Employed family caregivers in health care: from a logic of care to a logic of reconciliation / Berufstätige Angehörige im Gesundheitswesen: Von der Versorgungslogik zur Vereinbarkeitslogik

Introduction: In the context of illness, disability, and longevity, reconciliation of employment and family caregiving is evolving - in Switzerland termed „work & care“. Due to time, local, and personal restrictions, employed family caregivers need an organizational culture in health care which acknowledges their specific needs for reconciliation in order to remain employed and secure their financial situation.

Aim: To identify how organizational cultures in health care institutions influence reconciliation of employment and family caregiving.

Method: Within a larger study, case studies in three Swiss health care institutions were conducted within acute, long-term and homecare settings. Data triangulation included document analysis, expert interviews (N=13), field observations, and group discussions (N=5 each with 4-5 participants). The latter are focused in the analysis of this article.

Results: Three core categories are discussed: employed family caregivers providing care and receiving care, and how they are perceived physically present and absent, either employed or not employed. Employment of family caregivers was only marginally identified.

Discussion: Across all core categories, family caregivers are dominated by institutional rules in all care settings. This can foster or hinder reconciliation. Specific approaches, e. g. care coordination, enhance a sense of reconciliation within the health care system. Hence, health professionals can develop strategies that positively affect employment of family caregivers.

Conclusion: Health care institutions focus primarily on patients or residents. Thus, they follow predominantly a logic of care. This primacy should be complemented by a logic of reconciliation, in order to reinforce the lived reality of employed family caregivers.