1. Dept of Social Sciences & Philosophy Combining employment and caring for a partner in the Nordic countries and East Asia Teppo Kröger International Conference ‘Carers and Work-Care Reconciliation’ University of Leeds 13 August 2013

2. Dept of Social Sciences & Philosophy This presentation is based on two chapters published in Combining Paid Work and Family Care –Anu Leinonen and Ann-Britt Sand: Reconciling partner-care and paid work in Finland and Sweden: challenges and coping strategies –Mei-Chun Liu and Machiko Osawa: Partner-care in the East Asian system: combining paid work and caring in Japan and Taiwan

3. Dept of Social Sciences & Philosophy Invisibility of working partner-carers In Finland and Sweden, the circumstances of working partner-carers have received little attention as care between partners has been studied almost exclusively among older retired people In Japan and Taiwan, partner-care has received less attention than other forms of caring, though partner-care is one of the main types of caring and working-age partners with dual work and caring roles often encounter real hardship

4. Dept of Social Sciences & Philosophy The Nordic context Finland’s (1929) and Sweden’s (1987) Marriage Acts impose no statutory obligation to provide personal care for one’s spouse, although spouses are expected to help and support each other financially. In both countries, disabled people’s right to receive formal help is well established in law and policy (more firmly than that of frail older people). In recent years, however, cuts and reorganisations in public health and social care provisions have transferred some care responsibilities to family members.

5. Dept of Social Sciences & Philosophy The Nordic context In both countries, disabled people are eligible for financial benefits, transportation and interpretation services, aids, home repairs, and rehabilitation services These measures are designed to improve and maintain the well-being of disabled people but are also relevant for their partners and have implications for the well-being of the whole family

6. Dept of Social Sciences & Philosophy Nordic ’care leaves’ Like other working carers in Finland, working partner-carers are eligible, in agreement with their employer, for (unpaid) temporary ‘absence for an unforeseen family situation’ or ‘absence for care for a family member or other close person’. They can also apply for a ‘job alternation leave’ (max 1 year, benefit with low compensation rate) In Sweden, workers whose partner is terminally ill may take max 60 days leave and claim End of Life Care Allowance, an income-related payment (high compensation rate) available to relatives.

7. Dept of Social Sciences & Philosophy Carer’s Allowance in Finland In Finland, every second receiver of the Carer’s Allowance cares for a partner. This allowance also brings a right to three ‘free days’ per month when local authorities are responsible to organise respite care. Carer’s Allowance recipients are split roughly equally between those who are retired and aged 65 or over and those of working age, so while many supported partner-carers are above working age, many are not. Only a small part of all carers receive Carer’s Allowance in Finland.

8. Dept of Social Sciences & Philosophy Partner-carers in Sweden In Sweden in the 1990s, about a quarter of family carers employed by municipalities cared for a partner, and in the Swedish system, carers employed by municipalities can, and sometimes do, also hold another paid job. Carers regretted their own loss of free time; “too tired to have fun” (Swe) “I am a widow with a living husband.” (Swe)

9. Dept of Social Sciences & Philosophy Nordic preference to work The high value given to work in the Nordic countries: “I would feel like a prisoner. Now, when I leave to go to work, I feel I get a break from it all. I get to visit another world”. Retired Finnish and Swedish partners usually see themselves as the primary and obvious source of help for a partner needing care, but when the partner is employed, this raises additional issues. –The role of children (“to be kept at a minimum”) –The availability and quality of services

10. Dept of Social Sciences & Philosophy Case example from Sweden

11. Dept of Social Sciences & Philosophy Case example from Finland

12. Dept of Social Sciences & Philosophy Summary (Nordic) Partner-carers faced broadly similar conditions in Finland and Sweden: lack of attention, limited personal time and large variations in the flexibility available in the workplace or in local services. Nordic partner-carers value paid work highly and expect to receive formal support so that they can keep working. The Finnish interviewees said little about financial problems, which were among the greatest challenges for the Swedes. The Swedish interviewees had reduced their working hours, while the Finns had rearranged their daily working hours and place of work.

