. H., Skibbe, L. E., Miller, A., & Zimmerman, M. (2010). Ecological contexts and early learning: Contributions of child, family, and classroom factors during head start, to literacy and mathematics growth through first grade. Early Childhood Research Quarterly, 25(2), 235-250. doi:10.1016/j.ecresq.2009.11.003
  9. Lin, Y., & Magnuson, K. A. (2018). Classroom quality and children’s academic skills in child care centers: Understanding the role of teacher qualifications. Early Childhood Research Quarterly, 42, 215-227. doi:10.1016/j.ecresq.2017.10.003
  10. Mashburn, A. J., Downer, J. T., Hamre, B. K., Justice, L. M., & Pianta, R. C. (2010). Consultation for teachers and children's language and literacy development during pre- kindergarten. Applied Developmental Science, 14(4), 179-196. doi:10.1080/10888691.2010.516187
  11. Son, S. C., Kwon, K., Jeon, H., & Hong, S. (2013). Head start classrooms and children's school readiness benefit from teachers' qualifications and ongoing training. Child & Youth Care Forum, 42(6), 525-553. doi:10.1007/s10566-013-9213-2
  12. Reid, J. L., & Ready, D. D. (2013). High-quality preschool: The socioeconomic composition of preschool classrooms and children's learning. Early Education and Development, 24(8), 1082-1111. doi:10.1080/10409289.2012.757519
  13. Zellman, G., Perlman, M., Le, V., & Setodji, C. (2008). Assessing the validity of the Qualistar early learning quality rating and improvement system as a tool for improving child-care quality. Retrieved from the Rand Education website: http://www.rand.org/content/dam/rand/pubs/monographs/2008/RAND_MG650.pdf
  • Ashley Brunsek, Michal Perlman, Olesya Falenchuk, Brooke Fletcher, Gabriella Nocita, Nellie Kamkar, Prakeshkumar Shah, “A Meta-Analysis and Systematic Review of Professional Development of Early Childhood Educators and Children’s Outcomes.”

Purpose. The demand for quality in Early Childhood Education and Care (ECEC) settings has increased due to the purported benefits that early care settings have on children—particularly those from lower socioeconomic backgrounds 1-3. Educator quality is a strong predictor of children’s school-readiness4-6, but research on what constitutes educator quality has been elusive, with many common indicators showing weak associations with child outcomes 7,8. There is growing consensus that professional development (PD) is an important lever for improving educator practice in Early Childhood Education and Care (ECEC) programs. However, research on PD programs for early childhood educators (ECEs) is highly heterogeneous, making interpretations of the literature difficult. Purpose. The primary objective of this review was to address this issue and evaluate the associations between PD programs for ECEs that target various content areas and a myriad of preschool children’s outcomes. Methods. Searches of three electronic databases (Medline, PsycINFO, ERIC), large datasets and reference sections of all included articles were completed up to February 5, 2018. Studies that reported associations between PD programs for ECEs and child outcomes were included. Sixty-four studies (N = 32, 233 children) were included in the systematic review. Seven meta-analyses were conducted on PD programs that focused on:

  1. Language and Literacy, and
  2. Social/Emotional Functioning Through Interactions.

Results. The majority of analyses revealed positive effects of PD programs on child outcomes. A qualitative systematic review revealed similar results, noting stronger associations for child outcomes related to the focus of PD programs. Greater associations were revealed for programs that included a coaching component and were of a longer duration. Scholarly Significance. Programs that focus on early literacy and language and social/emotional functioning through strengthening educator-child interactions are an important level for improving children’s overall functioning and better preparing them for formal schooling.

References

  1. Nores, M., & Barnett, W. S. (2010). Benefits of early childhood interventions across the world: (Under) investing in the very young. Economics of Education Review, 29(2) 271- 282. https://doi.org/10.1016/j.econedurev.2009.09.001
  2. OECD. (2006). Education at a Glance 2006: OECD indicators – 2006 edition. OECD Publishing, Paris. Retrieved from: https://www.oecd.org/education/skills-beyond- school/37393408.pdf
  3. McCartney, K., Dearing, E., Taylor, B. A., & Bub, K. L. (2007). Quality child care supports the achievement of low-income children: Direct and indirect pathways through caregiving and the home environment. Journal of Applied Developmental Psychology, 28, 411–426. https://doi.org/10.1016/j.appdev.2007.06.010.
  4. Howes, C. (1997). Children’s experiences in center-based child care as a function of teacher background and adult: Child ratio. Merrill-Palmer Quarterly, 43(3), 404-425.
  5. Neuman, S. B., & Cunningham, L. (2009). The impact of professional development and coaching on early language and literacy instructional practices. American Educational Research Journal, 46(2), 532-566. doi:10.3102/0002831208328088
  6. NICHD Early Child Care Research Network. (2002). Child care structure --> process --> outcome: direct and indirect effects of child care quality on young children’s development. Psychological Science, 13(3), 199–206. https://doi.org/10.1111/1467- 9280.00438
  7. Dunn, L. (1993). Proximal and distal features of day care quality and children's development. Early Childhood Research Quarterly, 8(2), 167-192. doi:10.1016/S0885- 2006(05)80089-4
  8. Falenchuk, O., Perlman, M., McMullen, E., Fletcher, B., & Shah, P. S. (2017). Education of staff in preschool aged classrooms in child care centers and child outcomes: A meta- analysis and systematic review. PLOS ONE, 12(8), e0183673. doi:10.1371/journal.pone.0183673.


  • Michal Perlman, Evelyn McMullen, Olesya Falenchuk, Brooke Fletcher, Ashley Brunsek, Nellie Kamkar, Gabriella Nocita, Prakeshkumar Shah. “Is Early Childhood Education and Care Associated with Child Outcomes? An Umbrella Review of the Literature on Seven Quality Indicators.”

Purpose. A large proportion of young children in the U.S., Canada, and elsewhere spend significant amounts of time in Early Childhood Education and Care (ECEC) settings1,2. In light of the substantial amount of time children spend in ECEC settings, investigations of the quality of such care are of paramount importance. However, recent research reviews on specific quality indicators suggest that associations between ECEC quality and child outcomes are less consistent than previously thought3. The purpose of the current review is to comprehensively summarize results from several exhaustive systematic reviews and meta-analyses of associations between seven different ECEC quality indicators and child outcomes. Summarizing research in this area allowed us to identify gaps in the literature as well as promising avenues for quality improvement initiatives. Methods. In seven separate papers, we synthesized the literature on the following quality indicators: 1) educator early childhood training4, 2) educator years of experience5, 3) educator level of formal education6, 4) child/educator ratios7, 5) educator professional development8, 6) the Early Childhood Environment Ratings Scale and its revised form9, and 7) the Classroom Assessment Scoring System10. In total, we conducted 59 meta-analyses. Results. We found enormous heterogeneity in how quality indicators were operationalized, study designs, and the child outcomes examined across studies. Overall, few and weak associations between all quality indicators and child outcomes were found—with the exception of educator professional development. Professional development programs that target different areas of expertise were associated with a range of positive child outcomes. Scholarly Significance. Of the quality indicators we explored, professional development is by far the most promising avenue for quality improvement initiatives. This warrants a call for action on researchers and policy makers interested in supporting the development of the many children who spend significant amounts of time in ECEC settings.

References

  1. Child Care Aware. (2017). Checking In: A Snapshot of the Child Care Landscape – 2017 State Fact Sheets. Retrieved from http://usa.childcareaware.org/advocacy-public- policy/resources/research/statefactsheets.
  2. Sinha M. (2014). Childcare in Canada: Spotlight on Canadians: Results from the General Social Survey. Ottawa, Ontario. Statistics Canada, Catalogue no. 89652X - No. 005; Release date October 30, 2014. http://www.statcan.gc.ca/pub/89-652-x/89-652-x2014005-eng.pdf.
  3. Burchinal, M. (2018). Measuring early care and education quality. Child Development Perspectives, 12(1), 3-9.
  4. Nocita, G., Perlman, M., McMullen, M., Falenchuk, O., Brunsek, A., Fletcher, B., Kamkar, N., & Shah, P. S. (2018). Early Childhood Training of Educators and Preschool Children’s Outcomes: A Systematic Review and Meta-Analysis.
  5. Kamkar, N., Perlman, M., Falenchuk, O., McMullen, E., Fletcher, B., Brunsek, A., Nocita, G., & Shah, P. (under review). Is educator's years of experience in early childhood education and care settings associated with child outcomes? A systematic review and meta-analysis. Early Childhood Research Quarterly.
  6. Falenchuk, O., Perlman, M., McMullen, E., Fletcher, B., & Shah, P. S. (2017). Education of staff in preschool aged classrooms in child care centers and child outcomes: A meta-analysis and systematic review. PLoS One, 12(8): e183673. http://dx.doi.org/10.1371/journal.pone.0183673.
  7. Perlman, M., Fletcher, B., Falenchuk, O., Brunsek, A., McMullen, E., & Shah, P. S. (2017). Child-staff ratios in early childhood education and care settings and child outcomes: A systematic review and meta-analysis. PLoS One, 12(1): e0170256. http://dx.doi.org /10.1371/journal.pone.0170256.
  8. Brunsek, A., Perlman, M., McMullen, E., Falenchuk, O., Nocita, G., Fletcher, B., Kamkar, N., & Shah, P.S. (manuscript under review). A Meta-Analysis and Systematic Review of the Relationship Between Professional Development and Children's Functioning.
  9. Brunsek, A., Perlman, M. Falenchuk, O., McMullen, E., Fletcher, B., & Shah, P.S. (2017). The relationship between the Early Childhood Environment Rating Scale and its revised form and child outcomes: A Systematic review and meta-analysis. PLoS One, 12(6) e0178512 http://doi.org/10.1371/journal.pone.0178512.
  10. Perlman, M., Falenchuk, O., Fletcher, B., McMullen, E., Beyene, J., & Shah, P. S. (2016). A systematic review and meta-analysis of a measure of staff/child interaction quality (the Classroom Assessment Scoring System) in Early Childhood Education and Care settings and child outcomes. PloS one, 11(12), 33: e0167660. http://dx.doi.org/doi:10.1371/journal.pone.0167660.

