Governing Home Care
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Governing Home Care

A Cross-National Comparison

Viola Burau, Hildegard Theobald and Robert H. Blank

Care of the elderly in their own homes has increasingly come into the focus of contemporary welfare policies and raises important questions about the governance of welfare in general. By taking a comparative and thematic approach, this interesting and timely book offers a comprehensive analysis of the principal issues surrounding the governance of home care.
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Chapter 6: Care Workers: Defining the Boundaries of Occupational Territories

Viola Burau, Hildegard Theobald and Robert H. Blank


As the previous chapters illustrate, home care is high on the political agenda across many countries and in many instances this leads to various processes of formalising care arrangements. Various new funding schemes in formal care services are an example, as are the introduction of payments for informal carers. In relation to care workers, processes of formalisation, especially as they occur under tight financial constraints, raise issues about the boundaries between care workers with different levels of training on the one hand and boundaries between paid care workers and informal carers on the other (see Ewijk et al., 2002; Boom et al., 2004). Such issues often point to underlying conflicts between professional and economic rationales and lead to the redefinition of boundaries in terms of different processes of reskilling and deskilling. This chapter examines these processes across countries against the background of underlying governing arrangements that make for varying degrees of institutionalisation of care work as an occupational activity, and that in turn are related to broader contextual factors of the governance of home care. The following analysis focuses on paid care workers who deliver formal care services as part of formal employment and who tend to have formal training or even formal qualifications. It uses a typology developed by the European Foundation for the Improvement of Living and Working Conditions (2006), which includes traditional formal carers working in the public sector or the private for- and non-profit sector, independent formal carers registered with employment agencies and personal assistant carers...

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