13. Dept of Social Sciences & Philosophy Who does caring in Japan?

14. Dept of Social Sciences & Philosophy Partner-care in Japan Traditional marriage matchmaking has given way to marriage based on love in Japan, and this has led to a rising trend of partner-care. While a growing number of husbands take care of their wives, some problems have emerged: as men were not used to household work or to communicating regularly with neighbours, there is a tendency for them to become isolated and left without assistance from neighbours or friends, when a partner requires constant care at home.

15. Dept of Social Sciences & Philosophy Partner-care in Japan The launch of the LTCI in 2000 brought home care services available to many Japanese older people but partner-carers benefit only if their partner is over 65 Japan has introduced paid care leave for up to 93 days (40% compensation rate) and part-time employment with flexible work schedules is quite widespread Partner-carers of disabled adults can get publicly (LA) funded assistance with household tasks such as cooking, bathing and washing (10% user fee). There are an increasing number of disability services and welfare benefits developing in Japan but still at the moment partners bear a considerable economic responsibility, making their participation in paid work especially important

16. Dept of Social Sciences & Philosophy Case example from Japan

17. Dept of Social Sciences & Philosophy Case example from Taiwan

18. Dept of Social Sciences & Philosophy Partner-care in Taiwan In Taiwan, the moral and legal bond between the carer and the care recipient is defined by social, legal and cultural norms. Intimacy enhances the likelihood that a person will care for his or her disabled partner, especially in situations of temporary disability. Yet, in the moral and legal context in Taiwan, even if there is discord in the marital relationship, partners are obliged to take on a caring role. In such cases, partner-care is involuntary and can involve anger and conflict.

19. Dept of Social Sciences & Philosophy Partner-care in Taiwan In 2009, an official survey found that 63% of those caring for a disabled partner aged under 65 were female. Taiwanese carers are entitled to a total of seven days’ unpaid care leave per year There are service provisions to both disabled and older people in Taiwan but they are still limited to small groups (LTCI not yet laucnhed) The main way in Taiwan to cover gaps in the availability of care is to employ migrant live-in care workers (requires government approval), used also sometimes in partner-care situations

20. Dept of Social Sciences & Philosophy Summary (Japan & Taiwan) Both Japan and Taiwan are predominantly family-based care regimes in which care is delivered at home, primarily by relatives, with limited public support. Both countries are latecomers in building a care system to cope with the increasing care needs of their people. The two countries nevertheless have different socio-economic contexts and population profiles, leading to differences in the development of their care systems.

21. Dept of Social Sciences & Philosophy Summary (Japan & Taiwan) Japan entered the so-called ‘aged society’ much earlier than the rest of the world and experienced a sharply declining birth rate in the late 20th century, creating a care crisis to which it responded by introducing its LTC Insurance Act 2000, the first Asian country to recognise carers’ needs in this way. In contrast, the development of Taiwan’s social services has been very slow. The LTCI system is however under preparation in Taiwan.

22. Dept of Social Sciences & Philosophy Summary (Japan & Taiwan) The late start and consequent inadequacies of Taiwan’s public care provision and care leave policies make it very difficult for working people to cope with care needs in the family. Workers in the informal sector may have more flexible schedules to cope with their caring roles, but such jobs are poorly paid and lack security. Although Japan has introduced paid care leave and part-time employment with flexible work schedules, Japanese workers also still face difficulties in balancing work and care. This arises from low take- up of care leave (caused by the low compensation rate of 40%) and a relatively high labour force participation rate.

23. Dept of Social Sciences & Philosophy Conclusion Issues that need to be taken into account in developing support for partner-carers –Home care services need to be sensitive to family practices and routines of working-age people –Tailored respite care services for middle- aged and younger adults are needed –Good services and supportive work–life practices are necessary to ensure that carers can access paid work but also that they have some personal free time of their own

24. Dept of Social Sciences & Philosophy Conclusion ”Working carers’ life situations are all in some way unique and characterised by considerable diversity, yet their need for support and recognition is universal. All working carers deserve respect, an opportunity to organise suitable working hours, compensation for reduced working hours and high-quality services. Working partner-carers are no different from others in this sense and should have the chance to live their lives without their caregiving being stigmatised.” (Leinonen & Sand 2013)