1 Joint DG INFSO ICT for Inclusion & JRC IPTS Information Society Workshop on: Long-term care challenges in an ageing society: the role of ICT and migrants.

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Joint DG INFSO ICT for Inclusion & JRC IPTS Information Society Workshop on:

Long-term care challenges in an ageing society: the role of ICT and migrants

Brussels, 19th January 2010

Results from a cross-country comparison on Germany, Italy, Spain and the UK

Stefano Kluzer, JRC–IPTS Information Society Unit

Joint Research Centre (JRC)Institute for Prospective Technological Studies The European Commission´ s Research-Based Policy Support Organisation

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Research challenges

Informal caregivers

ICT use in LTC at home

Barriers to ICT opportunities for informal caregivers

Suggestions for action

Content of presentation

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Long-term care (LTC) = informal & socio-cultural specific activitiesLack of common definitions (scope / content) -> OECD pilotLack of data (general / comparable)

ICT-specific in LTCRecent, still limited diffusion -> limited information beyond expertsFew studies (Empirica)

Migrant-specificComparable statistics in EU under development Informal work -> limited coverage by labour/employment surveysUndocumented status -> lack of data + difficult to interview migrants

Exploratory research + caution on conclusions !!!

Research challenges

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Desk-based analysis of reports and statistics -> LTC provision, organization and ICT-related policies + migrant labour in LTC sector

Web searches and interviews with key informants -> ICT-based initiatives and services for LTC at home

in DE, IT and ES, tot. 40 informal migrant caregivers interviewed about their knowledge, use and expectations regarding ICT in care work

Research method

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IPTS

Formal contract/

social security

PaymentRecognised

nursing qualif. / certification

Documented (if migrant)

OECD*

Formal long-term care workers

Care workers

Yes salary/pay Yes Yes Practicing nurses

Yes salary/pay No YesPersonal care workers

Informal caregivers

Carers

No No No Yes /NoUncompensated informal caregivers

Nobenefits / allowance

No YesCompensated informal caregivers

Informal care assistants

No salary/pay Yes /No YesUndeclared caregivers

No salary/pay No NoUndocumented migrants

* See (Fujisawa & Colombo, 2009)

Caregivers definitions

Migrants in any category: as paid caregivers in all countries; as carers in DE and UK

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Informal caregivers play a crucial in LTC

How people in need are cared for Migrant paid caregivers

DE 2007 - 44% exclusively family members

50-100,000100,000 (illegally employed alone)

IT 2003 - 90% by family members

740,000 in 2006 (42% undoc; 25% doc/ no contract; 33% doc + job contract)

ES 2004- 75% exclusively informal care

200,000 - 600,000

UK

2001 Almost 6M carers (11% of pop.) 4.4M of working age

Few migrant ‘grey labour’

in 2001, > 10% care workers from BME groups in 2006, 16% of 650,000 care workers born abroad (London -> 68%)

Key features of migrant paid caregivers: Significant numbers in all 4 countries Almost only women (informal care assistants) Different migration projects, residence and work contractual status High vulnerability, reflecting low rights (informal care assistants)

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Challenging work/life conditions

Critical conditions Needs

Time devoted to care (up to 24/7)

•Balance work and caring functions•Coordinate with service providers and professionals•Remote access to basic services (shop, bank etc.)

Socialization and isolation -> emotional stress

•Communication with others•Share emotions and experiences with other caregivers•Specialized support

Limited experience and skills• Information, training and other support -> manage medical/care aspects: esp. emergency situations, but also everyday tasks (complex with 80+ care recipients)

Limited knowledge of services and support opportunities (including technology-related)

• Available and fast access to information and guidance

Sensitive personal information (themselves and recipients)

• Guarantee adequate security and privacy

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Additional challenges for migrant caregivers

Critical conditions Needs

Time devoted to care (up to 24/7)

•Balance work and caring functions•Coordinate with service providers and professionals•Remote access to basic services (shop, bank etc.)

Socialization and isolation -> emotional stress

•Communication with others•Share emotions and experiences with other caregivers•Specialized support

Limited experience and skillsInformation, training and other support -> manage medical/care aspects: esp. emergency situations, but also everyday tasks (complex with 80+ care recipients)

Limited knowledge of services and support opportunities (including technology-related)

• Available and fast access to information and guidance

Sensitive personal information (themselves and recipients)

• Guarantee adequate security and privacy

- lack social support network- intercultural and language barriers- lack basic understanding of care context (players, rules etc.)- due to work/residence status -> invisible + difficult access to training, support etc.

