Below is an excerpt from a recent piece “Systemic Resilience and Carework: An Asia-Pacific Perspective” by Ito Peng, contributing researcher for the Understanding and Measuring Care group. This article was published by Migrants and Systemic Resilience: A Global COVID19 Research and Policy Hub (Mig-Res-Hub).

 

In this think-piece I consider how we can build a resilient systemic response to the COVID-19 pandemic and future crises. I focus on systemic resilience in relation to carework and global migration of careworkers, and I approach this from an Asia-Pacific perspective. One of the fault lines exposed by the COVID-19 is the vulnerability of the existing care, carework and migration infrastructure to exogenous shocks. Asia-Pacific is an important site to examine because it is one of the major sites of global care migration, both as sender and receiver of migrant careworkers. This think-piece draws on the research from our global partnership project based at the University of Toronto, which looks at the dynamics of careworker migration in Asia-Pacific and the interconnections between social and economic forces and policies in shaping those dynamics from both sending and receiving country perspectives. The next section briefly outlines the pandemic’s impacts on carework and care migration in Asia-Pacific. I then discuss how we might achieve systemic resilience in global care migration by first emphasizing how our care systems are interlocked with the global migration of careworkers (what I call a global care interlock), and second, how we might achieve systemic resilience. Understanding the global care interlock is an important prerequisite to systemic resilience because it allows us to see carework and migration of careworkers as a part of a larger global infrastructure or ecosystem that has been, consciously or unconsciously, built, managed and sustained by multiple actors in different parts of the globe.

Read the entire article here.

Organized by the American University’s Care Work and the Economy Project and Levy Economics Institute of Bard College

The purpose of this course is to engage with fellow economists to enhance capacity building in research and teaching of gender-sensitive economic analysis, with a focus on care and macroeconomic policy aspects. The course will be built on four pillars: a) understanding and measuring the care economy; b) adapting social accounting matrices to account for paid and unpaid care activities; c) integrating the information from time-use surveys on unpaid care activities with other relevant sources of information such as national income accounts, labor force surveys and household or special surveys; and d) performing policy-relevant economic analyses that take systematic account of the interlinkages between care, macroeconomic processes,  and distribution.

We encourage economists in academia, research institutions, government, and civil society organizations to apply. The applicants must have completed at least two years of study in a graduate economics program or have received a Masters’ or Ph.D. degree in economics. The course will be conducted over three weeks. Five days a week, students are expected to do the required reading and then meet virtually with instructors and fellow students. We estimate that the required reading will take at least an hour for most participants. Each meeting consists of an hour of lecture followed by an hour of group discussion or exercises guided by instructors. Sessions will be held daily over three weeks between 10 am and 12:15 pm (EDT, GMT, and ICT

The deadline for applications is April 8, 2021. We will communicate the decision on participation by May 8, 2021. If you require further information regarding the course, please contact: the AU-Levy Intensive Course Administrator, Thomas Masterson (masterso@levy.org), cc:  Care Work and the Economy (CWE-GAM) Project Manager, Shirin Arslan (sarslan@american.edu).

This course is made possible by the generous support of the William and Flora Hewlett Foundation.

Please submit your application package via the form at this link. Email Thomas Masterson if you have any questions at: masterso@levy.org.

The application package should be a single PDF document. It should contain:

  1. Current curriculum vita that includes the following:
    1. Personal information: name, address, date of birth, nationality, and sex.
    2. Educational background: institutions attended beginning with the current or most recent; and degree awarded in each institution.
    3. Employment: list of employers beginning with the current or most recent; and, brief description of the position held and responsibilities at each job.
    4. Language proficiency: native language, whether English was a medium of instruction, and score in English proficiency test, if applicable.
  2. Sample of written academic work in English.
  3. Personal statement (under 750 words): a brief description of the applicant’s background, experience, and motivation for taking the course.
  4. For applicants currently enrolled in a Ph.D. program or with a Ph.D. or M.A. degree in the last two years, a copy of their transcripts in the Ph.D. or the M.A. program.

Letter of recommendation from someone familiar with the applicant’s training in economics.

