In this paper we examine how the use of robots in caring for elders can impact the meaningfulness of elders’ lives. We present a framework for understanding ‘meaningfulness in life’, and then apply that framework in discussing ways in which the use of robots to assist in activities of daily living can preserve, enhance or undermine the meaningfulness of elders’ lives. We conclude with a discussion of if and how having false beliefs about companion robots can affect meaningfulness in the (...) life of the person having those false beliefs. (shrink)

Hiring international migrant eldercare workers to work hard for little pay simply because this traveling workforce needs wages higher than those they would receive back home seems somehow “wrong.” The standard justification for hiring migrants seems more like an excuse than a justification. My purpose in this article, however, is not to condemn people who hire international migrant eldercare workers, but to suggest that these employers as well as their employees are caught in the same moral bind. Depending (...) on how uncaring a state is about meeting its people’s fundamental needs including adequate long-term care, it will create a hostile environment for the development of caring people. But a society without a sufficient number of caring people risks unraveling. People who avoid care work and who shun the practice of care are, in my estimation, “marginal” to society in that they are not contributing to the foundation that makes society possible. (shrink)

About half of Americans who live past age 65 will develop a long-lasting severe disability associated with aging and will require long-term services and supports for an average of two years. This eventuality is surprising to most Americans, despite the increasingly common experience of neighbors and family needing long-term assistance with self-care and daily tasks. Many people believe that serious disability simply won't happen to them or their family, and they avoid making plans to deal with the caregiving or financing (...) challenges associated with long-term disability. Of course, wealthy people can pay for the services they need, provided they can identify and... (shrink)

This essay investigates the demands on adult children to provide care for their elderly/ill parents from a socio-moral perspective. In order to narrow the examination, the question pursued here is agent-relative: What social and moral complexities are involved for the adult child when her parent(s) need care? First, this article examines our society’s expectation that adult children are morally obligated to provide care for their parents. Second, the essay articulates how transgressing against this normative expectation can inure significant moral criticism. (...) The final sections present these tensions within the context of disability. (shrink)

In recent years a number of important studies have explored the new international division of reproductive labor, but those works have concentrated, for the most part, on one end of the life cycle: nannies and childcare. This article focuses on the other end of it, home eldercare work. Jobs falling under this label encompass a variety of work situations but the title suggests a job that is more homogeneous than the occupation actually is. This article explores, through the narratives (...) of the workers and the exploration of this 24-hour job, what it means to work as a home eldercare assistant. (shrink)

Technological approaches are increasingly discussed as a solution for the provision of support in activities of daily living as well as in medical and nursing care for older people. The development and implementation of such assistive technologies for eldercare raise manifold ethical, legal, and social questions. The discussion of these questions is influenced by theoretical perspectives and approaches from medical and nursing ethics, especially the principlist framework of autonomy, non-maleficence, beneficence, and justice. Tying in with previous criticism, the present (...) contribution is taking these principles as a starting point and as a frame of reference to be critically re-examined. It thus aims to outline how existing ethical frameworks need to be extended or reconsidered to capture the ethical issues posed by technological developments regarding care for older people. In a first step, we provide a brief overview of assistive technologies in eldercare according to their purposes and functions. In the next step, we discuss how the questions and problems raised by new technologies in eldercare call for an expansion, re-interpretation, and revision of the principlist framework. We underline that the inclusion of ethical perspectives from engineering and computer science as well as a closer consideration of socio-political dimensions and fundamental anthropological and praxeological questions are needed. (shrink)

This article examines the problem of agency in resident–staff interaction in a Japanese eldercare facility. Data were collected during the morning care routines and analysed within the framework of Conversation Analysis. Focusing on the openings and closings, I show that the interactions in the setting under observation are marked by a clear dominance of the care workers. This becomes most obvious at the level of the turn-taking system, where the first pair part of a new sequence is commonly delivered (...) by a care worker, thus assigning a mainly reactive role to the residents. However, the data also contain instances where this pattern is broken up by a reversal of the turn structure. I show how this sequential re-organisation enables a resident to take a more proactive role in determining the relevant next action, arguing that there is much potential for higher resident agency even in routine interactions such as the morning care activities. I also discuss the practical implications of these findings for care communication in general. (shrink)

