Dirty Work and Maldistribution in Aged Care Work

1. Dirty Work and Maldistributionin Aged Care Work Therese Jefferson, Curtin Graduate School of Business Siobhan Austen, Rachel Ong, School of Economics and Finance, Curtin University Rhonda Sharp, Hawke Institute, University of South Australia Gill Lewin, Faculty of Health Sciences, Curtin University and Silver Chain Valerie Adams, Hawke Institute, University of South Australia

2. Dirty Work and Aged Care • Definitions and context • Data exploration • A key question • Some possible avenues for investigation and explanation

3. Defining “Dirty Work” • “Direct contact with bodily products, including secretions and excretions, and with the productions of infection” (with reference to nursing, Wolf, 1986: 29) • Challenge – it might be perceived as “dirty” or have an “ick factor” but involves personal care for assisting with activities of daily living

4. Context of aged care • Care work to assist those unable to independently care for themselves. • Ageing in place – residential care is increasingly ‘high need’

5. Some explorations of data • Data – Survey data of mature aged women working in aged care (3945 responses) • Interviews – 14 from pilot study and 43 in main study • Issue of ‘misrecognition’ emerged in pilot study and some data on recognition collected in subsequent survey and interviews

6. Some explorations of data • 73 per cent of survey respondents do some “dirty work” • Rates of pay were low. 80% earned less than $25 an hour, 53.4% earned less than $20 an hour. • In general, those who do the most dirty work get paid less.

7. A question: • Where is the theory of compensating wage differentials in this scenario?

8. A few comments on compensating wage differentials • History of the theory goes back to Smith • Support for the theory remains relatively visible • Theory used to ‘explain’ men’s higher earnings • ‘Psychic income’ from caring Footer text - slideshow title

9. Some challenges to the traditional theory • Barriers to competition and mobility – eg dual labour market theory • Criticism of love/money dichotomy – good wages could ‘crowd in’ good carers • But data suggests a more complex situation… Footer text - slideshow title

10. Some possible explanations… Dirty work in aged care encompasses intersecting sets of factors associated with low status: • “Women’s work” – a natural skill set and inclination • Ageing – “Low technology”, low status area of health sector • “Body work” – taboos and invisibility Can these factors contribute to patterns of low recognition and low pay? Footer text - slideshow title

11. Care as Nurturing “Women’s Work” Strong theme in large literature – reproduction of gendered division of labour in paid work reflects assumptions about roles about ‘women’s work’ “…they’ll try and do the Florence Nightingale trick, she’s here because she loves it, it’s bull, bullshit.” (Registered nurse in community care, Brisbane) “It didn’t really bother me. It’s like wiping a baby’s bum but bigger. You know, the other end of the scale, that’s all” (Personal carer, residential facility, Perth) Footer text - slideshow title

12. Attitudes to ageing “Body work” has lower status than working with technology Ageing associated with impairment and a drain on the public purse – elements of ageism “…aged care has always been perceived as the bottom of the ladder of nursing, that’s been the case for a long time.” (Registered Nurse, residential care, Adelaide) Footer text - slideshow title

13. Taboos and invisibility Is the work “socially dirty”? What are the implications of this? “…if you talk about that to somebody else it’s “eek!” You know, it’s just not discussed.” (Enrolled nurse, residential care, Adelaide) “I’ve heard some of the girls say “I wouldn’t admit that I was a personal carer”. And that’s a pity isn’t it?” (Team leader, residential care, Melbourne)

14. Implications and future directions Maldistribution Caring as women’s work Low status and low wages Retention and recruitment Perceptions of ageing Taboos and invisibility Quality of care