A Narrative on Care

In 2018, the Care Work and the Economy (CWE-GAM) Project’s Understanding and Measuring Care (UMC) Working Group set out to gain a deeper understanding of the nature of care work and the well-being of caregivers in the context of South Korea. The group used a unique qualitative method combining in-depth interview and oral historical approach to investigate care as a continuously recurring activity throughout one’s life course and a necessary part of human existence. As part of the project’s qualitative field work and with the help of Gallup Korea, the UMC Working Group conducted 96 interviews between May – December 2018, bringing together 96 comprehensive narratives of care work in the South Korea context.

The CWE-GAM Project’s qualitative field work in South Korea conducted 96 in-depth interviews of paid and unpaid caregivers to provide useful care narratives based on the Korean context to inform macro-modelling. The qualitative research team interviewed 25 family caregivers of the elderly, 20 family caregivers of children, 20 paid care workers for elderly, and 31 paid care workers for children. The interviews of family caregivers focused on the decision-making process and evaluation of care arrangements for the elderly and children. In-depth interviews were combined with an oral historical approach to gain a deeper understanding of care work, emphasizing active listening to gain a more holistic understanding of the narrator’s life story on care. Interviewees were also asked about their experiences with caregiving. The interviews of paid caregivers focused on dual care burdens in terms of paid care work in addition to unpaid care work in the home. To learn more about the CWE-GAM Project’s qualitative field work in South Korea, read the Qualitative Methodology Report by the Care Work and the Economy UMC Working Group.

The following is one of the 96 stories. The respondent, Sung, lives with and cares for her mother, who was diagnosed with dementia about ten years ago.

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Date: May 29, 2018

Seocho-gu, Seoul

Interviewer: Hyuna Moon

Interviewee: Sung (pseudonym)

Sung, born in 1968, is 50 years old. She has a son and a daughter. They are both over 19 years old. One is attending college, and the other is studying for the college entrance exam. She is currently living with her children and her mother. As for siblings, she has one younger brother who is married. About ten years ago, Sung’s mother was diagnosed with dementia. Sung’s dad cared for her mom in the beginning, but her dad was also later diagnosed with Parkinson’s disease. Sung thus decided to move into her parents’ house to live together. It was by the time her first child entered middle school and her second child reached the upper grades in primary school. Her dad died four years ago, and she now looks after her mother. Her mother became a grade 3 beneficiary of the Long-Term Care Insurance (LTC) in her initial stage.

When Sung found out that her parents were ill, she didn’t think about passing the care duty to her brother. The siblings first considered making living arrangements so that each of them would live with one of their parents, for instance, Sung living with their dad and her brother living their mom, but their parents did not want this; they wanted to live together, not separately. Sung also felt that she ought to take care of her mother because of her ten years of experience living abroad, away from her parents. Sung has never thought that taking care of her frail parents is a son’s or a daughter-in-law’s duty. She didn’t think it was her brother’s duty to live with their parents and provide support. Nonetheless, her brother has taken up the role of financially supporting their parents. According to Sung, this was not negotiated but naturally happened. Sung and her brother also tried having their parents stay at her brother’s house during weekends, but it was always troublesome because he was not familiar with the situation, thus constantly calling up Sung for help. This weekday/weekend division of care duty did not work for them. Sung’s mother started going to the elderly daycare center from 2015 after her husband died. Her mother moved to a different center once because the center was located too far away from Sung’s place. Sung’s mother attended the first center for two years. When the center stopped running its shuttle bus to Sung’s house, Sung had to drive her mother to and from the center for a year. During that time, she had to hire a private caregiver who was responsible for driving Sung’s mother home in the evenings.

The hired caregiver also prepared meals and did some simple house chores for Sung. Sung paid her 1,000,000 KRW ($850 USD) every month, in addition to the monthly senior center fee of 300,000~400,000 KRW ( $250 – $335 USD). Other care-related expenses include Sung’s mother’s caregiver’s wage and other care services such as home-visit bathing service on weekends, food, medical bills and daily necessities such as diapers and etc., totaling about 2,000,000 KRW ($1,700 USD) per month. Sung’s brother helped to cover their mother’s care-related expenses, as Sung’s own income also had to cover her children’s education and living costs.

Description of Care Arrangement

Sung’s mother goes to the senior daycare center on weekdays and receives a home-visit bathing service every Saturday morning. The current elderly care center runs a shuttle that arrives at Sung’s house at 8:20 am to pick up her mother and to ride her back home at 9 pm. Sung’s mother is using the center service fully, spending the whole day at the center. Sung takes care of her mother after 9 pm until she goes to bed. When her mother comes back home, Sung helps her take medicine and changes her clothes and diapers. Her mother sleeps before 10 pm. Sung said her mother usually gets home tired after engaging in a variety of programs and activities offered all day long at the center.