8.4. Paper Session: End of Life Care

Great Hall

  • Moderator: Guillermina Altomonte, New School for Social Research
  • Cindy Cain, University of Alabama at Birmingham, Jack Lam, University of Queensland, “Integrating Work and Home when Patients Are Dying.”

Extant research has found that flexible hours and locations of work can support better integration between work and home life, thus supporting workers’ wellbeing. Home-based hospice care is a type of care work that has a great deal of flexibility in work hours and places. Does this flexibility support hospice workers’ integration of work and home?

Using qualitative data from 30 semi-structured interviews and quantitative data from an original survey of 165 hospice workers in the U.S., we show that flexibility is not necessarily supportive of hospice workers’ integration or wellbeing. Qualitative findings show that hospice workers value unconditional devotion to patients. They discuss that this unconditional devotion means that they often prioritize work obligations over home life, especially when a patient is imminently dying. This sometimes means that flexibility produces longer and more unpredictable hours of work, causing conflict between work and home obligations. Quantitative findings show that feeling as though work takes too much time from home life is associated with increased stress, decreased overall life satisfaction, and increased burnout.

Our findings challenge the assumption that workers will use flexible work conditions to support their own wellbeing. In the case of these hospice workers, flexible work conditions do not mean better integration of work and home life. These findings illustrate that care work may differ from other types of work as it pertains to integration of work and family life.

  • Ann Vandenberg, Emory University, Alexis A. Bender, Emory University, Candace L. Kemp, Georgia State University, Mary M. Ball, Emory University, Molly M. Perkins, Emory University, “’We Quickly Find another Subject and Make Them Laugh’: Staff-Resident Communication About Death in Assisted Living.”

Assisted living (AL) is increasingly a site of end-of-life (EOL) care in the US. Communication about EOL in AL has focused primarily on advance care directives. Significant gaps remain in understanding how people communicate about death. Data used in this current analysis are from a 5-year NIA-funded prospective, qualitatively driven study (R01AG047048) examining EOL care in four diverse ALs in the greater Atlanta, Georgia area. Using thematic analysis, we build on our typology of resident and informal caregiver communication about death on a continuum from medical directives to the dying process. We compare the narratives of 14 direct care workers, 15 residents, and 15 informal caregivers regarding death communication behavior. We present a typology to identify gaps in communication among these stakeholders and its relation to AL facility policies, with implications for improving EOL communication in AL.

  • Francesca Degiuli, Fairleigh Dickinson University, “The Role of Geriatric Doctors in Shaping Long-Term Care and its Providers.”

This paper is based on preliminary findings related to a research project I am currently conducting in New York city and the surrounding metropolitan area. Traditionally research on long-term care and immigrant labor focuses on the triangle involving the state, families, and the market to understand how the organization of long-term care comes into place. Little to no attention instead has been paid, up to this point, to the role of geriatric doctors in shaping these relationships. This paper, attempts to fill this gap, by exploring how geriatric doctors, both directly and/or indirectly, may affect the decisions of families and the elders in designing individual long-term care projects and consequently hire immigrant home eldercare assistants. In addition, the paper explores what geriatric doctors think of the role of immigrant labor in long-term care and of the role that these workers play in this growing field.

  • Zhe Yan, University of Wuerzburg, “Ethics behind Dirty Work: Eldercare Workers' Experiences in China's Caregiving.”

Reflective both of a gradual erosion of Chinese families’ capacities for direct care of their elderly, and in the context of seismic shifts in terms of the Chinese government’s array of social contracts with her growing elderly population, this paper addresses an important but under-investigated component from the supply side of the current care sector: the care workers who deliver immediate, concrete, personal care to the elderly in institutional settings. Drawing on ethnographic work in diverse types of care facilities in both Northeast and Central China, it becomes clear that care workers negotiate their positions according to the resources they possess. Situated at the intersection of marketization and state (dis)engagement in the care sector, care workers’ perceptions and work experiences of caregiving reflect an inherent instability in initializing the development and implementation of new care polices on a macro-level. Normatively perceived as dirty work, care workers tend to reconcile and boost their occupational identity and social standing through identification with intrinsic and extrinsic motivations. I conceptualize care workers as agents who deliver care via cognitive schemata and emotion, and argue that the dirty work care workers shoulder is not only indicative of who they are within social constructions of care, but that their self-understandings also serve their ability to effectively transcend and address some shortcomings in the state’s development of contemporary welfare regimes. Though care workers utilize a discourse on the ethics of care to moralize their interpretation of their work, this moralizing address of an endemic instability in their workplace exposes challenges for Chinese society in constructing a sustainable long-term care system to ameliorate China’s care needs.

Session 9 (11:30 a.m. – 12:45 p.m.) Concurrent Sessions

9.1. Paper Session: Structures of Elder Care
Debates Room

  • Moderator: Kirstie McAllum, Université de Montréal
  • Mary Jean Hande, Mount Saint Vincent University, Christine Kelly, University of Manitoba, Lisette Dansereau, University of Manitoba, Katie Aubrecht, St. Francis Xavier University, Allison Williams, McMaster University, Anne Martin Matthews, University of British Columbia, “What’s Different About Working Under Direct-Funding? Exploring the Shifting Roles of Care Workers in Self and Family Managed Home Care in Manitoba.”

Directly-funded (DF) home care provides funds to individuals to arrange ongoing assistance with the activities of daily living. DF, also referred to as ‘self’ or ‘family-managed’ care, is often seen as an empowering alternative for older home care users and possible solution to relieve the strain on conventional home care systems. Even more than mainstream home care workers, however, very little is known about the workers employed through DF programs. This paper presents findings on the experiences of DF home care workers from an in-depth qualitative case study of the Self and Family Managed Care program in Manitoba. Guided by a feminist political economy analysis of care and the concept of health equity, we asked how do the roles of DF home care workers who care for older people differ from those of workers in conventional home care systems? And, how do changing demographics (e.g., growing immigrant and aging populations) influence shifting patterns of DF users and workers? We interviewed 7 key informants, 24 older users/family managers, 23 workers, and gathered basic information on demographics, work patterns and education in an online survey (n= 96). We found 3 themes highlighting the unique experiences of DF home care workers caring for older people: (1) highly flexible schedules and scope of practice; (2) blurred formal and informal relationships between workers, care users and their families; and (3) worker involvement in system navigation and care management. Together, these themes highlight the pressing need to understand how DF home care workers' roles differ from those of workers in conventional home care systems. Further, our analysis sheds light on the growing role of the DF policy mechanism in the changing political economy of home care labour in Canada.

  • Kate Laxer, York University, Tamara Daly, York University “The Formal Labour Force in Long-term Residential Care in Canada: Preliminary Analysis of New Survey Data on Gender, Work Organization and Working Conditions.”

Approximately 2,300 Long-term Residential Care (LTRC) facilities across Canada directly employ approximately 200,000 workers. These facilities are complex and highly gendered and racialized workplaces employing mostly female nurses and care aides (80-90%). Statistics Canada labour force data provides limited information about this sizable and critical workforce. In 2006, our team conducted the Long-term Care Workers’ Survey (LTC-WS) to better understand the work of Canada’s LTRC labour force and to compare conditions in Canada with Nordic countries (Sweden, Norway, Denmark and Finland). This ground breaking survey advanced knowledge about work in LTRC in Canada and internationally, highlighting issues surrounding gender, work and care, and underlining challenges for staffing, models of care and workers’ exposure to violence. This paper presents preliminary analysis of data from a new, expanded LTC-WS. Guided by feminist political economy, our analysis extends conventional categories commonly used in national labour force surveys, such as for complex identities, including race and ethnicity, and for mapping unpaid tasks. We examine how the demographic composition of the paid, formal workforce has changed over time; how work organization and working conditions have shifted; and the extent to which facility ownership affects staffing intensity, workload and turnover.

  • Vasuki Shanmuganathan, York University, “Quality, Cultural Care, and Labour in Canadian Long-Term Care Settings.”

Canadian long-term care homes are spaces where the quality of caregiving and receiving are largely measured using quantitative approaches and data results. Through recording blood pressure, weight, blood sugar levels, social behaviours, and other biometrics, the care worker articulates the daily wellbeing of their elder care recipient to various levels of health authorities. Affective and qualitative methods are often undervalued or overlooked as part of a comprehensive understanding of wellbeing in these settings. By extension, correlations between cultural care and quality of life for older adults in nursing homes are less studied as valuable data in assessing quality.

This paper will explore the interconnectedness of culture, care, and quality and use examples of innovations in Canadian long-term care settings. I draw on findings from the national multi-year study “Seniors Adding Life to Years.” In using an intersectional and critical race approach, I elaborate on where valuing cultural heritage can provide transformative experiences of care. In employing data gathered using rapid side-switching ethnography from site visits to Ontario, British Columbia, Alberta, and Nova Scotia, this paper will advance discussions on cultural care, quality, and labour.

I call attention to three aspects for my discussions: a) how the implementation of culturally specific care impacts the overall quality of the home b) how measuring care worker’s wellbeing on the job reveals deep gaps in the understanding of qualitative measures of care and c) how the presence of culturally-specific care supports elderly quality of life which in turn highlights different tensions in how care is comprehended through a health system, local and individual viewpoint.

  • Martha Macdonald, St. Mary's University, Pat Armstrong, York University, Hugh Armstrong, Carleton University, Malcom Doupe, University of Manitoba, “Privatization of Long-term Residential Care in Canada: The Case of Three Provinces.”

