Set against the backdrop of an ever changing ‘therapeutic landscape’ of contemporary India, this paper delves into the world of ayahs, a term colloquially used for female paid caregivers for childcare and eldercare. The presence of ayahs within the domestic space predates the British colonial period that witnessed ayahs as an integral component of British domesticity. Recruitment of ayahs in contemporary India is often deemed as a clarion call to the time-tested, home-situated, intergenerational, family-centred care. Quite contrary to it, the direction towards home-situated, ayah-centred care is redolent of the continuities, shifting and coalescing ideals in making decisions on care, and adopting appropriate measures for alleviation. It is part of the wider intersections between embodiment, ageing, illness and healing. Amassing qualitative-ethnographic data comprising illness narratives and care narratives from elderly patients, family caregivers and ayahs, this paper delineates the grid of intimate belongingness, filiality and familiality germane to planning, managing and receiving care. The moral predicament of conducting fieldwork in the cities with injunctions on hygiene at its peak juxtaposed to the the urban slums wherein the ayahs resided exemplified by relaxation hints at the fractured moralities illuminated the paradigm of care and steered towards a pandemic-informed methodological design. Moving away from a bio-gerontological, clinical and positivist perspective, this paper knits together medical anthropological tradition, social geography and critical care perspectives, to address the interacting forces of ageing and well-being across the lifecourse, solicitude politics, unsettled care and performing care in the age of liquid modernity.
Family caregivers provide a majority of care to people living with dementia and play a key role in filling in for shortcomings in the health and social care system. The types and level of care and support needed varies over the course of dementia progression and care trajectories vary significantly between care dyads. The diversity and evolving nature of caregiving experiences necessitate in-depth exploration of dementia caregiving journeys across families, over time. Noting the lack of longitudinal qualitative research on family caregivers’ experiences of dementia progression and shifting support needs over time, we conducted a multi-method study employing unstructured monthly diaries and quarterly-to-semi-annual semi-structured interviews over two years (i.e., during May 2021–September 2022), with fifteen people caring for family members with mild-to-advanced dementia in British Columbia, Canada. This presentation is based on 81 unstructured diaries written by seven of the participants (i.e., three spousal and four adult child caregivers) that were thematically analyzed through an interpretive approach to explore the emotional and relational aspects of their caregiving experience. We unpack a) patterns and changes in emotions felt by participants over time and how they make sense of these emotions and manage them, and b) how they view their evolving caregiving role, and how they manage their caregiver identity alongside familial and social relationships and their sense of self. Longitudinal diaries provided access to private, untold aspects of caregiving as they were being experienced and navigated, revealing opportunities for policy and practice to improve formal supports for family caregivers.
Background: Existing evidence from high-income countries suggests that policies aimed at enhancing access to formal care can reduce the burden on informal carers and facilitate their reentry into the labor market. However, there is limited evidence regarding the specific carers who have been most impacted by such insurance. This study focuses on China’s long-term care insurance (LTCI) and examines its effects on informal care burden and the labor market participation of different types of informal carers.
Methods: Drawing data from the China Health and Retirement Longitudinal Study of 2011, 2013, 2015, and 2018, we employ a staggered difference-in-differences model with propensity score matching to analyze the impact of LTCI.
Results: Our study demonstrates that LTCI substantially alleviates the burden on informal carers while markedly boosting labor market participation. Notably, we found a more pronounced decrease in care burden among spouses, amounting to a reduction of 8.5 hours per month. Concurrently, LTCI’s impact on enhancing labor market participation was more significant among younger household members, reflected in an average income increase of 4,534 yuan per year. Furthermore, subgroup analysis highlights that LTCI primarily benefits informal carers providing care for older people with low income or those who were farmers or previously engaged in informal sectors.
Conclusion: Our study demonstrates that LTCI has led to a reduction in care burdens and an enhancement in labor market participation. The impact is especially pronounced for informal carers of older people with low income or those with backgrounds in farming or informal work sectors.