Supporting working carers: do policies in England and The Netherlands reflect 'doulia rights'?

Governments of advanced European welfare states with ageing populations are struggling to reconcile what seem to be conflicting policies. On the one hand, they are trying to increase the labour market participation of women and older workers. On the other hand, they are making more demands on people to care for disabled, chronically ill and frail older relatives and friends. Those caregivers are more likely to be women and older people. In this paper, we present the policies and experiences of carers from two countries that differ in type of welfare state, health and social care system and labour market context: England and The Netherlands. The aim was to compare English and Dutch policy measures for carers and examine their impact with evidence from two studies of people who combine work and care. The analysis is informed by the theoretical concepts of 'doulia' (whereby the state, employers and other sections of society reciprocate carers and other dependency workers for their unpaid caregiving) and 'doulia rights' (a carer's right to provide care without the risk of impoverishment). The evidence suggests that English and Dutch carers' policies have different strengths and weaknesses, but in neither country do they show strong commitment to the right to doulia.

Respite care--an explorative study of demand and use in Dutch informal caregivers.

Recently, there has been increasing concern for the well-being of informal caregivers. Attention is directed at the development of respite care programs that provide support and relief by (temporarily) easing the burden for the caregiver. Yet, little is known about caregivers' needs, desires and use of respite care facilities. A survey was conducted among a population of informal caregivers, to investigate demand for and use of the four most common types of respite care, namely in-home respite care, day-care, short-stay and special holiday arrangements. The 273 caregivers that participated in this study were reasonably well informed about existing services, especially out-of-home services; least informed was a subgroup that needs but currently does not make use of respite. About one-third of caregivers made use of respite care. These caregivers experienced substantial burden and expected burden (60.7 on a 0-100 scale) to increase substantially in case respite care would no longer be available (+31 on a 0-100 scale). Caregivers and care recipients were generally satisfied with the respite care they receive. About half of the non-users indicated to need or desire respite care, in general those non-users experiencing a relatively high burden. The main impeding factor for use of respite care was care recipient resistance against respite (38%). A majority of carers (62%) anticipated that respite care could substantially decrease their subjective burden (-29 on a 0-100 scale). Mostly respite care facilities reach the caregivers most in need of support, but not all caregivers in need make use of respite. Improvements are possible in terms of information provision and focus on combined caregiver-care recipient needs and desires. More research is needed into the (cost-)effectiveness of respite care.