This paper examines trends in privatization of long-term residential care (nursing homes) in the Canadian context since the 1990s, comparing Ontario, Manitoba and Nova Scotia. It sets out both commonalities and differences in the trend among the three provinces, identifying factors that contribute to this variation within a single federation. While the Canada Health Act insures public provision of physician services and hospital care, the suite of services comprising the older adult care continuum, such as home-based services, nursing homes, and more recently some community-based housing with health services options (introduced as an alternative to nursing home care) have been excluded from this Act and the national standards it provides, as limited as these standards may be. This has led to major differences in the organization of, and access to, these care options across Canada. The exclusion of continuing care from the Canada Health Act has also led to vast additional inter-provincial differences as it relates to the supply and mix of services offered, to the staffing levels provided, and to regulatory (or in some instances, lack thereof) policies. We consider privatization in terms of formal ownership, contracting out of services, and the impacts of privatization on regulation. Using a feminist political economy approach, the implications for affordability, accessibility and quality of work and care are considered. This research is part of an eight year project funded by SSHRC on ‘Reimagining Long-term Residential Care: An International Study of Promising Practices’ (Pat Armstrong, Principal Investigator). The chapter will be part of a book from the project on ‘Privatizing care, the case of nursing homes’ to be published by Routledge.

9.2. Paper Session: Care and Social Change
Music Room

  • Moderator: Katherine Ravenswood, Auckland University of Technology
  • Simon Black, Brock University, “Precarious No More? Anti-Unionism, Union Resilience, and the Future of Home Care Worker Organizing in the United States.”

Disproportionately poor women of colour and immigrant women, home-based care workers in the United States have traditionally been excluded from coverage under labor and employment protections, including from minimum wage, prevailing wage, and overtime protections and the right to organize and collectively bargain. The work of home-based care is thus characterized by a gendered and racialized precariousness actively constructed and maintained by the state. Yet over the past fifteen years, publicly-funded home-based care workers in the US have organized for better wages and working conditions, overcoming political, geographic and social barriers to unionization. Union campaigns have involved community-labour coalitions lobbying state governments for legislation that opens the door to unionization by redefining home care workers as employees of the state for the purposes of collective bargaining. Yet the 2014 United States Supreme Court decision in Harris v. Quinn effectively introduced “right-to-work” in the state-funded home health care and home child care sector, threatening to undermine care worker unionism and efforts to mitigate precarious low-wage work in the sector. This paper explores how home health care and home child care workers and their unions are adapting to the post-Harris v. Quinn organizing environment. Comparing home care worker unions in New York, Washington and Illinois, I argue that while Harris v. Quinn denied women working in the home the same rights as other employees, far from being a death knell for home care worker unionism, a number of home care locals have reinvigorated their internal organizing and have fostered rank-and-file participation and militancy in the context of “right-to-work”. Against the backdrop of a mounting care crisis, these unions must continue to work in coalition with care consumers to demand greater public investment in care services and ensure decent work for home-based care workers.

  • Megan Undén, University of California - Santa Barbara, “The California Domestic Workers Coalition and Domestic Worker Bill of Rights: An Extended Case Study Addressing Social Movement Organizing and Political Success.”

This paper investigates the success of the California Domestic Workers Coalition to sponsor successful legislation with the passage of California SB 1015, the 2016 Domestic Worker Bill of Rights in 2016. The research design uses an extended case study to address the five legislative acts pursued by this organization with ethnography and document analysis.

Four of these five legislative acts occurred within a relatively stable political context (Democrat Trifecta rule) and were sponsored by CDWC and after their efforts to engage in multi-scalar organizing (National Domestic Workers Alliance and the International Domestic Workers Federation) to strategically connect mobilization with political strategies for intervention. For CDWC, this includes recognition as workers, to existing state labor employment through legislation that: repeals exclusions, ends partial exemptions, and provides specific additions to California Labor Codes and Wage Orders. This legislation provides structural changes for domestic workers with state recognition and use of mechanisms, such as wage enforcement through state agencies. This also uses government processes to change employment conditions and employment relations.

California laws allow legislators, groups, and individuals to sponsors legislation provided an elected legislator author and present the bill. The findings demonstrate the significance of connecting mobilization and political strategies (internal), as well as documenting political influence by this Social Movement Organization in state government processes and governmental documents (external) for SB 1015 and the prior legislative acts prior to establishing a permanent domestic worker bill.

The significance demonstrates how domestic workers organize and lead hybrid smo to build power with coalitions, multi-scaling organizing, and connect this to political victories to intervene in employment structures (external to the state) and democratic with expanded access to rights and benefits other workers enjoy such as overtime protections. Social movement organizations (including coalitions of domestic worker associations and unions) can build successful mobilization strategies to pursue political and legislative success, as well as document their roles in organization and governmental records. Thus, this looks at the strategies to pass this legislation and how passing legislation connects as a broader strategy to build power.

Grace Whiting, National Alliance for Caregiving, Liam O'Sullivan, Care Alliance Ireland, “Family Carer Policies in Three Diverse Countries- Canada, USA and Ireland-A Reflection.”

Family carers/caregivers across the globe provide the vast majority of care to loved ones. Despite the development of advanced welfare states and significant public investment in social care, families continue to be the main providers of such care, at a level that is estimated to be in the region of 80% in these three countries.

This paper, authored by three separate caregiver advocacy organizations from the US, Canada and Ireland, and drawing on a recent International Alliance of Carer Organizations (IACO) report, will seek to begin to provide a level of international comparisons in the area caregiver support. The paper will look at the current legislative basis for such support, policy and practice initiatives, income support measures, home care provision, the public discourse and the role and potential of advocacy organizations to deliver improved outcomes for family carers both nationally and internationally. This paper will also provide a brief narrative of the carers movement within each country and seek to anticipate the challenges of operating effectively within their respective jurisdictions. Finally, this paper will consider the extent to which how local or national carer support initiatives have the potential to be replicated in other countries.

  • Mariana de Santibañes, New York University, “Building a Care Agenda from the Bottom Up: The Relevance of Policy Narratives in the Design of Uruguay's Comprehensive Care System.”

Public issues are not part of a pre-given “neutral” reality, but language, discourse and rhetoric help construct our knowledge of society and its problems. In this context, the different associations with and understandings of care are far from insignificant; they hold the power to affect the ways policymakers approach care issues and shape care policies by deciding who receives and provides what kind of care, how much of it and of what quality. This study follows the narrative trajectory of care as a public problem and its relevance for the design of an unprecedented policy in Latin America: Uruguay’s Comprehensive Care System (SNIC). Grounded in both interpretive and critical paradigms, this qualitative research uses open-ended interviews and archival material to highlight the dynamic and complex nature of this process, whose course and outcomes were not and could not be determined a priori. Results help distinguish different phases, according to the characteristics and opportunities offered by civil society webs, the different types of participating actors and their priorities, the innovative structure of the links they established, and their conceptualizations of care, family, gender, work and social protection. This paper provides an interesting window into the way transformative care concepts - lying within a gender equality agenda - are used and played out in real-life situations and to what effect, and contributes empirically to the analysis of the institutionalization of care policy discourses in Latin America.

9.3. Panel Session: Negotiating Tensions in Long-term Residential Care: Reflections from an International, Interdisciplinary Study of Promising Practices
Great Hall

  • Moderator: Pat Armstrong, York University

In this panel presentation we draw on findings from the major collaborative initiative Reimagining Long-term Residential Care: An International Study of Promising Practices, which spanned across six countries and 27 sites, to explore some of the critical tensions that need to be negotiated in this sector. Focusing on examples of approaches, practices, programs, and interests that have conflicting or competing demands and/or consequences, we will draw on observational and interview data from various site studies to analyze some of the tensions that play out in the life of the nursing home. To use the most obvious example, there is a tension between the need to give priority to the increasingly complex medical needs of residents and the plan to provide the kind of support that emphasizes social care and interpersonal relationships. Similarly, there are tensions related to risk and safety: should a certain amount of risk be tolerated to enhance resident quality of life, and if so, how much risk can be tolerated, that have been recognized but deserve further exploration. But we also consider numerous tensions that are less obvious and seldom considered in the literature, such as those around family involvement in the everyday work and care of residents. Such tensions can mean significant tradeoffs or even negative consequences, as for instance when residents are put in wheelchairs to avoid falls but end up unable to walk as a result. We identify promising practices for negotiating and addressing these tensions in ways that can work for both those who need and those who provide care, while recognizing that tensions will remain.

  • Hugh Armstrong, Carleton University, “Risk Versus Safety.”

“Home-like” nursing homes in reality, and not simply in rhetoric, enable residents to participate in everyday life as they would if they were in their own home. Just as risks are to be found in private homes, so they were in a German nursing home, in which residents were encouraged to use their skills and abilities to the fullest, for example to cut vegetables. The risks involved in meal preparation, and potentially cutting fingers, need to be weighed against the risks of inactivity and boredom. Participation in the life of the nursing home can reduce risk, as it reduces alienation and frustration, including among residents with mild or moderate dementia. However, risk assessment is not a simple and “objective” issue. Nor is safety. The notions of risk and safety are not dichotomous. This is not an either/or situation, for there exist degrees of both risk and safety. A discussion about risk involves questions about how and what should be measured, by whom, and indeed when and where to acknowledge limits on what is measurable. To rigorously protect against every possible risk is to transform a nursing home into some sort of “total institution.” We turn to Canadian nursing homes as a contrasting example, where falls prevention and diet restrictions are prioritized in view of safety. It is clear from the examples that nursing homes, at least in Canada, should tolerate more risk. How much more risk is not so clear. Risk can be positive. It can promote mobility and social engagement. It can fight boredom, inactivity and social isolation, risks that are themselves unhealthy. The enduring tension is how to balance the encouragement of risk with the maintenance and in fact enhancement of safety for nursing home residents.