Sung thinks her mother’s enrollment at the day care center is better than her staying at home and being bored. Sung said the most difficult part in caring for her mother happens at night, when her mother wakes up due to defecation. In such instances, Sung has to respond quickly to avoid what would otherwise become an even longer night, with her having to clean up the remains that will be all over the place. It got worse since last year and called for the most attention when caring for her mother. Nevertheless, Sung said her mother’s situation of dementia is not too bad, considering that some people with dementia can be very aggressive and easily agitated. Sung’s mother is relatively well-behaved, but she has this stubbornness which makes it difficult for Sung to help her get washed and change her underwear for she finds these to be a shame.

 

Sung said weekend care is tougher than weekday care because she needs to prepare food for every meal. The LTC-funded caregiver visits every Saturday to provide bath support, which is of great help, but Sung also needs to partake in the bathing assistance, requiring her presence.

 

 

 

The Cost of Caregiving

For Sung, it was an overload of work when she started supporting her parents by living together, while also having to care for her two adolescent children and working for her job at the same time. Sung said she had suffered from depression a few years ago due to the high stress of managing all her responsibilities. She had to seek psychiatric and medical treatments to overcome her depression.

Sung is considering sending her mother to the 24-hour nursing home as her health status is gradually deteriorating. She has applied for the institution for her mother’s stay, but she faces a long waiting list with more than 200 people. Sung said the reason for such a long waiting list is because this is a public nursing home, which is believed to provide better quality care and facilities.

Two years, she said, is what she thinks as the maximum number of years that she would be able to live with her mother if the current situation holds. But if it worsens, that is, if her mother’s dementia symptoms get worse, Sung will also consider sending her mother to some other facility with a shorter waiting list but also with lower quality of care.

She said that she would have to set a deadline to her caregiving for her own sake. She does not want to spend the rest of her 50s trapped with the care duty to her mother. Her children are now independent adults. Sung wants to start living her own life. She also feels she has done enough for her mother, her families and relatives all know it, and nobody will blame her for making this decision. Sung said because she is also a human, she needs to have her life and has the right to pursue it instead of sacrificing for her family.

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See the surveys utilized for conducting this research below:

2018 South Korea Eldercare and Childcare Household Survey – Childcare

2018 South Korea Eldercare and Childcare Household Survey – Eldercare

Organized by the American University’s Care Work and the Economy Project and Levy Economics Institute of Bard College

 

The purpose of this course is to engage with fellow economists to enhance capacity building in research and teaching of gender-sensitive economic analysis, with a focus on care and macroeconomic policy aspects. The course will be built on four pillars: a) understanding and measuring the care economy; b) adapting social accounting matrices to account for paid and unpaid care activities; c) integrating the information from time-use surveys on unpaid care activities with other relevant sources of information such as national income accounts, labor force surveys and household or special surveys; and d) performing policy-relevant economic analyses that take systematic account of the interlinkages between care, macroeconomic processes,  and distribution.  Our goal is to guide the participants toward the formulation of viable research projects focused on addressing care needs in developing countries through a better understanding of the care economy and the formulation of gender-sensitive macroeconomic policies. Hence, the program will comprise lectures by experts and hands-on training in analytics.

We are especially interested in participants who either would like to or are currently involved in research aimed at influencing policymaking in order to address care needs in their countries. We particularly seek applications from the following countries: Colombia, Ghana, Kenya, Mexico, Mongolia, Senegal, Morocco, Ethiopia, Tanzania, Thailand, Sri Lanka, South Africa, Costa Rica, Uruguay, and Vietnam. Women and minorities (ethnic, racial, and other) are encouraged to apply.

We encourage economists in academia, research institutions, government, and civil society organizations to apply. The applicants must have completed at least two years of study in a graduate economics program or have received a Masters’ or Ph.D. degree in economics. We also expect that participants have the ability to analyze data using Excel. We also consider the ability to analyze data with STATA or other similar statistical software such as R highly desirable.These requirements may be waived under exceptional circumstances. The program will be conducted in English. Therefore, applicants are expected to be fluent in written and spoken English.

