Work and Family Policies for a Changing Work Force (1991) / Chapter Skim
Currently Skimming:
4 How Adults Cope: Dependent Care
4 How Adults Cope: Dependent Care
Pages 64-86
The Chapter Skim interface presents what we've algorithmically identified as the most significant single chunk of text within every page in the chapter.
Select key terms on the right to highlight them within pages of the chapter.
From page 64... ...
The costs of care for elderly parents and the cost, quality, and availability of child care are important factors in decisions about work. The mix of costs and benefits available to a given person at a given time-from insurance coverage to public and private subsidies such as employer-subsidized day care can relieve conflict and stress, or aggravate it.
|
From page 65... ...
To the extent that the elderly live far from their adult children, they will need more institutional care, and arranging for care will be more complex and expensive for their children. Hence, health care and nursing home facilities are likely to be strained in regions experiencing a heavy influx of older people.
|
From page 66... ...
Table 4-1 provides an overview of the projected numbers of the elderly using long-term care in nursing homes and paid home care; the number using both types of care is expected to increase markedly. For example, the number of those over 85 in nursing homes will double by 2020.
|
From page 67... ...
67 o o C~ 1 o Ct o ~o s~ Ct V o o Cq Ct o ._ C~ o $ ao E~ o o o o oo cr oo o oo U~ ~_ C~ .
|
From page 68... ...
This problem is likely to grow as the number of employed people with care obligations for elderly relatives increases. Nursing Home Care Nursing homes provide the primary form of institutional care for elderly people.
|
From page 69... ...
Not surprisingly, staff turnover ranges from 70 to 100 percent per year, further impairing the quality of care (Committee on Nursing Home Regulation, 1986~. Paid Home and Community Care For many elderly people, home care might be a lower-cost alternative, one that many of them prefer.
|
From page 70... ...
Federal and state support for noninstitution TABLE 4-2 The Elderly Population with Functional Disabilities Using Paid Home and Community Services, 1987 Percentage with Service Population Population AtIn Characteristic (thousands) a HomeCommunity Both Total 5,619 22.4 9.9 4.0 Age in years 65-74 1,993 18.4 8.2 5.4 75-84 2,315 22.8 9.3 3.9 85+ 1,310 27.7 13.3 2 Oh Male 1,788 14.3 8.6 2.5b Female 3,830 26.2 10.5 4.6 Functional status IADL only 2,261 17.3 9.6 3 3h 1-2 ADLs 2,108 21.3 12.2 4.5 3 or more ADLs 1,061 38.5 4.1b 4 5b Lives alone 2,364 29.5 13.0 6.9 Lives with others 3,255 16.9 7.4 1.7b aEstimates include the population with walking difficulties except where the level of Activities of Daily Living/Instrumental Activities of Daily Living (ADL/IADL)
|
From page 71... ...
Supporters argue that paid home care will substitute for nursing home or hospital care and, because they are less expensive, reduce the overall costs of long-term care to individuals and society. However, home-based programs appear to have had little effect on nursing home or hospital use.
|
From page 72... ...
found that the best predictor of institutionalization was the family's self-reported ability to provide home-based care. In other words, most elderly people will avoid nursing home care as long as possible, regardless of physical condition or family finances.
|
From page 73... ...
Absent such support, far larger numbers of elderly people will require institutional care. There are not sufficient nursing home beds to meet current needs, and significant expansion of such facilities is unlikely.
|
From page 74... ...
. Data from 1984 National LongTerrn Care Survey; March 1984 Current Population Survey.
|
From page 75... ...
1 978 [~1 1 983 . ~1 988 1 0 20 40 60 80 100 PERCENT FIGURE 4-1 Labor force participation rate of mothers by age of youngest child, 1977-1988.
|
From page 76... ...
At any given time, the majority of American children live in two-parent families, but at some point in their lives almost half of all children will live in a single-family home (Garfinkel and McLanahan, 1986~. Single parents face particular problems in securing appropriate child care arrangements.
|
From page 77... ...
Care by Parents Even when they are both employed, parents may choose work schedules that allow them to provide a substantial amount of in-home care. More than 9 percent of children with employed mothers are cared for by their fathers.
|
From page 78... ...
78 WORK AND FAMILY: POLICIES FOR A CHANGING WORK FORCE TABLE 4-4 Primary Child Care Arrangements Used by Employed Mothers of Children Under 15, 1984-1985 (percentage) Type of Child Care Under 1 1 and 2 3 and 4 5 to 14 Arrangement Total year years years years Care in child's home 17.8 37.3 32.7 27.0 11.8 By father 9.4 18.2 16.2 14.3 6.6 By grandparent 2.7 7.4 6.4 4.5 1.3 By other relative 3.0 3.2 4.5 3.3 2.7 By nonrelative 2.6 8.5 5.7 5.0 1.1 Care in another home 14.4 40.6 41.9 31.0 4.3 By grandparent 4.3 12.6 11.0 8.5 1.7 By other relative 1.8 5.1 4.0 4.7 0.5 By nonrelative 8.3 23.0 26.8 17.7 2.1 Organized child care facilites 9.1 14.1 17.2 32.2 2.8 Day/group care center 5.4 8.4 12.3 17.8 1.6 Nursery school/preschool 3.7 5.7 5.0 14.4 1.2 Kindergarten/grade school 52.2 1.7 75.2 Child cares for self 1.8 - 2.7 Parent cares for child 4.7 8.1 8.2 8.1 3.2 Total 100.0 100.0 100.0 100.0 100.0 Total number of children (26,455)
|
From page 79... ...
This is a matter of concern when considering the large proportion of American children who will spend their formative years in family day care arrangements. Center Care The fastest-growing type of child care is group care or centers.
|
From page 80... ...
Like nursing homes, centers are regulated by the states, although religious and part-day programs are usually exempt. There is a lively debate about the adequacy, effectiveness, and consequences of regulation, discussed below (Reisman et al., 1988; Blank et al., 1987; Hayes et al., 19901.
|
From page 81... ...
; the unavailability of affordable quality infant care causes severe hardship for low-income families, particularly single mothers who must return to work shortly after childbirth. · Overall, the growth in child care spaces for children ages 3 to 5 has kept pace with the number of such children who have employed mothers, but there remains a serious deficiency in affordable quality care for children from low-income families, children with disabilities, and children whose parents work nonstandard hours.
|
From page 82... ...
This reflects the lower earnings of single parents and also the fact that single parents have fewer opportunities for shared care arrangements. The dependent care tax credit repays a portion of these costs to families that earn enough to owe taxes.
|
From page 83... ...
. Their estimates of the costs of high-quality care coincide with Head Start projections for the costs of quality care for economically disadvantaged children.
|
From page 84... ...
In addition, a small but growing number of employers and unions are addressing problems of child care: some sponsor on-site and consortium child care centers or provide subsidies to employees to reduce the costs of purchasing care elsewhere, through vouchers or tax-based dependent care assistance programs; others sponsor resource and referral programs that offer information and attempt to improve quality. CARE FOR THE WORKING-AGE DISABLED In addition to elderly people and children, disabled adults also need care.
|
From page 85... ...
Nonetheless, much care continues to be provided by relatives, chiefly women, even though most of them are now in the labor force. Families directly pay for the majority of dependent care.
|
From page 86... ...
Nursing home care is very expensive, and there are substantial concerns about the quality of care provided. Paid home care services are developing but apparently will not significantly reduce the need for nursing home care.
|
Key Terms
This material may be derived from roughly machine-read images, and so is provided only to facilitate research.
More
information on Chapter Skim is available.