  • Albert Banerjee, Stockholm University, “Tensions Between Principles and Practices.”

A tension exists between the desire to provide attentive, personalized care and the use of the care plan to implement this type of care. The care plan is a document that is supposed to be integral to caring but we observed how it is ignored in practice: its role in guiding the work of care aides is minimal at best, reflecting the tension between principles and practices. On the surface, care planning makes sense to get to know the resident as a person, make notes about their needs and preferences, and use these to direct “person-centred” care. We draw on an Ontario example to show how the care plan has taken on a life of its own, used more to protect the home than to guide resident care. Considerable resources are dedicated to developing the technologies to monitor the care plan, such as the Resident Assessment Instrument-Minimum Data Set (RAI-MDS), as well as practices such as intake assessments, care conferences, and reporting requirements for staff in order to ensure plans of care are kept up to date. It is important for care aides to read and update the plan. However, whether and how this plan actually matters to the care that residents receive is lost. Aides reported they do not use the care plans because they do not have time to read them and the information in them is usually out of date, so they cannot trust them. Care aides also reported they have more immediate and reliable sources of information, such as the morning shift report or simply asking their colleagues. In essence, well-meaning principles that are meant to guide person-centred care have been reduced to a set of rigid rules with primary concerns on satisfying inspections.

  • Rachel Barken, York University, “Families and Care Homes.”

Tensions and contradictions are common in long-term residential care in relation to family involvement with the complex intersections between paid and unpaid caring labour. In this presentation, we explore these tensions and contradictions between the nursing homes and family members in the areas of care work, approaches to care, and knowledge of residents. Families occupy contradictory positions in long-term care. On the one hand, there are popular assumptions that families “abandon” older relatives in nursing homes, and the move to long-term care is often regarded as a failure on the part of families and individuals to provide enough care at home. On the other hand, family involvement in long-term care is both encouraged and assumed. While care homes typically encourage families to visit, tensions arise because conditions such as understaffing, funding cuts and privatization often render families, especially women, responsible for doing more care work than they are prepared for. In our study, there was a contradiction between the role of staff, who are tasked with ensuring the safety and security of the resident population as a whole, and families and friends who are often primarily concerned with the needs and interests of an individual resident. We also observed tensions between care homes and families with regards to knowledge of the resident and their preferences for care. Aging families face contradictory expectations: they are simultaneously expected to maintain close, caring relationships, and yet must relinquish some aspects of these relationships when a relative moves to long-term care. We draw on interview and observational data to discuss these tensions and then conclude with some promising practices that serve to recognize contradictions and handle tensions in ways that support the well-being of families and residents as well as staff.

  • Jacqueline Choiniere, York University, Ruth Lowndes, York University, “Tensions for Nurses in Long-term Residential Care.”

A primary tension for RNs is the intensification of care demands in environments that provide only minimum staffing levels and place considerable reliance on casual, part-time nurses and other care providers. We witnessed this in many locations, in spite of research supporting the link between staffing levels, staffing continuity, and quality of care in this sector. Another RN-related tension we observed is the selective way in which certain aspects of care are regulated with implications for staffing levels, staff-mix and division of labour. In Ontario, nursing homes are mandated to have an RN on duty at all times, and complex assessment, recording and reporting of clinically focused aspects of care are mandated. Yet, there is no regulation for staffing levels or mix, other than one RN on site 24/7. In this model of care, where care aides are responsible for most of the direct body care, RNs have little time to spend with residents to gain tacit knowledge, to engage in emotional care, or build relationships with residents and families. In one Manitoba home, collaborative teamwork was identified as a key aspect of the care philosophy of putting the resident first, which reduced this tension. Another tension for RNs is their level of involvement in training and ability to mentor others. Training that is increasingly provided to individuals one-at-a-time, through online platforms, instead of a hands-on, interactive, team-based approach, misses an important engagement opportunity for staff and residents, and raises another tension. We describe a German apprenticeship model that allowed for training and higher staffing levels. In the Canadian context, we draw on a promising Manitoba example, where staff were trained on the equipment they use for residents, a form of training that facilitated building of experiential insight and empathy for the residents and their positions as care recipients.

  • Ruth Lowndes, York University, James Struthers, “A Day in the Life: Comparisons of Social and Medical Care Models in Germany and Ontario, Canada.”

There is an obvious tension between dealing with the medical and physical needs of residents and their social need for human support and interaction. The tensions become more visible as residents who live in long-term residential care have increasingly complex medical needs. In a medical care model, biological data and the measurement of physiological evidence of health are prioritized over the more social or relational aspects of care. Work is organized in a task-oriented manner, decision-making tends to be hierarchical, divisions of labour are strict, and routines are often fixed and rigid. For instance, nutritional content and amount of food intake take precedence over the pleasurable aspects of dining. This approach to care is driven by detailed government regulations that require daily, quantifiable data entry, and often little time is left to meet residents’ social care needs. In contrast, we observed in different settings a more social approach to care embedded in practice that attempted to manage these tensions. In this presentation we draw on data from case studies in Ontario and Germany to compare social versus a more medical care approaches, and the difference each makes in the everyday experiences of residents and staff in these settings. Social care approaches prioritize important aspects such as building and maintaining relationships and socialization, exercising choice, freedom of movement and engagement in meaningful activities as residents would do if they were at home. Certain conditions such as sufficient, permanent staffing levels, managerial support for social care practices, and physical spaces like open areas and accessible, unit kitchens enable social care, which in turn improves care quality and resident quality of life.

Session 10 (12:45 – 2 p.m.) - Lunch
Great Hall

Concurrent activist and practitioner workshops

10.1. Workshop:Caritas and Care Ethics: Creating Caring Institutions

Debates Room

  • Organizers: Elaine Wright, Brescia University, Emily DeMoor, Brescia University

As they adapt to the needs of changing populations and economic conditions, faith-based organizations need to consider how the ethics of care and justice are prioritized and maintained in their mission and strategic plans. Caritas, or love in theological terms, is a dimension of care ethics that resonates with the values of faith-based programs and provides a guide for institutional culture. This workshop is based on a university initiative to more fully develop and integrate the concept and practice of caritas across its campus, curriculum, and community. Seeking to define caritas within multidisciplinary constructs and a religious infrastructure, the university facilitated professional development activities that included presentations on the background of caritas, breakout sessions to explore the concept from different academic perspectives, and a group discussion to brainstorm next steps for the institution to create a culture of caritas in an intentional manner. Using this model as a framework for the workshop, participants will engage in creative and reflective exercises to develop their own process of defining caritas and explore how it can be applied in their own programs and organizations.

10.2. Workshop: ReUnion Workshop: Reimagine Marriage/Redistributing Care

Music Room

  • Organizers: Yin Aiwen, ReUnion, Jelena Viskovic, ReUnion

ReUnion is a speculative platform for interpersonal contract of long-term relationships. It provides a space for people to map their immaterial labor for the relationship their commit to, and a friendly environment to facilitate them to redesign their relationship with their partners. The platform is aiming to become a new kind of social network, a new kind of welfare system and a new kind of legal framework that gives support to people that are outside of the nuclear family framework.

The project started with the critical reflections of marriage and family, which are state- sponsored contractual platform that presupposed the ways we organize our lives and caring for each other. Instead of centralizing care labor and financial stress into the unclear family, ReUnion offers a space where people can establish their network of care and support, negotiate and redistribute the immaterial labor in all the relationships they involved. For ReUnion, the future of family lies in groups of people that pledge long-term commitment to each other.

We would like to propose a workshop in which people can use our digital and analog proof-of-concept to map their interpersonal relationships, by reflecting on the care labor they committed for and received from others. Eventually, they can redesign their relationships with each other, redistribute the care labor within a self-formed community and allow a new type of organization emerged.

Session 11 (2–3:15 p.m.) - Concurrent Sessions

11.1. Paper Session: Protecting Domestic and Care Workers – Policy Approaches
East Common Room

  • Moderator: Mignon Duffy, University of Massachusetts, Lowell
  • Sophie Henderson, University of Auckland, “The Legal Protection of Women Migrant Domestic Workers from the Philippines and Sri Lanka: An Intersectional Rights-Based Approach.”

Sexual and racial division in the international labour market places feminised jobs, such as domestic work, at the lowest end of the global care economy and for the lowest pay. It is the intersecting inequalities of gender, race, ethnicity, socio-economic class and nationality that sustain a domestic worker’s disadvantaged position in a sex-segmented labour market, as well as shaping their vulnerability to exploitation. This paper uses data from semi-structured interviews conducted with advocacy groups, government agencies and international organizations in the Philippines, Sri Lanka and Hong Kong to contend that a rights-based approach, informed by intersectionality, is required to effectively safeguard women migrant domestic workers (MDWs) against rights violations throughout the migration cycle. State sponsorship of overseas employment has long been a key feature of national development policy in the Philippines and Sri Lanka, as two of the leading sending countries of MDWs in Asia. Both states are often accused of sacrificing the rights of their women MDWs in order to maximize remittances and advance economic growth, resulting in the commodification of reproductive labour. In light of this, the author argues that an intersectional rights-based approach is essential in understanding and addressing the ways in which migration regulations enforced by the two sending countries discriminate against women MDWs on multiple grounds, impeding their access to human and labour rights and heightening their vulnerability to abuse.

  • Jolin Joseph, York University, S. Irudaya Rajan, Centre for Development Studies, “Transnational Care Mobility to Mobilization: A Case for Closer Engagement with Civil Society and Local Actors in Policy and Praxis.”

