How can we see invisible care?

1. How can we see invisible care? Dr. Tamara Daly, CIHR Research Chair in Gender, Work & Health Associate Professor, School of Health Policy & Management York University, Toronto dalyt@yorku.ca

2. How do we see invisible care? • Invisible care work is provided by students, relatives and friends, privately paid companions, volunteers, and finally by paidcareworkers who fill gaps in the care needs. • We need more staff to provide good quality care • How do we see invisible care in the literature, policy and practice spaces? • How do we see the tensions and promise of a reliance on invisible care?

3. How do we see invisible care? • Literature: care work studies of facility care focus on paid work • Policy: with exceptions, invisible care work is unregulated, undocumented and not counted in comparison with paid work • Praxis: although facilities rely on this invisible care, it is not recognized for its importance as an overarching work organization model

4. Teaching Model • Promise: youth and others looking for new work are exposed to and possibly attracted to work in LTC • Tensions: extra "hands" available to provide care is unlike the reality of work in LTC

5. Familial Model • Promise: strong family councils • Tensions: staff feelings of surveillance; family members' feelings of burnout and stress

6. Paid Companions • Promise: residents get one-on-one attention, can attend some additional activities and go outside more often • Tensions: surveillance of staff; interruption of work flow

7. Volunteer Model • Promise: this model builds on community capacity; helpful where there are language and cultural specificities • Tensions: attracting, retaining and rewarding volunteers is full- time work

8. Staff "Volunteer" Model • Promise: ?? • Tensions: staff burnout and absenteeism

9. Concluding Thoughts • The informal and often unpaid work performed by students, volunteers, relatives, paid companions and staff exists in different configurations in different homes irrespective of country. • By spending time in facilities it is increasingly clear that the invisible labour is essential to under-staffed facilities • Homes adopt one main form of invisible labour to supplement their paid care work organization.   • Without higher staffing ... critical to care

10. References • Art from Gustav Vigeland, Erica McGilchrist, Franz Wilhelm Seiwert • Research supported by the Canadian Institute for Health Research and the Social Sciences and Humanities Research Council