Abstract

Family caregivers are historically major providers of home care and have thus been affected, either directly or indirectly, by home care reforms. In terms of individual effects, research on female carers shows that payments for care can either be experienced as reinforcing the obligation to care or, on the contrary, as a ‘reward and reciprocation’. Yet, one key issue that is still understudied is precisely what consequences these reforms have had on the economic autonomy that women can have as care-givers or as care users.

The objective of this article is to study some of the gendered consequences of recent home care reforms in Belgium, England, Germany and Italy. The literature questioning the gender aspects of the welfare state and the gendered consequences of its action often uses the concept of ‘defamilialisation’ which studies social policies’ potential to emancipate women and men from family obligations, particularly in terms of financial autonomy through employment or welfare payments. The way care regimes defamilialise (or fail to do so) can also be examined from the perspective of care receivers and professional care givers. While the defamilialising potential of public policies has been extensively examined from the perspective of family caregivers, it is less documented for care receivers and professional carers. The side of the cared-for and that of the professional carer is less documented. For care receivers, issues of autonomy vis-à- vis the family are also at stake: money transfers give the opportunity to choose (to opt for another form of care than that delivered by close relatives for instance) and to rely less on the willingness of a relative, to receive a (more or less) professionalized care or, if this is not available, to be able to give (money) in exchange for the care received and, in a sense, to reciprocate for family care. From the perspective of professional carers, issues of defamilialisation are mainly related to the fact that paid work in the formal care sector enables workers to uphold a “socially acceptable standard of living” themselves. In this article, we will discuss the three-fold defamilialization effect of care reforms. This effect is only interpretable taking into account nationally specific contextual elements.

After a brief presentation of this background, we will argue that the defamilialization effect of the care policies cannot be described as uniform between and within countries. We will distinguish between weak (or strong) defamilialising effects for professional care-givers with precarious (or regular) working conditions weak (or strong) defamilialising effects from the perspective of the cared-for who need affordable services, but strong (or weak) from the perspective of the families, that are offered more (or less) possibilities for externalising their care “duties”. Some individual characteristics (like social status or income) can also be of importance in estimating the defamililising effects of care policies. All these elements contribute to shape what we call ‘’composite worlds of defamilialisation’’.

We will first give some information on the background of the reforms in order to understand the context of defamilialization. It is not possible to understand the extent of the transformations that have occurred in care systems without establishing some of the main features of the “gender contract” and the reforms. In a second stage, we will examine the measures supporting the informal unpaid caregiver and the possibility he/she gets to be either replaced by formal care or remunerated. Then, we will discuss the professional paid carer and the conditions in which he/she performs care work, to see if a “socially acceptable standard of living” is achieved. Finally, we will also briefly discuss the care receiver perspective and offer country-specific conclusions by presenting the worlds of defamilialisation identified.