The course has two components. The self-study preparatory module of the course will require the students to complete a set of assigned readings before the start of the virtual intensive course. These readings will help the students acquaint themselves with the conceptual and technical aspects of the material to be covered in the course. The second component of the course is the set of lectures and hands-on training to be conducted virtually. There will be some degree of overlap between the readings for the self-study module and the required readings assigned for the lectures. The goal of the online lectures and group exercises/discussions is to deepen the understanding of the participants regarding the topics discussed in the self-study module and introduce the participants to recent research in gender-aware economic analysis with a focus on policy issues. We will also provide hands-on training in developing the modeling skills of the participants, including training in gender-sensitive analysis using packages such as STATA.

The course will be conducted over three weeks. Five days a week, students are expected to do the required reading and then meet virtually with instructors and fellow students. We estimate that the required reading will take at least an hour for most participants. Each meeting consists of an hour of lecture followed by an hour of group discussion or exercises guided by instructors. Sessions will be held daily over three weeks between 10 am and 12:15 pm (EDT, GMT, and ICT). Given the format and time requirements of the course, applicants are expected to make this time commitment for the entire duration of the course. Accepted applicants will be provided a modest stipend to help meet such needs as childcare, internet, and software, upon completion of the course.

We are offering the course in three time zones: Eastern Time (EDT: UTC–05:00), Greenwich Mean Time (GMT: UTC+0), and Indochina Time (ICT: UTC+8:00). The curriculum is uniform across time zones. We require that students admitted to the course choose one time zone for the entire course, to facilitate a more cohesive and effective learning experience. The course will be held between June 28, 2021, and July 16, 2021, for the EDT and GMT time zones and between June 29, 2021, and July 17, 2021, for the ICT time zone.

The deadline for applications is April 8, 2021. We will communicate the decision on participation by May 8, 2021. If you require further information regarding the course, please contact: the AU-Levy Intensive Course Administrator, Thomas Masterson (masterso@levy.org), cc:  Care Work and the Economy (CWE-GAM) Project Manager, Shirin Arslan (sarslan@american.edu).

This course is made possible by the generous support of the William and Flora Hewlett Foundation.

 

Application procedure

Please submit your application package via the form at this link. Email Thomas Masterson if you have any questions at: masterso@levy.org.

The application package should be a single PDF document. It should contain:

  1. Current curriculum vita that includes the following:
    1. Personal information: name, address, date of birth, nationality, and sex.
    2. Educational background: institutions attended beginning with the current or most recent; and degree awarded in each institution.
    3. Employment: list of employers beginning with the current or most recent; and, brief description of the position held and responsibilities at each job.
    4. Language proficiency: native language, whether English was a medium of instruction, and score in English proficiency test, if applicable.
  2. Sample of written academic work in English.
  3. Personal statement (under 750 words): a brief description of the applicant’s background, experience, and motivation for taking the course.
  4. For applicants currently enrolled in a Ph.D. program or with a Ph.D. or M.A. degree in the last two years, a copy of their transcripts in the Ph.D. or the M.A. program.

Letter of recommendation from someone familiar with the applicant’s training in economics.

The 2018 fieldwork for the CWE-GAM project aimed to understand and measure care work in the South Korean context in order to inform gender-aware care macroeconomic models. The fieldwork consisted of both quantitative and qualitative surveys. The quantitative surveys include two sets of questionnaires for paid care workers in eldercare and childcare (Paid Care Worker Survey) and two sets of questionnaires for the unpaid care providers in the households for eldercare and childcare (Care Work Family Survey). The qualitative component consists of two sets of in-depth interview questionnaires for care providers and care recipients.

PAID CARE WORK SURVEY

The Care Work and the Economy Paid Care Work Survey includes two sets of questionnaires for eldercare and childcare workers and a 24-hour time use diary. A purposive sampling method was used to sample 600 paid care workers, 300 eldercare workers and 300 childcare workers, because the exact size and distribution of paid care workers in Korea are unknown. Paid care workers are defined as those working in institutional settings, at the care recipients’ home, and informal workers working without formal contracts. The sample targeted those providing care of the elderly and children’s daily lives, excluding kindergarten teachers and  health care workers at hospitals and medical eldercare facilities. The sample of paid care workers associated with institutions were allocated to reflect the national distributions of eldercare facilities and daycare centers, and the sample of informal care workers were equally allocated across regions.

