Work schedules of home carers for the elderly in France: fragmented work, low quality, health effects

摘要

The increased need for carers as a result of policies that favour keeping the elderly and/or handicapped people in the home, as well as recruitment difficulties, have forced public authorities into upgrading both carers' job descriptions and salaries. However, most care work is funded by social security bodies and funding has not kept pace with the rising number of carees. Obviously, this has a direct impact on work content and organisation. Although the tasks performed tend to be more rewarding (more direct care such as washing and bathing or help with shopping and leisure activities, and less housework), work organisation is increasingly fragmented and care time per caree has decreased. This pattern has increased workloads and subjected carers to time pressure that has resulted in work intensification which has in turn had an adverse impact on carers' health and on the quality of care they are able to provide. Carers are having to make more and more visits, work longer hours and work more often on the weekend, with a corresponding adverse impact in terms of fatigue and the organization of their home life. Finally, the concentration of home care in certain peak periods reduces the possibility of working full-time unless carers are willing to accept more strenuous unskilled housework outside of these hours. However, these trends are not unstoppable and the carers who participated in a qualitative survey highlighted ways in which the situation could be improved, notably, by greater carer involvement in assessing caree needs.