The care for older and disabled people has been described as a core area of the Nordic model. The Nordic countries’ welfare model has also been described as women friendly, as women are not forced to make harder choices than men between work and family. The Swedish eldercare system has, during the last several decades, undergone significant changes. Previously, eldercare could be described as universal, meaning a publicly provided, comprehensive, high-quality service available to all citizens according to need (...) and not based on the ability to pay. In later years transformation of eldercare has been influenced by neoliberal politics, which emphasize economic efficiency and cost reduction through competition. Eldercare has become a more diverse multidimensional system, and a private market for home-based eldercare has been created. The numbers of eldercare providers have increased considerably, and new ways of organizing eldercare have been established. In January 2009, the Act on System of Choice in the Public Sector was introduced. The Act was supposed to provide an opportunity for interested municipalities and county councils to expose their publicly provided services to market competition, and to enable users to choose their providers. This article aims to illustrate how neoliberal reasoning dominated the policy process leading to adoption of the Act on System of Choice in the Public Sector. With the use of a discursive policy analysis the authors specifically explore how neoliberal logic dominated, and also how choice and equality were understood and interpreted in the policy process. They conclude that the neoliberal turn in eldercare claiming to centre on the individual choice of persons in need of care runs the risk of creating unequal care that decentres the eldercare worker and creates precarious work situations. (shrink)

Social categorizations regarding gender or age have proven to be relevant in human-robot interaction. Their stereotypical application in the development and implementation of robotics in eldercare is even discussed as a strategy to enhance the acceptance, well-being, and quality of life of older people. This raises serious ethical concerns, e.g., regarding autonomy of and discrimination against users. In this paper, we examine how relevant professional stakeholders perceive and evaluate the use of social categorizations and stereotypes regarding gender and age (...) in robotics for eldercare. Based on 16 semi-structured interviews with representatives from technology development, industry, and nursing science as well as practice, we explore the subjects’ awareness, evaluations, and lines of argument regarding the corresponding moral challenges. Six different approaches of dealing with categorizations and stereotypes regarding gender and age in care robotics for older people are identified: negation, functionalistic relativization, explanation, neutralization, stereotyping, and queering. We discuss the ethical implications of these approaches with regard to professional responsibility and draw conclusions for responsible age tech in pluralistic societies. (shrink)

My humanity is fractured if I neglect to care for vulnerable others. Indeed, if we grasp Virginia Held’s care ethics, we acknowledge that all humans are interdependent and that the vulnerable among us deserve particularly conscientious consideration—some level of care. Accordingly, I agree with Rosemarie Tong when she proposes that those who dodge caring roles marginalize themselves from society. This marginalization can occur if I squirm out of attending to my ailing family members’ needs, or if I avoid (employment or (...) volunteer) opportunities to care for those other than my family. It can also occur if I draw an arbitrary dichotomy between “work” and care, and devalue those in caring roles. Indeed, the United .. (shrink)

This contribution presents a corpus of spatial descriptions and describes the development of a human-driven spatial language robot system for their comprehension. The domain of application is an eldercare setting in which an assistive robot is asked to “fetch” an object for an elderly resident based on a natural language spatial description given by the resident. In Part One, we describe a corpus of naturally occurring descriptions elicited from a group of older adults within a virtual 3D home that (...) simulates the eldercare setting. We contrast descriptions elicited when participants offered descriptions to a human versus robot avatar, and under instructions to tell the addressee how to find the target versus where the target is. We summarize the key features of the spatial descriptions, including their dynamic versus static nature and the perspective adopted by the speaker. In Part Two, we discuss critical cognitive and perceptual processing capabilities necessary for the robot to establish a common ground with the human user and perform the “fetch” task. Based on the collected corpus, we focus here on resolving the perspective ambiguity and recognizing furniture items used as landmarks in the descriptions. Taken together, the work presented here offers the key building blocks of a robust system that takes as input natural spatial language descriptions and produces commands that drive the robot to successfully fetch objects within our eldercare scenario. (shrink)

