Camille Allard

The number of people who combine work and unpaid care is increasing rapidly as more people need care, public and private care systems are progressively under pressure and more people are required to work for longer. Without adequate support, these working carers may experience detrimental effects on their well-being. To adequately support working carers, it is important to first understand the challenges they face. A scoping review was carried out, using Arksey and O’Malley’s framework, to map the challenges of combining work and care and solutions described in the literature to address these challenges. The search included academic and grey literature between 2008 and 2018 and was conducted in April 2018, using electronic academic databases and reference list checks. Ninety-two publications were mapped, and the content analysed thematically. A conceptual framework was derived from the analysis which identified primary challenges (C1), directly resulting from combining work and care, primary solutions (S1) aiming to address these, secondary challenges (C2) resulting from solutions and secondary solutions (S2) aiming to address secondary challenges. Primary challenges were: (a) high and/or competing demands; (b) psychosocial/-emotional stressors; (c) distance; (d) carer’s health; (e) returning to work; and (f) financial pressure. This framework serves to help those aiming to support working carers to better understand the challenges they face and those developing solutions for the challenges of combining work and care to consider potential consequences or barriers. Gaps in the literature have been identified and discussed.

Most people with dementia (PwD) are cared for by unpaid family carers, many of whom must balance caring with paid work. This regularly entails dealing with care-related emergencies (CRE). This study aims to explore the impact of carers’ autonomy at work regarding breaks, schedule, and place on their ability to manage CRE, and use technology to that end. We conducted interviews with 16 working carers of PwD in Scotland. Data were analysed thematically to identify key themes. Autonomy at work appeared on a spectrum from no to complete autonomy. Carers’ position on this spectrum was often dynamic and determined by the nature of their work, their workplace culture and regulations, and their line managers’ support – or clients in the case of self-employed carers. Break autonomy allowed carers to use technology to be notified of and delegate the CRE response. Schedule autonomy allowed for an in-person response to CRE. Place autonomy allowed carers to work and care simultaneously, which enabled them to manage CRE immediately but presented them with additional challenges. Distance between workplace and PwD’s residence impacted carers’ ability to manage CRE, despite having complete autonomy. Implications for healthcare professionals, service providers, employers, policymakers, and technology developers are presented.

This article explores care workers and working carers’ experiences of work. It focuses on how both groups of workers experience pressures to adhere to an ideal, which this article argues, is centered on an emotional reaction of guilt. Through this ideal of a guilty worker, a “care ethic” is reconfigured to become a “work ethic.” Drawing on 120 semistructured interviews with care workers, working carers, trade union officers, and care company managers, the article examines how guilt is experienced and constructed in the workplace, and how it becomes beneficial to the aims of the employing organization. The article links the construction and instrumentalization of guilt to Acker’s analysis of the ideal worker and to the problematic discourse of the “heroism” of key workers during the Covid-19 pandemic. This discourse can reinforce the image of a sacrificial ideal worker; it implies that if workers do not take a sacrificial approach as part of their work and care ethics, they should feel guilty.

Many studies have discussed the challenges of reconciling work and care, but few address the role of carers’ voice in advocating for, and facilitating access to, workplace support. Drawing on qualitative case studies of three large UK organisations, we examine the role of working carers’ voice in the development of a carer’s leave policy at work. Findings indicate that working carers’ voice is shaped by various factors, including available voice mechanisms; workers’ perceptions of their care responsibilities; and stigma, work processes and inequalities. Research implications indicate the need for a more effective representation of working carers through voice channels at work.

Recent years have seen an emphasis on delivering mental health and wellbeing support in school settings. However, the process by which schools meet this resource allocation challenge is largely undocumented. Our study used theory-building process tracing to develop a mechanistic understanding of the process of mental health investment in schools. We conducted in-depth case study work with four school sites in England, comprising 29 interviews and the retrieval and analysis of 95 documents. The empirical work was used to develop process theories to explain how and why high-investing schools allocated resources to wellbeing and mental health. Our work suggested high mental health investment was catalysed by either a perceived need or a change in ethos. The decision-making process then proceeded with some elements that aligned with conventional rational choice models (such as the comparison of alternatives) but also some important differences. Notably schools reacted to tradeoffs by seeking alternative, often informal, sources of funding and support for initiatives. In doing this they could develop “care capital” and enter a virtuous cycle of network building and investment. While this theory requires further exploration in other settings, it maybe be useful for researchers and policy-makers seeking to better understand how to support schools in allocating resources for mental health and wellbeing. In particular, it suggests that schools may benefit from support in how to harness external resources for mental health and wellbeing equitably and efficiently, alongside making best use of their internal resources.