The Paid Care Worker Survey collected detailed and comprehensive information on the care work provided by paid care workers. The stylized questions and time use diaries of paid care workers collect information on the type, intensity, duration, and evaluation of care work from the perspective of paid care providers. The survey aimed to investigate the characteristics and working conditions of paid care workers, including their background, condition of contract, working environment, task arrangement, and subjective evaluation of the working conditions, and their well-being. The 24-hour time use diaries were collected to provide insights on how the day of a care worker is constructed and how care work is associated with other domains of daily life and time use, which can be analyzed in tandem with the stylized questions on the well-being of care workers.

FAMILY CARE WORK SURVEY

The Care Work Family Survey also consists of two sets of questionnaires for main care providers in the household engaged in childcare and eldercare respectively. 1,000 cases of main care providers in the household were interviewed (500 cases for childcare, 500 cases for eldercare) using a stratified cluster sampling method. Because it is not possible to know the distribution of the population of people who provide unpaid care in a society, children aged below 10 and the elderly aged over 65 were treated as the target population from which to draw the sample. Based on the distribution of the 2018 National Resident Registration Data in Korea, we allocated the number of target households to each area, identified eligible households with elderly or children in need of care, and then selected eligible respondents within the selected households.

The Care Work Family Survey was developed to provide a detailed and comprehensive picture of the care arrangements in South Korea. The survey aimed to investigate how care provision is arranged for the children and the elderly and why it is arranged in such ways. Therefore, the survey collects information from the main care provider, not the care recipients themselves, as it is often the case that the main care provider is the one who knows most about the care arrangements.

After screening for eligibility, respondents were asked questions on their demographic characteristics and information on the respondent, care recipients and other household members. Respondents were asked about the specific activities involved with their care work including frequency, subjective intensity, preferences and willingness to engage in the activities. Information on care arrangements were collected as well including how the care work is shared within the household, whether there are any gaps of care provision, the history of caregivers, use of care services, and decision-making of using care services. Other information such as financial responsibility and burden, experience and evaluation of care work, dual care burdens and well-being of caregivers were collected.

IN-DEPTH INTERVIEWS

The purpose of the in-depth interviews of paid and unpaid caregivers was to provide useful care narratives based on the Korean context to inform macro-modelling. The qualitative research team intervened 25 family caregivers of the elderly, 20 family caregivers of children, 20 paid care workers for elderly, and 31 paid care workers for children. The interviews of family caregivers focused on the decision-making process and evaluation of care arrangements for the elderly and children. Interviewees were also asked about their experiences with caregiving. The interviews of paid caregivers focused on dual care burdens in terms of paid care work in addition to unpaid care work in the home.

SIGNIFICANCE AND LIMITATIONS

The fieldwork for paid and unpaid care work in Korea was designed and conducted to investigate the nature and context of care work in Korea. The Paid Care Worker Survey and Care Work Family Survey have distinct characteristics that contribute to enhancing our understanding about the experience of caregiving in Korea. First, the set of questions that have been developed can be commonly applied to caregivers regardless of the type of care work or the subject of care to enable comparative analysis on the experience of caregiving. Second, not only the caregiving situation, but also the broader aspect of the caregiver’s life including the preferences and attitudes of the caregiver have been studied. Third, the surveys collect detailed information on how care is arranged. Lastly, a caregiver focused 24-hour time use diary has been developed to understand which activities could be considered as care.

This fieldwork only included certain types of caregivers due to the limited budget, time, and scope of the fieldwork. For instance, the sample did not include caregivers for the disabled, caregivers who work at hospital settings, and migrant care workers, despite their importance. Also, as the family survey for childcare limited the respondents to ‘mothers’, and consequently fathers and grandparents were excluded. We hope that the future rounds of surveys can be extended to have a larger sample size and to include a broader range of caregivers. Questions explored in this fieldwork provide important information about the experience of caregiving in Korea, and we hope the fieldwork in Korea can inform fieldwork in other countries.

Learn more about care arrangements and activities in South Korea based on our analysis on the 2018 Care Work and Family Survey here.

