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This chapter identifies a theoretical and empirical agenda for care investigators, starting with an attempt to specify the concepts of care, intimacy, and work. What exactly do we mean by intimate labors and carework? It then examines the variability of sites where care exists, both paid and unpaid. Within intimate labor, it distinguishes four different sites for personal care: unpaid care in intimate settings, unpaid care in economic organizations, paid care in intimate settings, and paid care in economic organizations such as hospitals, day-care centers, and doctors' offices. These four sites differ significantly in the character and organization of intimate labor. The chapter emphasizes confusions that have arisen in thinking about differences among these four sites.

This chapter explores the unsolved conflict between paid work and unpaid care. The meaning of the term ‘care relationship’ is considered and existing literature is used to explore the diversity of such relationships revealing the complex, finely-tuned and often delicate nature of associated work/care arrangements. It is asserted that society has a moral duty to recognise and reduce the heavy social burden imposed on those engaged in such relationships through shared responsibility. A consideration of women's labour market position relative to that of men reveals the relationship between gendered segregation and the division of labour within families and established labour market classifications. It is argued that the transformation currently taking place in working arrangements provides new opportunities to review the existing regulatory approach to the reconciliation of paid work and unpaid care.

This chapter provides the terms of reference and background for the text. It specifies the main aims which are to consider how paid work and unpaid care can be reconciled by exploring the potential for the development of a right to care in European employment law. The specific aim is to explore EU law's response to changes that have taken place in the employment context since the Community's inception and to assess its overall contribution to the reconciliation of the unpaid care/paid work conflict. A central claim is that the constitutional provisions of EU law already endorse a responsive approach to this conflict which, although merely implicit in the existing provisions at present, has the potential to be effectively utilised to provide individuals with a clear right to reconcile paid work and unpaid care.

This chapter considers the drivers of demand for care and support for older people and trends in those drivers. It concentrates on trends in disability and in household composition and unpaid care. The chapter sets the scene for discussions in later chapters. Understanding the drivers of demand is crucial in the context of concerns about the future affordability of care for older people. Demand for formal care depends on a range of factors including: needs in terms of disability, prices of services, incomes, availability of unpaid care, the funding system for public programmes and personal preferences. There is ongoing debate about whether as life expectancy rises the period of life with disability will rise, fall or remain broadly constant. Different countries have experienced different trends and may continue to experience different trends in the future. The future trend in availability of unpaid care is also a crucial influence on future demand for formal care.

Much of the international literature on health human resources focuses on highly trained, regulated and visible professionals with exclusionary social closure in neo-Weberian terms, such as doctors and nurses. However, researchers and policy makers are now paying more attention to the increasingly important role played by less well-trained, often unregulated, and less visible occupations such as personal support workers. Beyond these categories of paid workers exists another mostly uncharted health human resource: unpaid, little trained, largely unregulated and invisible informal carers. They include the family, friends and neighbours who provide the bulk of everyday care required to support the well being and independence of growing numbers of people facing multiple chronic health and social needs in community settings. Focusing on Canada, this chapter documents the characteristics and contributions of informal carers, and highlights the challenging realities of informal caregiving – both from the perspective of carers and policy makers considering how best to support and encourage unpaid, informal carers without driving up formal health system costs.

This chapter examines the complexity of caregivers' feelings about the labor they perform; it probes their emotions and their identities. How do they frame and make sense of the labor they perform? How are their perspectives tied to their identities? These questions are asked within the framework of prior studies of emotion work and emotional labor and Erickson and Stacey's theory of emotion practice, which advocates considering both macro- and microprocesses, as well as context, in examining the emotional labor of both paid and unpaid workers. Nurses have multifaceted forms of emotional labor and are skilled “emotional jugglers” who are able to adapt to the situation at hand without experiencing negative impacts on their identity. The chapter also take insights from Lopez's organized emotional care, which demonstrates how structural supports have been instrumental in reducing the emotional burdens of paid care workers in institutional settings. The analyses of emotion and identity for caregivers and nurses alike are seen within the context of the mutual labor process that is enacted — a labor process that transfers professional skills from paid to unpaid workers.

This concluding chapter reviews the findings of the rest book in order to map and discuss the most important challenges and dilemmas that long-term care policies are going to face internationally. The focus of policy has shifted from development of care services to meeting the challenges of increasing demand, rising expectations, constrained budgets and concerns about future supply of care. Policies must take account of the expected rise in the numbers of people needing care, rising expectations for high quality care and likely constraints on the supply of unpaid care and of resources for formal care. Promotion of improved quality, support for carers, a well-trained and motivated workforce, and better integration between health and social care will be essential. International comparisons are valuable in enabling countries to learn from successes and challenges in other similar countries.

This chapter talks about gender and pensions in relation to the European Union. It compares the trends in fertility and women's employment, along with the differing extent to which EU pension systems are sufficient and adapted to the needs of those with caring commitments. The chapter begins by looking at the social value of unpaid care work and then compares women's fertility and their employment across EU countries. The pension system in Britain is then compared with those of other EU countries in terms of adequacy, treatment of family caring, and gender inequality of later-life income.

This chapter explores the coherence of New Labour's approach to the family and the implications for gender roles of its policies. It describes the family policy in Britain before 1997, and the policies introduced by the New Labour governments. Their effects on gender divisions in paid work and unpaid care, and their differential impact on partnered and lone mothers, and on women of different social classes, are elaborated. The chapter then raises some questions about the overall coherence of these policies and identifies a number of different notions of parental responsibility. New Labour's policies on parenting involve a new definition of the relative responsibilities of the state and of parents. Men's roles in one- and two-parent families have been much less strongly targeted by the policies introduced, and their role in providing care for children remains a relatively peripheral one.

This chapter presents an important dimension to our understanding of unpaid care, by focusing on the role of children as active caring agents within their families. Children's accounts of their contributions to family life reveal their involvement in a complex range of care and support within their families, including childcare, domestic labour, financial assistance, and emotional sustenance. The issue of children's perceptions and experiences of maternal employment is an important one, especially for children in lone-mother households. Far from being passive and needy family members, these children are actively participating in constructing and reconstructing family life under very particular social and financial circumstances. These are low-income children who have experienced periods of poverty and exclusion.

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.