Plain Old Disrespect: Explorations of Recognition and Intrinsic Motivation in Care Work

1. Plain Old Disrespect: Explorations of Recognition and Intrinsic Motivation in Care Work Siobhan Austen & Therese Jefferson International Association for Feminist Economics Annual Conference Human Well-Being for the 21st Century: Weaving Alliances from Feminist Economics, Barcelona, Spain, 27-29 June.

2. Introduction • Defining care work: paid employment for the provision of elder care, child care, health and education services. • Economic significance: care work isaccounting for a rising and important proportion of measured GDP, and subject to both demand- and supply-side pressures as a result of population ageing and increases in the relative cost of service provision. • Aged care work is particularly important: the demand for aged care workers will increase substantially in coming decades as a result of population ageing and a decrease in the relative availability of unpaid carers.

3. We need to understand the determinants of the supply of care work • However, mainstream economic models do not support this. Their limited conceptualisation of human motivation cannot capture the range of reasons why women enter and remain in care work. • Feminist economic analyses of care work provide better insights. However, there is scope/need for further theoretical and empirical work.

4. This paper • Introduces the concept of recognition to an analysis of labour supply in Australia’s aged care sector. • Contributing data on the meaning and importance of recognition to caring motivation from • a small qualitative study of the working experiences of mid life aged care workers; & • A survey of 4000 mid-life Australian aged care workers • Discussing theoretical perspectives on how to understand and respond to the issue of recognition.

5. Recognition The valuing of particular others for their achievements, and in particular for the contribution that they make to societal goals • Its importance is emphasised in Axel Honneth’s approach to social justice “...the justice or well-being of a society is proportionate to its ability to secure conditions of mutual recognition under which personal identity-formation, hence individual self-realization, can proceed adequately.”

6. The qualitative phase • Collected qualitative data via interviews with 14 carers/nursing assistants • employed in 2 Western Australian aged care agencies • ranging in age from 47 to 79.

7. The qualitative phase • Interviews targeted the women’s feelings about their work • Can we talk about some of the things that you enjoy about your work or that make your work difficult? • How do you feel about working in aged and community care?

8. The qualitative phase Our results indicate that many carers perceive that their contributions are not respected by members of their own families, friends and the broader community. Her father felt she was ‘wasting her brain’ by working as a carer. “my sons think it’s demeaning” and “I think that’s what most people think”.

9. It’s one of the jobs perhaps that when you’re looking after people who cannot look after themselves, well I know there’s nothing glamorous about it but a lot of people don’t even really like to stop and think “Oh, good on you” but most of them just go “Oh, no, never.” The reasons for relatively negative perceptions held by family and friends, as described by care workers, varied. For some it appeared that the ‘dirty’ nature of the work undertaken by care workers meant that it was strongly perceived as low status.

10. “... [we, care workers, are] really trying hard, working at jobs and doing personal care that a lot of people would not ever touch, that needs someone who is very good at being with people, who does not make that person feel as though they’re a nuisance or a pain in the butt or just a waste of space and to do all of those things. I think [as care workers] these people are not valued to what they should be. Definitely not.” Other carers spoke generally of the lack of value for their work in society.

11. “[the manager]was actually talking ... about how without ‘us’, the support workers, they could not function and I got so angry. I got so angry – if I’d been brave enough I would have stood up and said ‘What an absolute load of rot’. We get paid like we’re just peasants.” And several carers identified the critical role of wages in providing a source of social recognition. “They [we, the carers] could go to Subway and make sandwiches and get more money than they get looking after people’s lives.”

12. It’s all tied into that ‘how do other people see my job” and I’ve said people see it as quite a demeaning sort of a job. So that affects me. That makes me feel dissatisfied a lot in life I suppose and I hope that doesn’t reflect on the way I do my job • Importantly, misrecognition affects care workers’ well-being and their motivation to continue in aged care.

13. The quantitative phase • A dedicated survey sent to mid life women employed as either carers or nurses in 18 aged and community care organisations across Australia in late 2011. • 7656 survey forms distributed to the sample population, of which 3177 (41.5%) were returned. • An on-line version of the survey, advertised through the websites of the relevant unions and peak care organisation, attracted a further 773 responses.

14. The quantitative phase • Aim was to identify the factors that influence the willingness and ability of mid-life women to continue in their aged care roles • Some questions that specifically targeted the issue of recognition. • Are your thoughts about leaving paid work contributed to by a perception that “your work in aged care is not valued”? • Do you feel that your work is valued by your supervisors, management, family, people in your community, and the clients or residents in your care? • Is sufficient time available to provide the care she believes her clients need? • Does your job involve ‘dirty’ work?

15. The quantitative phase • Early findings show the importance of understanding the motivation of care workers to remain in their paid aged care work roles. • more than 47% of the women we surveyed reported that they thought about leaving the sector. • Almost 30% of this group said that they had these thoughts at least once week; and • a further 40% had thoughts of leaving at least once a month.

16. The quantitative phase • Recognition is important: • “my work is not valued” was a common reason for thoughts about leaving. • Dissatisfaction with pay was high in the group of survey respondents and almost 50% of respondents rated their pay as “not at all” satisfactory in relation to the importance of their work to society. • Most of the care workers reported that their work was highly valued by their clients and the families of their clients. • However, community support was less widely perceived and many care workers perceived low levels of recognition from the managers of their organisation. • Almost 75% said they did dirty work.

17. Conclusions and further directions • The results of the initial phases of our study indicate that misrecognition harms aged care workers and impacts on their motivation to care. • However, a key theme in relevant literature (especially work by Nancy Fraser) is that there are substantial risks involved in focusing on recognition for care workers. • By emphasising the importance of community recognition of aged care work we may divert attention from institutional misrecognition and maldistribution, and from the urgent need to improve care workers’ wages.

18. Conclusions and further directions So how can misrecognition be addressed? Some ideas: • Address the invisibility of aged care work in the community. • Challenge claims that care should not pay • Publicise and encourage ‘best practices’ management, which would include the allocation of sufficient time to care. • Ensure that efforts at improving community recognition of aged care workers does not limit efforts at addressing the issues of maldistribution through promotion of unionisation and public funding