This blog was authored by Bong (Regina) Sun Seo, contributing researcher for the Understanding and Measuring Care group

 

 

Japan, Korea and Germany introduced universal, mandatory public long-term care insurance (LTCI) as their populations began to age. LTCI is a social insurance program that covers the cost of care in case people need assistance to manage their daily living activities. In these countries LTCI covers a broad range of activities for daily living associated with aging and disability, from light home-helper services to intensive institutional care. The coverage is available for any level of care need, not simply for the most severe cases of disability.

These countries serve as good examples of countries that have paved different paths by focusing on the continuum of care, public insurance system and regulations. Japan, Korea and Germany share a couple of basic principles in the set-up of the financial mechanisms for LTCI:

1) a universal public social care system dedicated to LTC; and

2) a continuum of care system, starting from light home-based services all the way to intensive institutional care.

In developing LTCI, governments also developed regulations to cover how care needs could be assessed and by whom, who can provide care and under what conditions, the costs of care services, and the training, skills and wages of care workers. Government regulation is also important to ensure good-quality, accessible LTC.

With COVID-19, we see that the benefits of the continuum of care principle extend beyond economics and quality of life: this approach also removes people from the types of multi-residential locations that are most prone to the rapid spread of infection.

Many of our international peers have been more active and thoughtful with LTC policies than Canada, and we have lots to learn as we go about reforming our LTC systems. This system would help people with activities of daily living where they need it, and it would not cost the government much more than what it is spending now. Further, Canada also needs to develop a better set of regulations if we want to ensure good-quality and accessible LTC for all.

Original article “We can draw lessons from countries with strong long-term care system” was published in Policy Option, the digital magazine by the Institute for Research on Public Policy (IRPP), June 5, 2020.

This article is part of the Facing up to Canada’s long-term care policy crisis special feature.

This blog was authored by Ito Peng who is part of the Care Work and the Economy research group Understanding and Measuring Care.

 

 

A social accounting matrix (SAM) is an economy-wide consistent representation of the payments in an economy, linking production, primary factors, and institutions (the latter often split into households, government, and the rest of the world). In the words of Round (2003), “it is a comprehensive, flexible, and dis-aggregated framework which elaborates and articulates the generation of income by activities of production and the distribution and redistribution of income between social and institutional groups.” Most of the time, a SAM refers to the economy of a country for one year. It may be used to describe the structure of an economy and as a data input to economic models, most importantly CGE models. This paper documents a gendered Social Accounting Matrix (SAM) for South Korea for 2014: the steps followed in its construction, the data sources, and what the SAM says about the economic structure of this country (for brevity from now on referred to as Korea), including gender, time use, and the role of households in providing care and other services provided by households. The SAM that is presented is the key data input to a forthcoming analysis of gender and care in Korea’s economy based on GEM Care, a computable general equilibrium (CGE) model.

At an aggregate level, the value-added in the GDP economy is roughly 86 percent of the total (with agriculture, industry, services accounting for 2, 33, and 51 percent, respectively) and the non-GDP economy 14 percent. This information may be contrasted with aggregate time shares in terms of which, the non-GDP economy accounts for a much larger share, 40 percent. If leisure also were included, then it would on its own account for 50 percent of total time, 53 percent for men and 47 percent for women. The share of time allocated to household activities are drastically different for men and women, 15 and 57 percent, respectively. For women, non-care household services comprise the largest time using activity by a wide margin, followed by household childcare, trade services, and hotel and restaurant services. For men, manufacturing dominates, followed by trade services, household non-care services, and construction. For agriculture and industry, the lesser educated dominate all activities except electricity for both men and women. For services, the differences across sectors are drastic with some dominated by those with high education and others by those with low. These are few of the many descriptive findings from the gendered SAM developed by the authors.

This paper will be available December 2019.

This blog was authored by Binderiya Byambasuren, Kijong Kim & Hans Lofgren

Close up of woman using a walker

Attitudes towards family care are changing. Only 27% of Koreans surveyed in 2018 agreed that the family is responsible for elderly family member care. As for population aging, the middle age group of Korean society is becoming a true “Sandwiched Generation” (supporting both unmarried children and elderly parents) due to the longevity increase among elderly parents and postponement of marriage among the young generation. In addition, caring for grandchildren by the young elderly group is becoming more prevalent as the number of employed married women has increased in recent decades. To respond to this family burden, Long Term Care Insurance for the Elderly (LTCI) has been expanded since 2008. Statistics of the LTCI program show a stiff increase in care provision for supporting the daily lives of elderly who suffer from physical and mental ailments.