Transnational careworker migration to the Gulf has long been a significant avenue of employment and mobility for Indian women. However, migrant women – particularly domestic workers – often confront structural barriers that leave them vulnerable and erode potential benefits of labour migration. Despite academic and activist attention to migrant domestic worker rights and the differential impacts of migration and care policies in these contexts, there remains no dedicated, comprehensive policy framework that represents and responds to the multi-faceted needs and challenges of these workers and communities and engages them in policy development. Addressing this, we argue, requires recognizing the myriad actors involved in the recruitment, migration, and support of migrant domestic workers as well as the multiple, complex local configurations of care and carework.

In articulating an alternative approach to migration governance, this paper considers the efficacy of current policy architecture related to carework, migration and women (including the Indian Emigration Act, 1983 and Gulf labour laws) that do not adequately address the social and systemic factors that frame these movements. It explores how grassroots efforts (as represented by NGOs and migrant associations) to organize and advocate for the rights of domestic workers, engage with the politics and possibilities of migrant domestic worker rights in their broader commitments and activities. Based on two months of fieldwork among migrants and civil society in key sending states of Andhra Pradesh and Telangana, we analyze the meso-level social organization of domestic work migration and implications of migrants enacting and mobilizing activism. Drawing on the example of PARA and Navayugam, two migrant organizations operating in South India and Saudi Arabia, the analysis suggests that bringing non-state actors into the formal migration apparatus and strengthening their capacity can enhance policy objectives, outcomes, and initiatives that respond to the challenges and opportunities arising from domestic worker migration.

  • Rafaela Rodrigues, American University, “Care and Domestic Work: An Analysis of the Legal Changes for Domestic Workers in Brazil and the Impacts on Brazilian Families.”

According to ILO, Brazil has the largest number of domestic workers in the world. However, only in 2013, the domestic workers achieved some of the same labor rights guaranteed in the Brazilian Constitution to workers in general. Moreover, data have shown that the number of domestic workers in the market is shrinking. The use of cheap labor for domestic work shaped Brazilian families in a certain way. Women from different classes had extremely different experiences regarding the care/domestic work that was done in the house. Most of middle-class families in Brazil had a housemaid in the house taking care of domestic work and chores. This social arrangement allowed middle class women to go the labor market. In this paper we will show that a paradigm shift is occurring in Brazil regarding domestic work. The greater access to education of girls and young women, the country’s economic growth, and the new domestic workers’ labor rights have changed the domestic work market in Brazil. As a result, families are facing new challenges regarding care work arrangements. This paper discusses the impact of the Constitutional Amendment No.72 on the Domestic Workers’ labor market, the implementation of the law and the impacts on care work on Brazilian families.

  • Michael McCormack, UCLA Fielding School of Public Health, “Domestic Work and Economic Migration: Evidence of Gendered Work Permit Conditions in Law and Policy.”

Economic push and pull factors remain one of the major forces contributing to migration flows around the world today. Economic migrants of all skill levels, occupations and industries apply for temporary work visas in search of better opportunities in states with strong labor markets. The significant demand for domestic work in high income countries has made it a significant share of migrant labor flows in today’s global economy. It is also well documented that migrant workers in this occupation are especially vulnerable to exploitation, mistreatment and social exclusion, and that the care work of women is systematically devalued.

This paper examines how the gendered nature of domestic work is embedded within the work permit regulations for immigrant workers in domestic work occupations. Using new comparative law and policy data on migration from 150 UN member states created at the WORLD Policy Analysis Center at the University of California Los Angeles, we explore differences in the protections and conditions of domestic work permits versus general work permits and those permits more likely to be filled by men. This data provides evidence of how the feminization of labor and the devaluation of care work is expressed in the terms and conditions of work permits specific to domestic workers across 20 countries. Among those countries with work permits specific to domestic work, Domestic work permits are more restrictive in regards to renewability, lengths of validity, and are more likely to place restrictions on changing employers. Restrictions on family reunification for domestic work permit holders were also common. These differences can be viewed as a legal expression of the devaluation of immigrant care work, and point to the need of more equitable conditions across temporary work visas to remedy such devaluation.

11.2. Paper Session: Webs of Care: Reciprocity and Interdependence
Debates Room

  • Moderator: Janette Dill, University of Minnesota
  • Rachel Barken, York University, Megan J. Davies, York University, “A Relational Ethic of Rural Home Support: Care in Two Gulf Island Communities, 1978- 2018.”

This paper maps out a relational ethic of rural home support. It is based on a socio-historical study of the Hornby & Denman Community Health Care Society. Located on British Columbia’s Northern Gulf Islands, ‘The Society’ was founded in the late 1970s’, at a time when welfare state policies provided these fledgling local organizations with significant flexibility to design and implement community health services. In their everyday practice, early workers provided personalized, relational care that extended beyond a narrow definition of health to address the physical, social, and emotional needs of older persons at home and in their community. The Society remains a promising model of late twentieth-century rural eldercare and a compelling case study of grassroots health policy formation. But even in the early years, and in a stronger fashion recently, provincial policies have rationalized and winnowed away community services, limiting local workers’ autonomy as well as clients’ access to care.

In our paper, we show how past and present care workers engage with relational ethics to challenge the neo-liberal discourses of efficiency guiding mainstream health policies. Drawing on a combined analysis of archival documents and oral history interviews with Society board members, administrators, and care workers as well as clients and families, we consider how individuals located within a specific geographical and socio-cultural context ‘do care’ in distinctly relational rather than task-oriented ways. We identify three themes central to a relational ethic of rural home support: the strength of intergenerational connections, community- embedded relationships, and collective rather than family values. Within each theme, we consider how shifting policy structures inform changes over time in the nature and delivery of home support. To conclude, we consider how a relational ethic may be implemented more broadly, to bolster the work and well-being of care workers and older persons in rural locations.

  • Brenda S.A. Yeoh, National University of Singapore, Elaine Ho, National University of Singapore, Shirlena Huang, National University of Singapore, “Tracing Webs of Care for the Elderly: Migrant Care Labour and Care Mobilities in Singapore.”

As Singapore becomes one of the fastest ageing populations in Asia, the state is rolling out eldercare policies which are mainly predicated on the principle that the family remains the ‘primary caregiving unit’ and where home-based care is the preferred option for the care of the elderly. In this context, households faced with growing care deficits have turned to external sources of care labour to plug the gaps. Gender based strategies of care substitution have developed, of which the global householding strategy of importing transnational domestic labour (mainly from Indonesia, the Philippines and Myanmar) into the privatised sphere of the home has become predominant among middle-class families. Drawing on life-story as well as go-along interview data collected through a recent ethnographic study of 60 Singaporean families coping with eldercare demands, the paper draws on the relationality of care as a bifocal lens to examine the politics of interdependence and mutuality of care between ‘carer’ (the migrant domestic worker) and “cared for” (the elderly). First, we explore care relations by analysing the webs of care, or the spatial-temporal assembling of multiple carers over space (connecting different public and private care-spaces) and time (temporal variations over the week), among middle-income families where transnational migrant domestic workers are employed within the home as primary carers for the elderly. Second, we aim to provide critical insight on the interconnections between different scales of care mobility in a city-state where the daily mobility configurations of older citizens are being facilitated by the transnational migration of foreign careworkers.

  • Yang-Sook Kim, University of Toronto, “Caring for Co-Ethnics: Immigrant Women In-Home Supportive Service Workers in Koreatown.”

In this paper, I examine the multifaceted challenges that immigrant women home-based eldercare workers face in improving their working conditions in the context in which the social responsibility of care is outsourced to ethnic communities. Drawing upon in-depth interviews and participant observations conducted in Los Angeles Korea town, I find the intersectional dynamics of gender, migration and race channel middle-aged Korean women with little opportunity in the mainstream labour market into In-Home Supportive Service (IHSS), a publicly-subsidized home-based elder care, coercing them to take care of Korean recipients in Korea town in “Korean way.” As the publicly-subsidized program operates within the ethnic economy, the gendered and coercive logic of care in the ethnic communities is reinforced, and the tacit cultural norms within the insular ethnic community replace the government regulations on IHSS.

To protect themselves from the coercive logic of care that enables Korean recipients to have control over the workers, and to Korean workers’ distinct needs to be reflected in the union, Korean IHSS workers have organized themselves and established their own Korean group within the Service Employee International Union (SEIU). While meeting to Korean elders’ culturally specific needs to some extent to work in Korea town, these workers have developed tactics to negotiate their workload and schedule with the recipient by utilizing the cultural norms. They also developed a counter narrative that they are not the servant but government workers who are paid by the government thus deserve better treatments. By documenting how these workers, who are pushed to care work as their last resort, utilize oppressive cultural norms for their labour protection and self-mobilization, I highlight workers’ capacity to develop alternative protection strategies even when they are heavily constrained in an insular community.

11.3. Panel Session: Care and Practices of Liberation

Music Room

  • Chair: Sophie Bourgault, University of Ottawa
  • Inge van Nistelrooij & Rodante van der Waal, University of Humanistic Studies, The Netherlands, “‘Liberating the Pregnant Body’: Disempowerment and Disembodiment in Maternity Care.”

Since its early days, starting with the works of Ruddick (1980) and Gilligan (1982), care ethics has worked to carve out space in Western thought for women to express their own experience, morality and politics, which were partly rooted in maternal experience.

The focus of our paper is on the pregnant body as being appropriated and disempowered by capitalist society and obstetric thinking (Murphy-Lawless), in e.g. successful Pro-life actions and neglect and violence against women in obstetric care.

Women’s own experience and knowledge of pregnancy are oppressed in Western (obstetric) thought via the centering of the unborn baby and the decentering of the pregnant woman. In this paper we aim to analyze how ‘the pregnant body’ has historically become subjected to patriarchal medical knowledge .