This paper develops a Foucauldian analytics of resistance in relation to components of a system of governance – a governmentality. Techniques of resistance that can transform a governmentality towards the development of a new politics of truth require the design of techniques of resistance to counter directly oppressive techniques of biopower and disciplinary power, in turn to produce new regimes of practices or counter-conduct that can engender a new mentality and set of discourses to convey it. Strategies of resistance towards (...) transformative change in the governance of a population as well as of the self therefore require development following, and in relation to, an analytics of governance. I thread these points through a particular case, the problem of care for the infirm elderly in the United States, focusing specifically on nursing homes by critically synthesizing issues from inter-disciplinary literatures and casting them in terms of governmentalities. I frame the problems of eldercare broadly in terms of interrelated neoliberal and scientific mentalities and associated discourses, and then examine the associated techniques of biopower, disciplinary power, and regimes of practices to identify roots of problems, explain failures of policies, and crucially, to frame the design of techniques of resistance to produce new regimes of counter-conduct. I suggest avenues of resistance in relation to existing governmentalities on the terrain of inter-firm relations and everyday life in nursing-home care, all currently entangled with government policies, economies of documentation, and dehumanizing scientific practice. (shrink)

This paper explores the relationship between dignity and robot care for older people. It highlights the disquiet that is often expressed about failures to maintain the dignity of vulnerable older people, but points out some of the contradictory uses of the word ‘dignity’. Certain authors have resolved these contradictions by identifying different senses of dignity; contrasting the inviolable dignity inherent in human life to other forms of dignity which can be present to varying degrees. The Capability Approach (CA) is introduced (...) as a different but tangible account of what it means to live a life worthy of human dignity. It is used here as a framework for the assessment of the possible effects of eldercare robots on human dignity. The CA enables the identification of circumstances in which robots could enhance dignity by expanding the set of capabilities that are accessible to frail older people. At the same time, it is also possible within its framework to identify ways in which robots could have a negative impact, by impeding the access of older people to essential capabilities. It is concluded that the CA has some advantages over other accounts of dignity, but that further work and empirical study is needed in order to adapt it to the particular circumstances and concerns of those in the latter part of their lives. (shrink)

This book explores the associative duties we owe to our children, parents, friends, colleagues, associates and compatriots and defends a novel account which justifies such duties through the realization of values that are produced in these various kinds of social relationships. Seglow engages with several key contemporary debates including parental rights over children’s education, the burdens of eldercare, permissible partiality to friends, and global justice versus compatriot duties.

Abstractabstract:Assistive care technologies, developed to replace, support, or extend human capabilities and to address the surging demands of care, have been gaining prominence recently. The current trend summons a posthuman approach through decentering the privileged role of humans in several spaces of caregiving, such as hospitals and eldercare homes. The existence of these cutting-edge assistive technologies, exciting as they are, hints at a possible future when the distinction between humans and technology will be blurred, thus transforming care relations. However, (...) these technological advances carry equal promises and dangers. While care robots may reduce the burden of caregiving, they also threaten to minimize human contact with vulnerable populations. This critical assessment reviews technological advances in care and close-reads several single-panel cartoons to theorize the impact of technologies on caring relations. The article also examines the neoliberal underpinnings of such technologies and the moral dangers of their unreflective use. (shrink)

Alcohol use has been recognized as a challenge in eldercare and social care, and some anticipate that problems related to alcohol use will increase in the future as the current adult generation has high alcohol consumption rates. Accordingly, it is suggested that care workers are at risk of becoming passive bystanders to the destructive lifestyles of vulnerable older adults and even facilitating these lifestyles. In the present paper, we suggest that alcohol exacerbates and underscores inherent difficulties in eldercare, (...) such as finding an appropriate balance between the personal freedom of the older adult and the responsibility of the care worker to provide care. The specific focus in the paper regard the communication and interaction involving values between people in eldercare in cases of problematic alcohol‐related situations to uncover the difficulties. We found it noteworthy that the objectives and perspectives of older adults, care workers, managers and relatives have implications regarding their interactions and communications because their varying experiences involve values that are not necessarily aligned. Sometimes, care workers have no choice but to act against what, in the public sphere and to the other care workers, is ruled out by virtue of their professional ethics. It is suggested that care workers describe and judge situations where alcohol is present paradoxically by virtue of their professional ethics, yet regulate their care to preserve the dignity of older adults, even when they find the situation to be an apparent dilemma. (shrink)