Cha & Moon (2019) investigate the nature of family care in the context of expanding public care provision. Using the 2018 Family Survey for Child and Elder Care, the authors assess the role of family care and how family members take part in the changing elderly care process. Family caregivers spend, on average, about 8 hours a day providing care to elderly family members on caring days, or about 50 hours a week. However, the average preferred number of hours for care is 24 hours per week, almost half of the actual care hours. Those who are classified as mildly or severely over-caring tend to live with their elderly family member, partly because the elder family member has a severe limitation in their Activities of Daily Living (ADL) and is unlikely to spend more than 3 hours per day alone.

On the other hand, care givers whose hours matched their desired hours are relatively young and the employment rate is higher than among other types. Compared to this matched case, over-caring is more common when attentiveness is required, when the caregiver perceives the necessity to take on greater responsibility for the elderly care recipient, and when time consuming care tasks are needed to care for the elderly family member. The authors speculate that the different types of care arrangements—under-caring, matched, and over-caring—appear to represent the sequential process of elderly care, from making regular care-visits to constantly ‘being there’ next to the recipient.

This paper will be available December 2019.

Nurse holding an elderly patient's hand

In response to the imminent aging problem in South Korea, the National Long-Term Care Insurance (NLTCI) system was introduced in 2008. The goal of the NLTCI was to give support to the families who are taking care of their elderly. The burden of family care can be grouped into four broad categories – unpaid and at home, paid and at home, paid and in facility, and unpaid visit of the family when care recipient is in facilities. Moon et al (2019) focus on the challenges faced by providers of unpaid care within families – unpaid care by family members is the most prevalent form of elderly care in Korean society.

Korean’s attitudes or thoughts on the family care responsibility of their old parents have changed surprisingly as time passed. In 1998, 89.9% of Koreans agreed with the idea that the care responsibility of their old parents belongs to the family. In 2014, the figure dropped to about a third of the population – only 34.1% of surveyed adults agreed to share the responsibility. The authors take this trend and generational gap as the departure point for their qualitative analysis of the difficulties faced by caregivers, with a view that there might be a clash or inconsistency in the care behaviors of the family members or in their ways of thinking on elderly care.

Using a combination of oral history and in-depth interviews, Moon et al (2019) shed light on the increasing burden of labor force participation and aging parents and in-laws on Korean women. Many elderly persons need attention and care continuously for 24 hours – in this regard the public care service providers provide limited relief as they work for only three hours at a time. In addition to the public-private and paid-unpaid differences in the burden of care, the authors draw attention to the difficulty of deciding who in the family takes up the responsibility. In many cases, the traditional caretaker roles fulfilled by the daughters-in-law have shifted to the daughters of the elderly. Social norms also contributed to the disproportionate caretaking burden borne by women.

The rise of the care crisis in South Korea has evolved with Korea’s demographic shifts, increasing female work force participation, and changes in the norms and values of family and care over previous decades. Childcare and eldercare, once regarded as women’s typical role within family, are now gaining more social recognition in the public realm. Kang and Eun (2019) examine the nature of, and demand for, caregiving in various areas of the South Korean economy, including family care, care services, childcare and eldercare. The study is based on the nationally representative Care Work Family Surveys on Childcare and Eldercare.

The authors find a significant gap between the number of hours spent on childcare by mothers and fathers. A majority of respondents (women) used at least one external care service. Among caregiving activities, housework such as preparing meals, cleaning, and laundry were reported as the most difficult as well as the most frequently performed activities. Relational and physical activities such as helping to dress, wash, or play with children were reported as less difficult. Caregiving for the elderly can be more complex compared to care arrangements for children, because the range of participants in the family varies. Among all respondents, daughters-in-law were the primary caregiver in the greatest number of cases, followed by daughters, spouses, and sons. Spouses spent the highest number of hours on caregiving, followed by daughter in laws. External care services were not as common for elderly care. Home visit care and home bathing services from the National Long-Term Care program were the most commonly utilized services, although the 3-hour limit per visit amounts to a low amount of total caregiving time. Assisting with bathing and using the restroom was considered especially difficult for the elderly. Housework was performed with the same intensity and frequency in both childcare and eldercare, highlighting the important role it plays in both.

This paper will be available December 2019

 

This blog was authored by Eunhye Kang and Ki-Soo Eun