Esp. newly arrived and from ‘culture-linguistically distant’ countries

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Policies pay still limited attention to informal caregivers

LTC policy and informal caregivers (carers) Formally acknowledged, but focus mostly on financial measures UK has established and articulated measures (and robust data on carers)

ICT policies for LTC UK: coherent national strategy / carers’ multiple needs considered DE, ES and IT: no national strategy / carers “play –if at all- a minor role”

Carers movements UK: long-established and effective -> (national level) lobbying, research,

information; (local level) carers’ centres, services and support DE: first national carers association Wir pflegen in March 2008

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Caredperson

Careworker

Doctors

Healthcareprofessionals

Care organizations

Carer

Carers Voluntarygroups

Carers assoc.

Informal care

assistant

Info&service providers

Informal care

assistant

Actors in LTC delivery at home

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Situation of ICT in LTC at home

Caredperson

Careworker

Doctors


Care organizations

Mainstream: social alarms + assistive tech.Pilots: Telecare/Telehealth

Carer


Carers assoc.

Informal care

assistant


Informal care

assistant

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Caredperson

Careworker

Doctors


Care organizations


Mainstream: mobile phones, PCs, e-mail, websites … GPS

Carer


Carers assoc.

Informal care

assistant


Informal care

assistant

Communication & CoordinationEmergency mgtOn the job support

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Caredperson

Careworker

Doctors


Care organizations



Carer


Carers assoc.

Informal care

assistant


Informal care

assistant

Emerging


Emerging

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Caredperson

Careworker

Doctors


Care organizations



Carer


Carers assoc.

Informal care

assistant


Informal care

assistant

Emerging

Info & guidanceHelp linesTraining

Mainstream: phone-based and web initiatives

Peer supportInfo & guidanceHelp linesTraining


Emerging

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Caredperson

Careworker

Doctors


Care organizations



Carer


Carers assoc.

Informal care

assistant


Informal care

assistant

Emerging

Info & guidanceHelp linesTraining

Mainstream: phone-based and web initiatives

Peer supportInfo & guidanceHelp linesTraining


Emerging

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Caredperson

Careworker

Doctors


Care organizations

Carer


Carers assoc.

Informal care

assistant

Informal care

assistant

Examples of ICT for informal caregivers

LifeSensor (DE)


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Caredperson

Careworker

Doctors


Care organizations

Carer


Carers assoc.

Informal care

assistant

Informal care

assistant


LifeSensor (DE)

Information & guidance- Carers Direct Helpline (UK)- Nottingham (assistive tech)

Training- Sercuidador (ES)- Caring with confidence (UK)


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Caredperson

Careworker

Doctors


Care organizations

Carer


Carers assoc.

Informal care

assistant

Informal care

assistant


LifeSensor (DE)

Info – mutual help- Carers UK - Un cuidador, 2 vidas (ES)- SEKIS (Berlin, DE)




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Caredperson

Careworker

Doctors


Care organizations

Carer


Carers assoc.

Informal care

assistant

Informal care

assistant


LifeSensor (DE)

Info – mutual help- Carers UK - Un cuidador, 2 vidas (ES)- SEKIS (Berlin, DE)

Online community- Cuidadoras en Red (ES)Training- Aspasia (IT)




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ICT

can

im

pro

ve Quality of Care

CommunicationCoordinationCollaboration

Information

Training

Private lifesocial integration

Working conditionshealth & wellbeing

Opportunities

ICT

in

LT

C

po

lici

esm

igra

nt

sp

ecif

ic

Barriers

Not targeted at carers→ Carers’ needs overlooked

Lack of knowledge & awareness

Few initiatives

Use

of

ICT

Privacy/security fears

ICT skills: level & match

ICT access restrictions at work

Limited availability of ICT

Technical barriers

Language barrier

Residence status -> barrier/incentive

Large migrant communities with ageing members

High ICT use/motivation

by migrants

Opportunities and barriers for informal caregivers

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mig

ran

t s

pec

ificU

se of

ICT

ICT

in

LT

C

po

licies

Breaking Barriers & Seizing Opportunities

carers’ needs

knowledge & awareness

few initiatives

privacy/security fears

skills: level & match

access

availability

technology

language barriers

incentive to use ICT

Digital inclusion measures: targeted and focused

Mother tongue/multilingual - information

- (vocational) training - online social networks

ICT for language learning

Adapt ICT for LTC devices: icon-based/multilingual

Awareness raising:- carers’ needs

- ICT opportunities- ICT impact

Privacy & trust-building solutions

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Thank you !!!

[email protected]

1 Joint DG INFSO ICT for Inclusion & JRC IPTS Information Society Workshop on: Long-term care challenges in an ageing society: the role of ICT and migrants.

Documents

informal migrant caregivers

longterm care ltc

longterm care challenges

care work research method

ict opportunities

infso ict

role of ict

ltc recent