Barbara Duden (1993) traces the ways in which technology and a new discourse cooperate in order to instrumentalize and disembody pregnancy; a disembodiment that is also internalized by women themselves. Silvia Federici (2004) considers capitalism as the cause of this violent transformation that turns holistic women’s bodies into production machines of manpower, and shifts the focus to babies as the necessary product. Putting these theories together, it becomes in combination with the work ‘The Invention of Women’ by Oyèrónké Oyèwùmí (1997) manifest, that, and how, the pregnant body today is a suppressive construct of imperialistic power.

Defined as a ‘construct’, we further aim to investigate whether the pregnant body could be liberated - a term we prefer to ‘decolonizing', as the latter should be reserved for the liberation of native cultures in former colonies. This paper presents a relational care ethical perspective on the possibility of ‘liberating’ via ‘women’s writing’ (Hélène Cixous 1994). Shifting to women’s voices and relational ethics is vital for humanizing obstetric practices.

  • Tula Brannelly, Bournemouth University, “Decolonising Research Methodologies through Indigenous and Non-Indigenous Partnerships: Care-Based Methodologies.”

With a growing emphasis on internationalisation, alongside some disciplinary prevalence for international research, academics from the global north are more encouraged than ever to research in the global south. In the UK, the Economic and Social Research Council (ESRC) currently funded Global Challenges are an example of prestigious funders encouraging researchers from the global north to research and educate about research in the global south. Uncritically, research partnerships are an exercise in development where the global north researchers educate researchers from the global south, that does not recognize that, for example, indigenous people have their own research methods based in an indigenous world view. This situation has two problems. The first is that the assumption is that the world operates in a space of post-colonisation, which is contested in any colonised state by indigenous peoples (and allies). Secondly, positioning global north researchers as vanguard of methods and knowledge has significant potential for recolonization as experienced by indigenous people.

Tula Brannelly and Ros Edwards from the UK, Helen Moewaka-Barnes from Aotearoa New Zealand and Deb McGregor from Canada collaborated in a partnership to provide practical guidance and critical questions for non-indigenous researchers entering into research relationships with indigenous partners. This international collaboration was funded by the ESRC, following petition by Ros Edwards for the need for raising awareness for global north researchers about decolonising research. In this presentation, a video resource will be shared where the group discuss the process of partnership as a model for decolonising practices, and how the ethics of care guided research practices. Further resources are available from each of the academics involved through a website that will also be shared.

Project members: Professor Ros Edwards, University of Southampton, UK, Dr Tula Brannelly, Bournemouth University, UK, Professor Helen Moewaka-Barnes, Massey University, New Zealand, and Professor Deb McGregor, York University, Canada.

  • Joan Tronto, University of Minnesota, “Decolonizing Global Care Chains.”

This paper will explore the ways in which so-called global care chains, which provide care workers in health care and personal services, are rightly considered a part of colonial legacies. It will draw upon empirical evidence about the nature of global exchanges of care labor, both between higher-income and lower-income nations and in other patterns around the world. It will argue that in the neoliberal age, colonialism is no longer primarily about the relationships among states, but that we must be attentive to important shifts in the structures of colonialism. In this case, citizens from different states act as stand-ins in ongoing colonial relationships. Such privatized interactions, e.g., between individuals from the Philippines and the USA or Canada, thus seem to be purely matters of economic ambitions on the part of the individuals concerned, and “free” of colonial implications. But the effect of such a narrative is simply to obscure the realities and to remove responsibility for these ongoing patterns of inequality. The paper will then describe what steps might be taken to reallocate responsibility for such practices as a way to “decolonize” them.

  • Panel discussants: Elena Pulcini, University of Florence, Sophie Bourgault, University of Ottawa, Merel Visse, University of Humanistic Studies.

11.4. Paper Session: Falling Through the Cracks: Care Gaps

Great Hall

  • Moderator: Kim Price-Glynn, University of Connecticut
  • Nathan Boucher, Durham Veterans Affairs Medical Center Health Services Research & Development, “Designing Lay Navigation for Caregivers of Older US military Veterans with Advanced Illness.”

Of the approximately 65 million Americans who serve as informal caregivers of persons with chronic disability or illness, about 5.5 million are caring for military Veterans. Veterans’ caregivers play significant roles providing direct care and coordinating services for their care recipients, but often report low confidence in care they provide, financial hardship, and poor personal health. Caregivers’ burdens are linked to the availability of resources to support them in their complex role; a role made more complex in the context of older age, of both caregivers and Veteran care recipients. Systematic needs assessment of caregivers of older, community-dwelling seriously ill Veterans and linkages to existing resources could fill important gaps in available social and practical supports for Veterans’ caregivers. This presentation 1) briefly reviews the literature on informal caregiving for US military Veterans with advanced stage illness; 2) identifies the gaps in social and practical supports for Veterans’ caregivers; and 3) discusses the first year – Stakeholder Advisory Board formation and qualitative interviews with older caregivers and their seriously illness Veterans – of a 5-year US Veterans Administration grant (PI – Boucher) to develop a lay navigator program directly supporting older caregivers of seriously ill Veterans. The intent is to make this a learning session allowing time for targeted discussion regarding caregiving for those following military service in the US and other countries.

  • Melissa Popiel, Wilfrid Laurier University, “Episodic Caring: Exploring Life Impacts from an Unpredictable Caring Role.”

Episodic caring is an underexplored form of family/friend care provision, happening in response to periods of chronic, episodic illness, unpredictable in their length, severity, and occurrence. Unpredictable illness episodes may have ripple effects on the carer, including influencing access to social determinants of health, such as employment or income support. While many people living with episodic illnesses have one or more family/ friends/ partners/ or significant others who provide a variety of life and health-related supports over time, little is understood about the socio-economic and relational ways the lives of carers are altered by unpredictable, episodic caring.

Informed by the feminist economic concept of provisioning, examining the indispensable social, emotional, and temporal value in the range of work done by women, and using constructivist grounded theory methods, this presentation will discuss the findings of an exploratory dissertation project on the complexities of episodic caring. Using data from semi-structured interviews, the presentation will discuss contextualized experiences of episodic care of family members/ friends/ significant others living with HIV or MS in Southern Ontario. Juxtaposing health unpredictability with the carer role, these alterations include transitioning into episodic caring, followed by navigating the long-term role shift from family member/friend to care provider. The resulting theoretical framework outlines the multiple, intersecting impacts of unpredictable caring over time, including what might help episodic carers provide meaningful supports, as well as ways to reduce carer burden. The intent is to contribute to gender-responsive, more expansive carer policy, thereby improving the social and economic wellbeing of episodic carers now and into the future.

  • Anna Przednowek, Nipissing University, “Are We Falling Short? Recontextualizing Familial Care Provision with Adults with Intellectual and Developmental Disabilities.”

Over the last four decades, deinstitutionalization and subsequent neoliberal policies have re-shaped care for adults with Intellectual and Developmental Disabilities (IDD) in Ontario Canada. Today, familial care is the new norm, with women (including mothers, sisters or sisters-in-law) assuming the bulk of the unwaged care work for adult family members with IDD, often in addition to their precarious waged work. While recent research makes visible conditions that give rise to resilience, adaptation and transformation, few studies empirically investigate everyday caring relationships in their intricacies and complexities. Drawing on ongoing, feminist ethnographic and arts-based research with 15 families (including care providers and adults with IDD), I clarify how contextualizing familial care provision reveals tensions and contradictions, as current care and disability policies are not only falling short in supporting unwaged familial care, but in many instances these policies are coercive. By attending to how care providers are burning out and also fighting back, and by exploring how care relations are mediated by political and economic relations, my work promotes the inclusion of people with IDD and their care providers, while bringing disability related issues into conversations and currents in feminist care theory.

Session 12 (3:30 – 4:45 p.m.)
Concurrent Sessions

12.1. Paper Session: Macro-Politics of Care East

Common Room

  • Moderator: Kirstie McAllum, Université de Montréal
  • Paula-Irene Villa, LMU Munich, Barbara Thiessan, HAW Landshut, “Who Cares How in Bavaria? A Multidisciplinary Research Network on Gender & Care.”

The multidisciplinary Research Network “ForGenderCare” was installed in October 2015, running through until mid-2019. It is funded by the Bavarian Ministry of Research and Education in Southern Germany, including twelve research projects from a wide range of disciplines, e.g. engineering, ethics/medicine, history, media studies, sociology, philosophy, computer analysis, economics/management studies. The overall aim of the Research Network ForGenderCare is to explore and understand the multidimensional co-constitution of gender and care in a specific political and socio-cultural region, and to develop expertise for policy advice for future strategies and policies targeting a more sustainable, less unequally gendered, and more inclusive care work regime.

Our presentation will focus on two aspects: First, we will present selected findings from our research on topics such as working conditions in the care of the elderly, notions of care among young adults, representation of care in educational material, experiences of fathers in parental leave, gender and diversity sensibility in technological development (robotics for example), etc. Second, cross-cutting through the variety of projects, we will discuss:

  • Which are our core concepts and notions of care?
  • How do we make them work in a multidisciplinary research setting? Here, we shall focus on autonomy and vulnerability as the main normative framings, and discuss their diverse meanings.
  • How do we (not) work with a decisively intersectional notion of gender in a highly diverse research setting?
  • How can we deal with economic, sociodemographic, cultural disparities and specificities within a regionally defined research area such as 'Bavaria'?
  • Kate Bezanson, Brock University, “Feminism, Federalism and Families: Canada’s Mixed Social Policy Architecture.”

