1 joint dg infso ict for inclusion & jrc ipts information society workshop on: long-term care...
TRANSCRIPT
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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
Healthcareprofessionals
Care organizations
Mainstream: social alarms + assistive tech.Pilots: Telecare/Telehealth
Carer
Carers Voluntarygroups
Carers assoc.
Informal care
assistant
Info&service providers
Informal care
assistant
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Situation of ICT in LTC at home
Caredperson
Careworker
Doctors
Healthcareprofessionals
Care organizations
Mainstream: social alarms + assistive tech.Pilots: Telecare/Telehealth
Mainstream: mobile phones, PCs, e-mail, websites … GPS
Carer
Carers Voluntarygroups
Carers assoc.
Informal care
assistant
Info&service providers
Informal care
assistant
Communication & CoordinationEmergency mgtOn the job support
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Situation of ICT in LTC at home
Caredperson
Careworker
Doctors
Healthcareprofessionals
Care organizations
Mainstream: social alarms + assistive tech.Pilots: Telecare/Telehealth
Mainstream: mobile phones, PCs, e-mail, websites … GPS
Carer
Carers Voluntarygroups
Carers assoc.
Informal care
assistant
Info&service providers
Informal care
assistant
Emerging
Communication & CoordinationEmergency mgtOn the job support
Emerging
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Situation of ICT in LTC at home
Caredperson
Careworker
Doctors
Healthcareprofessionals
Care organizations
Mainstream: social alarms + assistive tech.Pilots: Telecare/Telehealth
Mainstream: mobile phones, PCs, e-mail, websites … GPS
Carer
Carers Voluntarygroups
Carers assoc.
Informal care
assistant
Info&service providers
Informal care
assistant
Emerging
Info & guidanceHelp linesTraining
Mainstream: phone-based and web initiatives
Peer supportInfo & guidanceHelp linesTraining
Communication & CoordinationEmergency mgtOn the job support
Emerging
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Situation of ICT in LTC at home
Caredperson
Careworker
Doctors
Healthcareprofessionals
Care organizations
Mainstream: social alarms + assistive tech.Pilots: Telecare/Telehealth
Mainstream: mobile phones, PCs, e-mail, websites … GPS
Carer
Carers Voluntarygroups
Carers assoc.
Informal care
assistant
Info&service providers
Informal care
assistant
Emerging
Info & guidanceHelp linesTraining
Mainstream: phone-based and web initiatives
Peer supportInfo & guidanceHelp linesTraining
Communication & CoordinationEmergency mgtOn the job support
Emerging
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Caredperson
Careworker
Doctors
Healthcareprofessionals
Care organizations
Carer
Carers Voluntarygroups
Carers assoc.
Informal care
assistant
Informal care
assistant
Examples of ICT for informal caregivers
LifeSensor (DE)
Info&service providers
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Caredperson
Careworker
Doctors
Healthcareprofessionals
Care organizations
Carer
Carers Voluntarygroups
Carers assoc.
Informal care
assistant
Informal care
assistant
Examples of ICT for informal caregivers
LifeSensor (DE)
Information & guidance- Carers Direct Helpline (UK)- Nottingham (assistive tech)
Training- Sercuidador (ES)- Caring with confidence (UK)
Info&service providers
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Caredperson
Careworker
Doctors
Healthcareprofessionals
Care organizations
Carer
Carers Voluntarygroups
Carers assoc.
Informal care
assistant
Informal care
assistant
Examples of ICT for informal caregivers
LifeSensor (DE)
Info – mutual help- Carers UK - Un cuidador, 2 vidas (ES)- SEKIS (Berlin, DE)
Information & guidance- Carers Direct Helpline (UK)- Nottingham (assistive tech)
Training- Sercuidador (ES)- Caring with confidence (UK)
Info&service providers
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Caredperson
Careworker
Doctors
Healthcareprofessionals
Care organizations
Carer
Carers Voluntarygroups
Carers assoc.
Informal care
assistant
Informal care
assistant
Examples of ICT for informal caregivers
LifeSensor (DE)
Info – mutual help- Carers UK - Un cuidador, 2 vidas (ES)- SEKIS (Berlin, DE)
Online community- Cuidadoras en Red (ES)Training- Aspasia (IT)
Information & guidance- Carers Direct Helpline (UK)- Nottingham (assistive tech)
Training- Sercuidador (ES)- Caring with confidence (UK)
Info&service providers
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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