As the baby boomer generation ages, the need for laws to enhance quality of life for the elderly and meet the increasing demand for family caregivers will continue to grow. This paper reviews the national family leave laws of nine major OECD countries (Canada, Denmark, France, Germany, Italy, Japan, Netherlands, Spain, and the United Kingdom) and provides a state-by-state analysis within the U.S. We find that the U.S. has the least generous family leave laws among the nine OECD countries. With (...) the exception of two states (California and New Jersey), the U.S. federal Family Medical Leave Act of 1993 provides no right to paid family leave for eldercare. We survey the current evidence from the literature on how paid leave can impact family caregivers' employment and health outcomes, gender equality, and economic arguments for and against such laws. We argue that a generous and flexible family leave law, financed through social insurance, would not only be equitable, but also financially sustainable. (shrink)

This article discusses the application of artificially intelligent robots within eldercare and explores a series of ethical considerations, including the challenges that AI (Artificial Intelligence) technology poses to traditional Chinese Confucian filial piety. From the perspective of Confucian ethics, the paper argues that robots cannot adequately fulfill duties of care. Due to their detachment from personal relationships and interactions, the “emotions” of AI robots are merely performative reactions in different situations, rather than actual emotional abilities. No matter how “humanized” (...) robots become, it is difficult to establish genuine empathy and a meaningful relationship with them for this reason. Even so, we acknowledge that AI robots are a significant tool in managing the demands of elder care and the growth of care poverty, and as such, we attempt to outline some parameters within which care robotics could be acceptable within a Confucian ethical system. Finally, the paper discusses the social impact and ethical considerations brought on by the interaction between humans and machines. It is observed that the relationship between humans and technology has always had both utopian and dystopian aspects, and robotic elder care is no exception. AI caregiver robots will likely become a part of elder care, and the transformation of these robots from “service providers” to “companions” seems inevitable. In light of this, the application of AI-augmented robotic elder care will also eventually change our understanding of interpersonal relationships and traditional requirements of filial piety. (shrink)

The recent passing of Ann Sharp, Co-Founder and Associate Director of the Institute for the Advancement of Philosophy for Children, at the age of 68, has left many of us involved in the movement of philosophy for/with children bereft, no doubt in many different ways. The warmth and intensity of her personal and professional focus, the simple clarity of her thinking, and her boundless energy in the work of international dissemination of the concept and practice of philosophizing with children, resonate (...) even more sonorously in her death. We thought it appropriate to try following at least one pathway backwards in her life story through the memory and testimony of her chief collaborator over a period of 35 years, Matthew Lipman. I interviewed Lipman, age 87, in the single room of the eldercare center in New Jersey that has become the site for his dogged and tenacious struggle with Parkinson’s Disease, and asked him to reflect on their long partnership. The transcript ends suddenly, not because we stopped talking, but because I stopped taping, sensing his fatigue, and suggesting that we return for another round, at which point we turned to other, less somber matters. (shrink)

In Algerian Kabyle families, the intersection of tradition and modernity creates a dilemma for family-based eldercare. As daughters-in-law choose to live independently from their in-laws’ home, some unmarried daughters may be left to fill the care gap. Given the shift from traditional to modern caregiving arrangements, how can elders and the members of their family survive and thrive? Choosing an empirical case study that is analyzed using key concepts from care ethics and gender justice, we develop a notion of (...) “caring with the heart” for aging family members in need of long-term care. We offer seven possible solutions and policy options for the modern Kabyle context. (shrink)

The aim of this article is to reveal how care workers in the home-help services handle the process when older people’s relocation to a residential home is under consideration. Since the care workers are engaged daily in defining care receivers’ needs and yet have no formal influence on care decisions in Sweden, the focus is on how they solve this dilemma. In this inductive study, the theoretical framework is based on occupational alliances, relationship-based practice, and discretion. Thirty-three care workers in (...) home-help services are included in open semi-structured interviews. Prominent features in the findings are that the care workers take their stand at the borderland of care management, when they know or try to find out what is right. The conclusions drawn are that care workers find ways to informally influence the decision-making process, quite contrary to the idea of approaches referred to as purchaser/provider models. The implications for social work policy and practice are that a distinction between assessment and intervention may not benefit the field of eldercare and should therefore be regarded as an area in need of thorough reconsideration. (shrink)