In 2018, with a self-declared feminist prime minister, a federal commitment to gender-based budget analysis, and a Cabinet composed of ministers who are 50 percent women, Canada’s social policy architecture is being transformed. This transformation is taking place alongside the rise of a reactionary conservative populism abroad and on the heels of almost a decade of federal Conservative social policy based on “family-values” in Canada. Despite its comparatively progressive character, Canada’s social policy architecture remains nested in a liberal welfare state model, with potentially deleterious outcomes especially for mothers, lower income, and racialized women. Further, populist discourses around families, and the social and tax policies associated with them, remain popular among many voters. Such approaches are often regressive and may entrench inequalities, yet they continue to flavour some of Canada’s policies related to families. This paper explores some of the consequences of Canada’s family policy incoherence. It examines key federal family-related policies over the last decade, including the Liberal government’s recent extension of parental leaves to eighteen months, its income-based targeting of childcare spending, and its 2018 Gender Equality Budget. This exploration: (1) offers a dynamic theoretical framework for understanding gender in relation to law and social policy; (2) considers why families and federalism are complex political and policy terrain; (3) catalogues Canada’s mixed family policy architecture; and (4) recommends that a feminist future in Canadian social policy will require deviation from the current trajectory to include recalibration of parental leaves and an orientation to childcare as a public good.

  • Rachel H. Brown, Washington University in St. Louis, “Situating Carework within the Settler State.”

This paper addresses the need to understand the feminist ethics of care and the redistribution of caring responsibility through the lens of settler colonialism. Developing a political theory of care that accounts for the connection between migrant carework and indigeneity, I argue that feminist interventions addressing carework must appraise settler narratives determining who is worthy of care. Drawing from interviews I conducted in Palestine/Israel with migrant caregivers from the Philippines, India, and Nepal, and their elderly Jewish-Israeli employers, I explore how feminist theories of care can better attend to the ways vulnerability becomes instrumentalized by the state and attached to narratives about who possesses the right to receive care. I also explore how a settler colonial lens can generate proposals to collectivize or "common" care that attend to the differential access to citizenship among settler populations, the migrants who do a disproportionate amount of carework, and indigenous populations.

After situating migrant caregivers within the Israeli context, I argue that the multiple challenges migrant caregivers face requires a broader discussion about the role of the state in perpetuating an ethno-racial citizenship regime. I illustrate how the re-organization of state priorities with respect to eldercare, and social reproduction more broadly, are inextricable from broader health and socioeconomic inequalities between Jewish-Israelis and Palestinian citizens of Israel, inequalities central to the self-indigenizing of Jewish-Israeli citizens. The complex interplay between reproductive labor, migrant carework, and ethno-racial nationalism thus requires a simultaneous rethinking of how the “collective” body in question has already been prefiguratively defined. This paper thus asks how the outsourcing of care works to reinforce the role of Jewish-Israelis as citizen-employers, and Palestinians, as threats to the racial state. In conclusion I suggest how a settler colonial framework can reveal the multiple resistances caregivers deploy to improve their working conditions.

12.2. Paper Session: Migrating for Care, Caring for Families
Debates Room

  • Moderator: Crystal Gaudet, University of Western Ontario
  • Conely de Leon, Ryerson University, “’Pagod, Dugo’t, Pawis’ (Exhaustion, Blood, and Sweat): Transnational Practices of Care and Emotional Labour among Filipino Kin Networks.”

This paper draws on multisited ethnographic research conducted with a total of 70 participants in three sites: Canada, the Philippines, and Hong Kong. Tracing the transnational caring practices of four Filipino migrant networks – specifically, their innovative use of traveling artifacts and information and communication technologies (ICTs) – this paper provides a more expansive and culturally nuanced approach to understanding transnational care and emotional labour as multiphased, multidirectional, multirelational, and multilocational in scope. This paper further suggest that such an approach contributes to scholarship on gender, migration, and care in the following key ways: First, it highlights the multidirectionality of care, recognizing that care does not flow unidirectionally along a hierarchical chain as exemplified in the global care chains literature; second, it understands that transnational care occurs across the life course and therefore involves generations and broader communities of carers; third, it decenters the Western heteronormative, nuclear family structure and calls for a queering of transnational relations of care; and finally, in decentering nuclear family arrangements, it moves away from an exclusive focus on mothering and the mother-child dyad, thus opening up conversations around other modes of caring.

  • Bahar Hashemi, University of Toronto, “Informal Multigenerational Care within Mixed Legal Status Families: The Case of Senior Iranian Women in Canada.”

This paper analyzes the work of informal multigenerational care within mixed legal status families by looking at the experiences of senior Iranian women, who immigrated to Canada through the “Parent and Grandparent Sponsorship Program.” This study brings into conversation scholarship on non-citizenship with the literature on gender and migration by considering how non-citizenship, a dynamic, relational process (Blomeraad 2018; Landolt and Goldring 2015), interacts with gender and generational power relations to shape the work of care in immigrant families. Through the case of senior Iranian women, the paper specifically asks, what are the negotiations that precarious non-citizen women in mixed status families engage in, with other family members, over the division of informal care work at home? My analysis draws from semi-structured, in-depth interviews with 20 senior Iranian women, who have been sponsored by their children and have lived in Toronto for at least 5 years. I conceptualize the mixed status family as a site consisting of tensions and solidarities through which migrants can negotiate rights yet also experience constraints (Luibhéid, et al., 2018; Rodriguez, 2016; Schueths 2012). The study shows how members of mixed status families engage in negotiations and develop strategies, sometimes as individuals in conflict with one another and sometimes as a unit, to access citizenship rights including the right to care (Creese et al., 2008; Espiritu, 2003; Goldring and Landolt, 2013; Menjivar, 2003). This study shows how migration policies that tie an immigrant’s entry and presence in the country to a sponsoring family member interact with gendered household strategies to shape these immigrant women’s experiences. The study contributes to broader discussions around non-citizenship that show how the erosion of citizenship is increasingly extended not only to noncitizens but also to citizens and permanent resident and can have long term effects for broader social inequalities in Canada.

  • Theodora Lam, National University of Singapore, “Living up to the Challenge: Left-behind Mothering in the Migration Context.”

With the increasing feminization of labour migration in Southeast Asia, much scholarly attention has been focused on migrant mothers and long-distance mothering whilst overlooking the experiences of left-behind mothers. Given prevailing gendered assumptions that the absence of fathers will rarely disrupt mothers’ biological, naturalised and archetypally full-time roles as caregivers, the care of children when fathers migrate for long periods are often ignored. In the light of this lacuna where the caring work performed by left-behind mothers remained arguably under-researched in social sciences, this paper seeks to examine the experiences of the primary caregiver, usually – though not always be – assumedly mothers, of children in the absence of the migrant father. Drawing from both quantitative and qualitative data of a longitudinal study on child health and migrant parents in Southeast Asia (CHAMPSEA) conducted in two waves between 2008 and 2016, the paper first examines how familial care responsibilities are negotiated among possible care substitutes in the household’s web of care, and explores how gender roles and subjectivities are transformed and reworked in the wake of parental migration. The paper investigates whether understandings and performances of care, motherhood and femininity undergo parallel changes in the case of men’s migration. Confronted with their own challenges of living up to socially constructed discourses of good mothering encompassing nurture, sacrifice and raising ‘good’ successful children, the paper interrogates how left-behind mother-caregivers negotiate their caregiving roles in the absence of their husbands as well as their gender subjectivities within the migration context.

12.3. Paper Session: Expanding the Boundaries of Care

Music Room

  • Moderator: Erica Jablonski, University of New Hampshire
  • A. dela Cruz, University of Toronto, “The Care Chain and the Long Line: Self-Care of Nonbinary Filipinx Youth at New Ho Queen.”

Ethnographic mappings of carework across the Filipino-Canadian diaspora reveal that the maintenance of the white, nuclear, heteronormative family relies on the subjugation of the physical and affective labour of Filipino/a caregivers, at the same time positing these bodies as devalued commodities (McKay, 2007; Tungohan, 2013; Nyaga & Torres, 2017). Yet an investigation of the legacies of the Care Chain, Foreign Domestics Movement, and Live-In Caregiver Program in Canada rarely conceptualize carework through the perspectives of sexually excluded racialized youth, particularly queer and trans children of Filipino/a caregivers, “who pursue modalities of care outside of legible iterations of kinship” (Diaz, 2016, p. 329). To further understand the scope of the Care Chain we must expand our interrogation towards these queer and trans subjectivities, whose embodiments are informed through the conceptions of gender and care articulated through carework. Using refusals of nonbinary Filipinx youth to stay at New Ho Queen, Toronto’s premier queer Asian love party, this paper suggests that nonbinary Filipinx youth are conducting a new form of carework, parallel to the carework that demarcates the Filipino-Canadian diaspora, and exploring the impacts of commodification, neoliberalism, multiculturalism, homonationalism through their own carework. How do these longer histories of gendered domestic labour across the Filipino-Canadian diaspora shape the relationships of nonbinary Filipinx youth to ideologies of gender, intimacy, and care? How do the gestures and ephemeral movements of nonbinary Filipinx within, outside, and across the space of New Ho Queen reveal new intimacies to care? I argue that the self-love and self-care embodied and exercised by nonbinary Filipinx youth at New Ho Queen rearticulates the value of diasporic Filipinx bodies within Canada, reasserts the value of being a queer Filipinx subject in Canada, and subverts the assumption of carework of Filipinos/as as devalued labour within the Care Chain.

References

  • Diaz, R. (2016). Queer unsettlements: Diasporic Filipinos in Canada's World Pride. Journal of Asian American Studies, 19(3), 327-350.
  • McKay, D. (2007). ‘Sending dollars shows feeling’– emotions and economies in Filipino migration. Mobilities, 2(2), 175-194.
  • Nyaga, D., & Torres, R. A. (2017). Gendered citizenship: A case study of paid Filipino male live-in caregivers in Toronto. International Journal of Asia-Pacific Studies, 13(1).
  • Tungohan, E. (2013). Reconceptualizing motherhood, reconceptualizing resistance: migrant domestic workers, transnational hyper-maternalism and activism. International Feminist Journal of Politics, 15(1), 39-57.
  • Loree Erickson, Ryerson University, “Collective Care: Taking Care of Each Other and Building Community through Radical Care.”

