Beyond Applause? Improving Working Conditions in Long-Term Care / Organisation for Economic Co-operation and Development.

Format:

Book

Author/Creator:

Organisation for Economic Co-operation and Development, author.

Language:

English

Subjects (All):

Employment.

Physical Description:

1 online resource (202 pages)

Edition:

1st ed.

Place of Publication:

Paris : OECD Publishing, 2023.

Summary:

This report presents an in-depth cross-country analysis of how long-term care workers fare along the different dimensions of job quality. In the initial stages of the COVID-19 pandemic, the applause for care workers was a clear expression of the strong recognition of their hard work and exposure to risks in their job. However, as the applause faded after the peak of the crisis, questions have re-emerged about how to improve the working conditions of long-term care workers in a sustainable way. Over the coming decades, the demand for these workers will increase substantially. Several countries are already facing shortages as the large baby-boom generation joins the older population. To go Beyond Applause, a comprehensive policy strategy is needed to tackle poor working conditions and insufficient social recognition of long-term care work, attract workers in the sector and avoid labour shortages reaching unacceptable levels. Such a strategy should cover several dimensions, with different priorities across countries depending on their specific context, including: direct interventions to raise wages and increase staff requirements; increasing public financing and fostering the leading role by governments; supporting collective bargaining and social dialogue; strengthening training; increasing use of new technologies; and, strengthening health prevention policies.

Contents:

Intro

Foreword

Editorial

Table of contents

Executive summary

LTC labour shortages may reach socially unacceptable levels if no decisive action is taken now

Tough working conditions diminish care quality and dissuade potential workers

Policy implications

Key facts and figures (Infographic)

1 Beyond Applause? Improving working conditions in long-term care: An overview

Beyond applause: Better working conditions are key to meeting increasing long-term care needs

1.1. Labour shortages may reach unacceptable levels in the near future if no decisive action is taken now

1.1.1. One-quarter of people with severe limitations in activities of daily living receive neither formal nor family care

1.1.2. Many countries have been struggling to recruit LTC workers

1.1.3. Demand for LTC workers as a share of total employment is projected to increase by 32% over the forthcoming decade

1.1.4. Labour shortages will grow substantially even with large efficiency gains

1.2. Tough working conditions affect care quality and dissuade potential workers

1.2.1. High physical and mental health risks and difficult working hours

1.2.2. Low wages, especially for personal care workers

1.2.3. Lack of recognition of LTC workers and of the skills and competences required

1.3. Why wages are low and working conditions do not improve despite shortages

1.3.1. Factors contributing to low wages in the LTC sector

1.3.2. Low wages despite persistent shortages

Low labour market power of LTC workers

Mismatches

Insufficient financing

1.4. Policy implications

1.4.1. More public financing and leading role by governments to improve working conditions

1.4.2. Direct interventions: increasing wages and strengthening staff requirements

1.4.3. Supporting collective bargaining and social dialogue.

1.4.4. Improving training to reduce arduous work and enhance the quality of care

1.4.5. Promoting the social recognition of long-term care workers

1.4.6. Improving efficiency and reducing arduous work through introducing new technologies

1.4.7. Strengthening preventive health policies to reduce long-term care needs

References

Annex 1.A. Definitions

Long-term care

Formal care: Nurses and personal care workers

Informal care

Declared and undeclared work

Long-term care settings

Notes

2 Work and wages in long-term care today

Introduction

Key findings

2.1. What is long-term care work?

2.1.1. What do long-term care workers do?

Personal care workers

Nurses

2.1.2. How to become an LTC worker?

Educational levels and qualification requirements

Abilities and skills needed by personal care workers

Competency requirements and future challenges

2.1.3. How many workers work at LTC jobs?

2.1.4. Is home-based care expanding faster than residential care?

2.2. Wages of LTC workers

2.2.1. How do wages of LTC workers compare to those of other workers?

Workers in residential and non-residential care sectors earn on average 80% of economy-wide average wage

Personal care workers earn about 70% of the economy-wide average wage

Nurses earn substantially more than personal care workers

Wages of personal care workers in residential and non-residential care sectors have kept pace with the average

2.2.2. What drives wages of LTC workers?

PIAAC data allows for a novel wage analysis of LTC workers

Half of wage differences between personal care workers and nurses relates to differences in education and other personal characteristics

The LTC sector pays significantly less than the hospital sector to similar workers.