Body care is considered a key aspect of nursing and imperative for the health, wellbeing, and dignity of older people. In Scandinavian countries, body care as a professional practice has undergone considerable changes, bringing new understandings, values, and dilemmas into nursing. A systematic mapping review was conducted with the aims of identifying and mapping international nursing research on body care of older people in different institutionalized settings in the healthcare system and to critically discuss the dominant assumptions within the research (...) by adapting a problematization approach. Most identified papers reported on empirical research with a biomedical approach focusing on outcome and effectiveness. Conceptual papers, papers with a focus on the perspectives of the older people, or contextual and material aspects were lacking. The research field is dominated by four dominant assumptions: Body care as an evidence‐based practice, body care as a relational ethical practice, the body as a body‐object and a body‐subject, the objects in the body care practices as nonrelational materialities. Given the complexities of professional body care practices, there is a need for other research designs and theoretical perspectives within nursing that expand our understanding of body care taking into consideration the multiple social and material realities. (shrink)

Workplace learning and competence development in work are frequently used concepts. A wide spread notion is that societal, institutional, and organizational changes require the development of knowledge, methods and strategies for learning at workplaces, in both public and private enterprises. In research on learning and competence development at work, the organizational learning and development as well as individual accomplishments are investigated from various perspectives and in different contexts. The theoretical base for research projects can, accordingly, be focused at a number (...) of organizational and system levels. This paper describes a research project called "Workplace development and learning in elder care" in which learning and knowledge were key issues and where Activity Theory was used as the theoretical base. The project was joint project between two research and development field units. These were UFFE, a municipal social services’ field research unit, and Äldrecentrum Västerbotten, a county council field research unit which aims to serve the interests of the elderly. The project was launched in the fall of 2000 and ended in the summer of 2003. I was employed part-time as a research leader at the municipal research unit and became the research leader for this particular project. A number of students, as well as employees from the county council geriatric care services and the municipal elder care participated in the project. The general aims of the project were to: a) investigate the prerequisites for development and learning; b) test and evaluate interventions at a workgroup level; and c) identify the need for new knowledge. The results were expected to be useful for the field research units as well as for the municipal and county eldercare services in their research and development work. I start with a presentation of the theoretical concepts and apply them in order to form a tentative hypothesis on the status of learning and knowledge in elder care. The next section contains a short description of the different parts of the project and the main results are presented. Finally, the results are discussed and related to the conditions and impact of workplace interventions. (shrink)

In this article I investigate the nature and extent of filial obligations. The question what (adult) children owe their parents is not only philosophically interesting, but also of increasing relevance in ageing societies. Its answer matters to elderly people and their adult children, and is relevant to social policy issues in various ways. I present the strongest arguments for and against three models of filial obligations: the ‘past parental sacrifices’ model, the ‘special relationship’ model, and the conventionalist model. There is (...) something to be said—and after consideration of objections something remains to be said—for all three models. In other words: filial obligations have more than one source, and an adequate model of filial obligations should reflect this. On its own, each of the above models is one-sided. They also fail to show the connections between the question of filial obligations and various other issues, such as issues of gender justice, the extent of institutionalization of eldercare, and social conventions regarding filial responsibility. Therefore, I integrate what I think we should keep from the aforementioned models into a contextual, pluralist model, which places filial obligations in a broader social and cultural context and relates them to issues of social justice. The model also highlights the difference between general and specific filial obligations, and the factors that determine their nature and extent, thus enabling a deeper and more comprehensive understanding of filial obligations. (shrink)

This study attempts to identify differences in the perceptions of top management (defined as CEOs, directors, and presidents) and employees (defined as middle and supervisory management) regarding (a) the effects of dependent care responsibilities on job performance, and (b) the extent of a firm's responsibility in providing support for those faced with caring needs concerning eldercare, childcare, substance abuse, and mental/physical handicaps.The results indicate that these two groups have significantly different perceptions of the effect of dependent care responsibilities on (...) job performance, and on the firm's responsibility in providing support for three types of dependent care. (shrink)