This paper situates the project of collective care/care collectives as part of broader transformative justice work. I started meeting my daily care needs (i.e. getting into bed, going to the bathroom, getting into/out of fabulous outfits, taking care of my cat, sorting student papers, cooking together, organizing sparkly things) collectively almost 20 years ago. My collective was inspired by other community-based responses to state harm and neglect and legacies of queer chosen family networks caring in the face of hate and stigma. I will share some of the knowledge generated in countless moments of enacting care from a disability justice perspective. Collective care puts into visceral practice queercrip strategies that simultaneously make ideological and practical interventions while building new practices to disrupt the disposability, commodification and individualism that shape state-based/state-biased approaches to care. This work of practising and putting into practice ways of collective caring is absolutely critical in this particular moment of neoliberalism and necropolitics. How does embodying a framework of shared vulnerability, interdependence, chosen family, sites of shame as sites of resistance and radical access transform our understanding and lived materiality of bodies, care, how we show up for and take care of each other?

  • Jennifer Lum, University of California Berkeley, “Drugging as Caring: Reading the Rhetoric of Care for Alzheimer’s in the Pharmaceutical Imaginary.”

This paper explores the history of representations of drug therapies as devices of care for people diagnosed with Alzheimer’s disease (AD). Dementia studies scholars have voiced concern that the biomedicalization of AD has gone hand-in-hand with the denigration of caregiving (Ballenger 2006), and has compromised the ‘person within’ the diagnosis (Estes and Binney 1991; Lyman 1989; Whitehouse 2009). However, I revisit the notion that technological advancement and person-oriented caregiving are inimical to one another, by asking how ideas about care have been expressed within pharmaceutical drug culture. What has it meant to provide good care for people with dementia/AD, and how have these visions and objectives of care changed over the past 50 years, within the pharmaceutical imaginary?

I turn to an archive of ads for anti-dementia drugs circulating in biomedical journals, on TV, and online between the mid- 1950s and the early 2000s in North America. I show how, during the mid-20th century, proper care for an AD subject was imagined to stem from a robust physician-patient relationship. At stake was the stabilization of the person’s gendered and racialized identity within the nuclear family, within the context of Cold War-era social and geopolitical unrest. By the early 2000s, however, an effective drug-based care regimen for AD was imagined to empower the patient to navigate the health care system, as a consumer-citizen, and even as a citizen-scientist, while destabilizing the constraints of gender and race. I argue that the shift from physician-authorized care to self- care within these narratives reflects social, structural, and epistemic developments since the 1980s, including cuts to the welfare state’s provisions of health care; the responsibilization of the individual AD patient; the commodification of high-tech medicine; and social justice-oriented struggles for equal representation of women and minorities in clinical drug trials.

References

  • Ballenger, Jesse. 2006. Self, Senility, and Alzheimer’s Disease in Modern America: A History. Baltimore: The Johns Hopkins University Press.
  • Estes, Carroll, and Elizabeth Binney. 1991. “The Biomedicalization of Aging: Dangers and Dilemmas.” In Critical Perspectives on Aging: The Political and Moral Economy of Growing Old, ed. M. Minkler and C. Estes, 117-134. Amityville, NY: Baywood Publishing.
  • Lyman, Karen. 1989. “Bringing the Social Back In: A Critique of the Biomedicalization of Dementia.” The Gerontologist 29 (5): 597-605.
  • Whitehouse, Peter. 2009. “Can We Fix This with a Pill? Qualities of Life and the Aging Brain.” In Treating Dementia: Do We Have a Pill for It?, ed. Jesse Ballenger, Peter Whitehouse, Constantine Lyketsos, Peter Rabins, and Jason Karlawish, 168-82. Baltimore: The Johns Hopkins University Press.
  • Adam Rosenblatt, Duke University, “Reclaiming Cemeteries: Carework for the Marginalized Dead.”

Caring for the dead is a human universal, something most of us believe every person should receive—possibly even as a human right. Yet this widespread type of carework is rarely mentioned in conversations about caring labor. This paper explores how care for the dead becomes a political practice. Focusing on neglected African American cemeteries and burial grounds near former mental asylums, it describes the volunteer labor of people who maintain, memorialize, and care for these spaces. In repeatedly (and incorrectly) calling them “abandoned,” many narratives about these cemeteries participate in the widespread privatization of all questions relating to care—relating it to intimate and private acts rather than structures or public goods (In the U.S., public funding supports the maintenance of Confederate graves and monuments that glorify the fight for slavery, but not most historic African American cemeteries). Volunteer labor caring for spaces of the dead thus becomes a new site of political practice—of “making things public”—and prompts complex face-to-face negotiations around identity, memory, and community. My fieldwork in these cemeteries reveals how caring for the dead produces new communities of care, increased engagement with local politics and public space, and a generative tension between volunteers. This tension arises, for example, as volunteers grapple with the conflict between an apolitical and universalist approach to caring for graves (focused on the individual dignity of the dead) versus explicitly anti-racist, anti-ableist, and other politicized ways of framing the relationship with the dead and the reclaiming of public space.

12.4. Panel Session: Coalitions in Carework
Great Hall

Moderator: Sara Charlesworth, RMIT University

In most developed countries disability and aged care workers employed in private homes and in residential facilities have poorer minimum labour standards than other workers and face greater difficulties in enforcing these limited rights. The invisibility of care work in the public sphere and ‘cash for care’ funding mechanisms further undermine workers’ labour rights. These factors present significant and complex challenges to collective action by unions and by civil society groups to protect and advance care workers’ rights. In the context of underfunded and marketised care the rights of workers are often seen as competing with the rights of the vulnerable people to whom they provide support, which adds to this complexity. The panel addresses these challenges and the potential for diverse coalitions or alliances between workers, unions, civil society groups and the broader community. In doing so it draws on the work and experience of activists and scholars in the very different contexts of Australia, California, Quebec and Ontario.

  • Cynthia Cranford, University of Toronto, “Alliances for Flexibility with Security: A Comparative Analysis of Personal Home Care in California and Ontario.”

This paper examines the potential and challenges of coalitions between labour and disability movements to improve conditions for both. It draws on the case of personal home care, that is, paid help with daily activities in one’s own home. It begins with an understanding of tensions between recipients’ quest for flexibility and workers’ desires for security in terms of what is done, when, where, how and by whom. These tensions stem in part from funding levels and program design but also from recipients’ and workers’ distinct location in a matrix of intersecting inequalities. This framework lends itself to a politics not of sameness but of alliance. Alliances may be easier if workers and recipients experience some similar inequalities, for example if they are both poor, or both immigrants. Yet, coalitions must reckon with how disability and age shape the experience of being poor or an immigrant, as well as how race and immigrant status shape the experience of being a worker. By comparing three personal home care programs where the degree and kind of coalition varies, drawing on interviews with workers, recipients and social movement activists, it analyzes the dynamics that hinder or facilitate coalitions. The analysis suggests that alliance requires much creative thinking and organizing because it must take place on multiple levels and be ongoing.

  • Melissa Coad, United Voice Australia, “Coalition Building to Advance Workers Rights in Aged Care & Disability Support in Australia.”

In Australia, the provision of disability and aged care home support services are separately funded. While the focus in both is on individualised care, disability support and aged care each have has different 'cash for care' mechanisms. This presentation will examine why it is important for Unions to build coalitions with advocacy groups across the disability and aged care sectors to affect positive change for workers. It explores why doing it together can be stronger than doing it alone and how the apparent clash between workers rights and the rights of service users this can be resolved. I use the example of the National Aged Care Alliance (NACA), an alliance of aged care providers, unions, consumer groups and others, and the deep involvement of that Alliance in a major national aged care reform package called ‘Living Longer Living Better’. The power of a strong cross sector alliance in that case delivered once in a generation reforms to the sector. I then compare and contrast attempts by Australia’s main union in the care sector, United Voice, to mirror that coalition building in the disability support sector. I briefly outline the different nature of both sectors, their history, recent policy reforms and why coalition building in the disability sector to date has not been as successful in securing worker rights as in aged care.

  • Louise Boivin, Université du Québec en Outaouais, Marie-Hélène Verville, Université du Québec en Outaouais,, “Institutional and Political Obstacles to Community-Labor Coalitions in Social Care Networks and Beyond: A Quebec Study.”

Our paper focuses on the challenges posed by institutional and political obstacles to the creation of community-labor coalitions in home care and residential care services, where the mainly female workers include a significant proportion of racialized women. In these network-based forms of organization, employment relations are multilateral, involving various public and private organizations. In the home care services we studied, the private entities considered as the legal employer are the users themselves: the aged and people with disability using a cash-for-care program. In the residential services the legal employers are local subsidiaries of large corporations using residential care as real estate investment. Yet, bargaining rights, as with other labour rights, are based on the gendered and racialized fordist norm of the integrated firm and bilateral employer–employee relations. Union structures, together with union practices and traditions, have also been forged by this fordist norm and its underlying intersectional power relations. Our paper draws on two case studies on mobilizations in Quebec examining how these institutional and political obstacles create constraints as well as opportunities. The first mobilization was organized in 2004-2005 by an ad hoc coalition made up of five local disability rights advocacy associations supporting users of cash-for-care programs. The second mobilization was a coordinated strike in private residential aged care organized in 2016 by SEIU-Quebec linked to the broader Fight for $15 minimum wage campaign by Quebec unions.

  • Brigid Buckingham, SEIU-Healthcare Ontario, “Coalitions in Ontario Home Care.”

5 – 6:30 p.m. -Keynote Address
Great Hall

  • Keynote speaker: Juliana Martínez Franzoni, University of Costa Rica
  • Keynote title: Imploding and Redrawing Care Regimes: Opportunities and Challenges