Gender differences in hourly wages are lower for LTC workers than on average for other workers

Regression results do not provide evidence of pay discrimination against foreign-born LTC workers

Higher wages for those with health-related education, working in larger companies and in the public sector

2.2.3. Why do LTC jobs pay low wages despite labour shortages?

Low wages and labour shortages

Amenities and unobserved characteristics of workers

Devaluation of women's work

Entry barriers

Financing constraints, rent sharing and labour market power

3 Work environment and collective bargaining in long-term care

Work environment

Collective bargaining

3.1. Tenure and labour market security of long-term care workers

3.1.1. Tenure and retention

3.1.2. Labour market security

3.2. Quality of the working environment in long-term care

3.2.1. Arduousness of LTC work

Absence from work

Physicality of LTC work

Psychological impact of LTC work

3.2.2. Working-time arrangements

Night and weekend work

Part-time work

3.2.3. Opportunities for adult learning

3.2.4. Enforcement of labour regulations

3.3. A portrait of collective bargaining in the long-term care sector

3.3.1. Unionisation and bargaining coverage among long-term care workers tend to mirror national patterns

3.3.2. Good practices exist within heterogenous OECD collective bargaining systems

4 Social recognition, gender- and migration-related issues in long-term care

Social recognition

Gender

Migration

4.1. Social recognition of long-term care work

4.1.1. Social recognition of LTC work by different actors and the variety of forms it takes

How different actors value LTC work.

Social recognition can take various forms

4.1.2. Undervaluation of LTC work

What is social value?

Gender norms: care as "women's nature"

Care for money or for love?

4.1.3. Measures taken to boost social recognition of LTC workers

Increasing remuneration of LTC workers

Education and training

Campaigns to improve the public image of LTC workers

4.2. Gender issues in the long-term care sector

4.2.1. Are gender gaps in employment and wages wider in the LTC sector?

Employment

Earnings

4.2.2. Why are most LTC workers women?

4.2.3. Recruiting more men to improve the gender balance in the LTC sector

4.3. Role of migrants in the long-term care sector

4.3.1. How migrants are filling employment gaps in long-term care

Share of foreign-born workers

Legal channels for recruitment and recruitment campaigns

4.3.2. Are migrant LTC workers treated fairly?

Many migrant workers provide live-in care for which labour regulations are harder to enforce

Comparison of earnings and qualifications

5 Looking ahead: Current and future labour shortfalls in long-term care

Shortages of LTC workers

New technologies

5.1. Evidence on current unmet needs and staff shortages in long-term care

5.1.1. Many older people experience unmet long-term care needs

5.1.2. Shortages of LTC workers are structural and intensified during COVID-19 crisis

Identifying staff shortages is challenging

Many countries report shortages of LTC workers

With COVID-19, job offers for LTC workers increased substantially in 2020

5.2. Recent measures taken to address LTC staff shortages

5.3. Key drivers of higher labour demand for LTC workers over time

5.3.1. Several factors generate shortages of LTC workers.

5.3.2. Ageing boosts LTC needs and inhibits their fulfilment

5.3.3. Extent of healthy ageing and demographic effects on labour demand in LTC

5.3.4. Income and productivity growth effects on the demand for LTC workers

5.4. How new technologies may limit labour shortages in long-term care

5.4.1. New technologies are available to help workers in most LTC tasks

5.4.2. The use of new technologies in LTC is limited, but some are promising

Low IT-related investments in the LTC sector

Most new technologies used in the LTC sector are inexpensive and easy to implement

Robotic technology could be used for a variety of tasks in LTC

5.4.3. New technologies may help limit the demand for LTC workers in the future

New technologies may reduce demand for LTC workers and improve working conditions

New technologies may facilitate independent living of older people

5.4.4. Needed skills to successfully implement new technologies

Acquiring standard digital skills is the first step

Boosting older people's digital skills to improve use of new technologies

Annex 5.A. Projections of the number of people in selected age groups

Annex 5.B. Longevity and disability-free years of life

Notes.

Notes:

Description based on publisher supplied metadata and other sources.

ISBN:

92-64-44558-7