Liminal and invisible long-term care labour: Precarity in the face of austerity

Abstract

Using feminist political economy, this article argues that companions hired privately by families to care for residents in publicly funded long-term care facilities (nursing homes) are a liminal and invisible labour force. A care gap, created by public sector austerity, has resulted in insufficient staff to meet residents' health and social care needs. Families pay to fill this care gap in public funding with companion care, which limits demands on the state to collectively bear the costs of care for older adults. We assess companions' work in light of Vosko's (2015) and Rodgers and Rodgers' (1989) dimensions for precariousness. We discuss how to classify paid care work that overlaps with paid formal and unpaid informal care. Our findings illuminate how companions' labour is simultaneously autonomous and precarious; it fills a care gap and creates one, and can be relational compared with staffs' task-oriented work.

What is precarious employment? A systematic review of definitions and operationalizations from quantitative and qualitative studies

“…The second dimension derived from the analysisincome inadequacy -reflected salaried work, a dimension which has been included with little variation in all theory-based definitions of PE we have come across (12, 27, 36, 44, 54, 58-62, 65, 75, 78). There is however, a debate as to whether income inadequacy should be measured solely on the individual's salaried work and benefits or should also account for either employment-related income protection such as sickness or unemployment benefits and/or household income (54,65,75,101,102). None of the studies in this review considered income from work-related benefits or insurance (sickness absence, unemployment etc.).…”

“…Income level was mainly investigated as hourly wage, monthly salary, or annual income (12,27,36,43,(59)(60)(61)(62). One study made a distinction between direct and indirect income in order to be able to differentiate between wage and any supplementary income derived from other sources, such as government transfers and government-and employer-sponsored benefits (75). In all studies, to characterize income inadequacy, a low income level was set depending on the specific context and country, usually relating to national standards for minimum wage, poverty line or median income (44,54,58,59,78).…”

“…Number of included studies according to study characteristics. One mixed method, one historical article tive observational studies(12,, while 18 were qualitative studies(64)(65)(66)(67)(68)(69)(70)(71)(72)(73)(74)(75)(76)(77)(78)(79)(80)(81). Only one article conducted a mixed-methods approach(83) and one was an historical article(82).…”

Experiences of moral distress by privately hired companions in Ontario’s long-term care facilities

“…They sometimes work without any form of employment contract. Their work is precarious in terms of pay, benefits, hours, and job security (Daly and Armstrong, 2016). Some companions are trained PSWs and are hired through agencies, but there is a wide range of preparation for the job.…”

The work of care: tensions, contradictions and promising practices

“…At all levels of analysis, there is growing recognition of the complexity of care relationships, which involves not only tensions between familial and formal care, but often takes place in the 'liminal' spaces between them (Daly and Armstrong 2016). As is appropriate to such a complex field of study, care work studies tend to be strongly based in theory, particularly gender, feminist political economy and labour process theory (Baines et al, 2014;Bolton and Boyd 2003;Charlesworth 2010;Peterson 2005;Vosko 2002).…”