Creating a caring kampung: Rethink how to care and support caregivers

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With informal caregiving demands on the rise, Singapore needs to think about care more deeply, and value caregiving with a comprehensive societywide approach to create the inclusive society it wants.

But what does it take to create a "caring kampung"?

At a recent Institute of Policy Studies (IPS) Women's Conference, the panel on "Home is where the work is" called for a self-help time bank to create a resource pool of volunteers and accord more recognition to caregiving work.

But these can run contrary to what a caring kampung means because a time bank takes the "care" out of caregiving and replaces it with a transactional market exchange of time/labour.

And by seeing caregiving as labour, it diminishes the moral duty a caregiver has and ignores the integral place it occupies in the life of a caregiver.

There is thus a need for a fundamental rethinking of what care and caregiving means before we can propose ways to build a caring kampung.

In philosophy, care ethics offers some useful perspectives to help build ethical care relationships. First, care ethics emphasises the compelling moral importance in attending to and meeting the needs of those for whom we take responsibility.

Second, it values moral emotions such as sympathy, empathy, sensitivity and responsiveness to guide us in our personal relationships.

Third, it stresses that carers act for their own and the interests of the particular other they care for, and are not seeking to further their own interests or for the interests of all others.

Finally, it argues that fostering social bonds and cooperation are solutions to problematic social and political arrangements.

 

Importance of moral emotions

A relationship of care is unlike other relationships because it is fundamentally a dependent relationship, where there is an attendant higher level of responsibility, and where a respect for the dignity of those cared for is paramount.

When a relationship of care is devoid of virtuous dispositions or unguided by appropriate moral emotions, it is reduced to a simple provision of needs in the way we think about labour - a key reason for what went wrong in all the incidences of elder abuse and neglect seen in recent years.

A time bank is clearly an arrangement of services that does not require virtues or appropriate moral emotions. It is a credit system which uses time as currency or medium of exchange - for example, an hour of service is equivalent to one time dollar, which can be used to draw on the services rendered by others in the credit system.

In Japan, a "Volunteer Labour Bank" was first set up for housewives to provide mutual help, and later adapted as an "hour deposit system" to allow relatively young and recently retired persons to provide eldercare in return for hours that they can store for future use.

This was popularised as the "Fureai Kippu" or "caring relationship" ticket system, and its later variations use a mix of time credits and cash payment deposits in response to volunteers' call for allowances to defray costs and flexibility in the currency of exchange.

Such "paid volunteerism" opens up several questions. Some Japanese scholars argued strongly that any voluntary work involving money cannot be called voluntary since on its first principles, such forms of work must be free.

Others reported that volunteers themselves found monetary remuneration inappropriate and regretted how it damaged their personal relationships with users, as users now respond in a business-like manner for a paid service.

Even as the Fureai Kippu model tries to mediate this problem by offering volunteers the choice of time credits in lieu of or as part of cash payments, there is already far-reaching damage.

Exchanges, in whichever form, in care relationships naturally raises doubt about the sincerity of any acts of "kindness" and "neighbourliness", and renders any claims of altruism contradictory.

Moreover, those who need help the most are excluded in this system - for not being able to afford user fee, or have time today to shore up deposits for future claims.

Most importantly, moral norms and civic values that define social cooperation are now replaced with competition and maximisation of returns.

IPS has announced its plan to establish a nationwide time-banking system, "Eldersave", by December next year. Should instrumental rationality of the market economy find its way into care relationships - allowing care to become a service that can be quantified, stored as deposit and exchanged?

What are we saying about the value and importance of altruism if we encourage a nationwide system that expects a return from unrelated individuals for every good deed we do?

There are many in our society who still believe in helping a person in need - near or distant - as a duty towards another because they belong to the same household, same community, same humankind.

An exchange system of services will surely undermine the importance of this sense of duty. There are also many volunteers who are not born and bred in Singapore, but have devoted their time, heart and soul to care for an unrelated member in our community. An exchange system will clearly undermine the value of unconditional care.

 

Recognising caregiving

There are other ways to recognise caregiving without reducing it to a form of labour. In Asian cultures, many caregivers do not see themselves as providing caregiving work because of the emphasis on family duty and moral responsibility.

It is common for caregiving responsibilities to exceed the expectations defined in their relationships - a husband taking care of his chronically ill wife would not see himself as a caregiver, but as a husband to the patient, a father to their children.

To address this, we need to first help caregivers recognise their caregiver identity before they can seek support for their own needs. Each caregiver needs different skills, social network and support structure, but every caregiver needs similar assurance that they belong to the broader community.

Caregiver Alliance Limited, a non-profit organisation that helps the caregivers of those with mental health issues, is an example of an organisation that helps shape caregivers' sense of identity and belonging to the community.

Second, we need to go beyond the idea of a support network and build a social environment that recognises that anyone can be a caregiver.

We need to build an empathic community that any caregivers can engage with - for extended family ties and friendships, to alleviate guilt, and share a sense of accomplishment when they have helped their loved ones complete the circle of life according to their desires and wishes.

Third, we can build more supportive workplaces. In the face of an ageing population and shrinking family sizes, organisational leaders and human resources practitioners have to acknowledge that more of their employees will take on the role as long-term caregivers.

Caregiver support schemes such as compassionate or eldercare leave may offer only limited and temporary relief, but giving work flexibility will help their employees navigate these important life responsibilities.

But for long-term caregivers who have to take on casual work, there is little support from their place of employment. There are also many elderly caregivers caring for their spouses without an income.

For them, financial assistance schemes for seniors and caregivers may provide some help, but the application process may have its hurdles, and such assistance may apply only to certain, and not all, groups of caregivers. A community that steps up to help is perhaps a humanistic and long-term solution for them.

Creating a caring kampung needs a rethinking about care in a more fundamental way, and beginning a care relationship with caregivers. This will prevent us from taking a small step forward, only to take many steps back.

We need to see that care relationships are grounded in virtues and/or moral emotions, and not reduce caregiving to a form of labour in an economy of exchanges without care. This will help us accord proper value to the self-sacrificial quality of caregiving, and make appropriate adjustments in order to care for caregivers in our communities, our workplaces, and our society.

Associate Professor Jennifer Ang is director of the Centre for University Core at the Singapore University of Social Sciences (SUSS); and Dr Caroline Lim is head, Organisation and Leadership for Non-Profits Programme, and Dr Millie Su is senior lecturer, Human Resource Programme, both at the S R Nathan School of Human Development at SUSS.

 

Source: The Straits Times © Singapore Press Holdings Limited. Reproduced with permission.

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