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This chapter considers why we should care about carers and engages with different theoretical approaches to recognising the caring relationship and the implications of this for those involved in such relationships. In particular the chapter considers an approach grounded in the ethic of care and one based on relational autonomy. The chapter engages with an area of Irish health law where carers are clearly excluded from the legal framework – the mental health system. The mental health system is a useful case-study as it illustrates the complexities around balancing the interests of carers and cared for persons. The chapter concludes that it is important to care about carers, but doing so must be in a manner which continues to respect the distinct individual rights of each of the parties to the caring relationship.

This chapter presents developments in public policy affecting carers of working age in the six countries included in the book: Australia, England, Finland, Sweden, Japan and Taiwan. It briefly outlines the broad approach taken to supporting or involving carers in each type of welfare system. It then explains in more detail what services are available to support carers of working age; what rights and entitlements carers of working age have in each country when in employment; and the financial support available to carers of working age. These can include carers’ benefits, income support for carers disconnected from the labour market, payments to care, cash-for-care payments to carers enabling them to purchase alternative care support, and payments to carers to offset the extra costs of caring. The chapter also considers the role of voluntary organisations in supporting carers and in lobbying for better public policy carer support in each of the six countries. It concludes by highlighting the policy variations identified in the six countries.

This chapter examines the issue of combining paid work with the care of a disabled or seriously ill partner in England and Australia. It begins by using survey data on working-age partner-carers’ demographic characteristics, participation in paid employment, the services and welfare benefits they access, their reasons for leaving paid work and their future employment plans. In both countries, carers of a disabled or seriously ill partner tend to be older than carers of other people, have heavier care responsibilities, and are more likely to be in paid employment. Approximately half of English and Australian partner carers are men, a much higher percentage than carers of other people. In both countries, there are no support services dedicated specifically to partner-carers, although they have access to policies and initiatives available to carers in general. Case studies are used to illustrate the challenges faced by partner-carers in trying to reconcile their caring and employment roles, and recent policy developments in each country and their implications for this group of carers are discussed. The chapter concludes by considering the effectiveness of the support available to partner-carers and the implications of the evidence available for future policy development.

This chapter concludes the book, highlighting its attention to the care provided by family members of working age to people with long-term care needs in three kinds of relational context (to a parent, to a son/daughter and to a partner); its focus on the influence of carers’ organisations as well as on demographic pressures and labour market change; and its coverage of the issues arising in three types of welfare system: liberal-democratic, Nordic and East Asian. The chapter draws out the main comparative findings of the earlier chapters, highlighting both convergence and differentiation and noting that while the balance between family, private and public care provision remains very different in the three types of welfare system, all the systems considered are changing and all face common challenges which mean the prevalence of caring among people of working age is expected to rise rapidly in coming decades. This situation has already produced some similar responses: all the countries studied now offer some kinds of support to at least some family carers; all offer some employees with caring responsibilities some type of work-care reconciliation options; and in all evidence about the circumstances of working age carers is now accumulating.

This chapter explores the characteristics, activities and living arrangements of carers of older people in Australia and England, paying particular attention to those who are of working age. It notes the importance of trends towards living alone and independently among older people in both countries and the implications of these for their children of working age when care needs arise. The chapter presents data from censuses and surveys in each country which have collected data about people of working age who provide regular care to their older relatives. The data highlight the nature of the care given and of the tasks involved, the impact caring has on adult children’s participation in paid work, and the challenges and difficulties many carers face in reconciling work and care, an issue of particular importance for women, although growing numbers of men are also affected. Some of the difficulties carers face have been partially addressed in both countries through a range of new policies laws and strategic public policy commitments to extend and enhance support for carers, often under pressure from or influenced by the associations of carers which exist in both countries.

Japan and Taiwan are deeply influenced by Confucian thinking which views the care of older people as a family responsibility and frames care as a private issue rather than a public matter. The chapter explores similarities and differences in both countries’ changing systems of care for older people. It analyses the processes involved in securing carers’ rights through a struggle between the state and the carers’ movement, in which shifting carer subjectivities are shaped by discourses of rights and duties.

This introductory chapter provides an overview of the working lives of paid carers over two centuries. The emergence of modern nursing is usually dated to the mid-nineteenth century. Its complex evolution and international variations were shaped by the relationship between nursing and the state, religious influences, economics, a concern with social welfare, class and gender issues, scientific innovation, the reform of hospitals, and the development of a distinct body of nursing knowledge. Such analysis tends to prioritise the experiences of the general nurse while the asylum attendant/ psychiatric nurse tends to be either overlooked or described in a way that suggests inferiority. A narrative of catching up and falling behind imbues these debates with general nursing serving as an exemplar. This perspective neglects to consider the appropriateness of general hospital attitudes and practices to the care of the mentally ill, the special qualities and specific skills that might be demanded of the asylum attendant/ nurse, and the distinctive problems presented by their working environment. The idea that nurses’ needs and experiences can shape their responses to patient needs, and thus wider care regimes, is only just gaining credence but is the starting point for this collection of essays.