DO WE ASSESS THE NEEDS OF HOME HELP CONSUMERS EQUALLY?

Transcription

1 DO WE ASSESS THE NEEDS OF HOME HELP CONSUMERS EQUALLY? A gender mainstreaming project on how we assess men s and women s needs for assistance in the home November 2000 City of Göteborg City District: Backa Mona Grönberg Raila Hjelmroth-Carlberg

2 1 CONTENTS BACKGROUND... 2 PURPOSE...2 THE 3R METHOD... 2 PROCEDURE... 3 TIME FRAME... 4 REPRESENTATION... 4 RESOURCES... 5 REALIA... 8 PLAN OF ACTION Are the needs of home service consumers assessed equally?

3 2 BACKGROUND The city executive board has the overall responsibility for work with equal opportunity. The city council has declared that gender equality is to be incorporated into all operations. Each committee is responsible for working with gender equality in accordance with the city council s decision in the budget for the year The director of the city district is ultimately responsible for working with gender equality within their district, thus, in supervising their operation and staff each supervisor is to take into consideration aspects of gender equality. The prerequisite for this is making visible the conditions for women and men in all areas. We are also to increase the knowledge of those who have the ultimate responsibility and of those who are case workers. It is important to develop work methods and methodologies which will aid in the work with gender equality. In November 1998, the Home Help Services in the district Backa drew up a plan of activities for working with gender equality in The plan consisted of making a comparison of women and men born in 1915, who had applied for assistance in the form of home help. It was then decided that with the plan as a point of departure, we would examine gender equality more thoroughly from the perspective of the consumer. PURPOSE The purpose is to make visible whether or not we treat our consumers equally when assessing their need for home help. Do we make the same demands on women and men? How are the services distributed between women and men? How do we assess women s and men s needs, is the service they receive steered only by their needs or is it influenced by the person s gender? THE 3R METHOD

4 3 In its project, JämKom, the Swedish Association of Local Authorities developed an instrument for analysing gender mainstreaming, the 3R Method. By answering questions under the headings Representation, Resources and Realia, a municipal operation can be analysed from the perspective of gender. In this sense, the 3R Method is a tool or a strategy for use in municipal work with gender equality. Gender mainstreaming means that the perspective of gender equality is integrated into the ordinary tasks of the municipal operation. PROCEDURE Information on the amount of care or home help service the patient receives was gathered from the Home Help Service s data system, SHD (Social Home Help Data) for February 21, We selected single persons. Including couples would have been too complicated since joint cases are, for the most part, registered in the man s name. In addition, it would not be possible to see which service the one or the other of the spouses received. We decided to take a closer look at how many women and men in Care Group 1 received assistance with cleaning and food service. Care Group 1 means that the consumer has less than 2.5 hours of assistance a week. We have also taken a look at how many women and men have been granted a security phone. After we had gathered this information, we read the reports on these people to see if there were differences and similarities in diagnoses and social situations which could have influenced the assistance assessment. In a group discussion, the assistance assessors helped us to analyse our findings and gave their explanations for why the distribution looks the way it does. ORGANISATION The project group consisted of the Project Manager and a project co-worker. The project was run in parallel to ordinary work, no extra resources were allocated in the form of time or money.

5 4 TIME FRAME The project duration Feb. 24, 2000 Nov. 17, 2000 The survey Feb. 24, 2000 May 19, 2000 Analysis May 20, 2000 Sept. 18, 2000 Writing the report Sept. 21, 2000 Nov. 17, 2000 REPRESENTATION Representation within the operation Four people work with assessing assistance needs within the operation and all 4 of them are women. Even the miscellaneous administration within the operation consists of women. The Home Help groups who perform the services which have been granted are 97% women. The population of Backa as of December 31, 1999 was women and men, 20 years of age and older. Population Backa Dec. 31, ,0% 60,0% 40,0% 20,0% 0,0% Women 50,4% 55,5% 59% 65% 74% Men 49,6% 44,5% 41% 35% 26% 341 people in Backa receive Home Help, divided into 225 women and 116 men. This figure includes all forms of assistance, except for an alarm, all age groups, married and single. 81 women and 46 men are registered for an alarm.

6 5 Patients with Home Help Total Feb. 21, % 60% 40% 20% 0% Women 52% 53% 64% 74% 75% Men 48% 47% 36% 26% 25% RESOURCES Cleaning for Singles in Care Group 1

7 6 There is a total of 71 women and 27 men who are single in Care Group 1. The patient is placed in Care Group 1 if he or she receives less that 2.5 hours of home help a week. 74 % of the cleaning services go to the women and 26% to the men in this Care Group. However, this varies rather a lot between the different age groups. Single in CG1 with cleaning Feb. 21, % 80% 60% 40% 20% 0% Women 82% 40% 73% 84% 79% Men 18% 60% 27% 16% 21% Age Women Total of all Men Total of all W % 2 11 % 82% 18 % % 6 35 % 40% 60 % % 3 18 % 73% 27 % % 3 18 % 84% 16 % % 3 18 % 79% 21 % % % 74% 26 % M Food Service for Singles in CG 1 There were 4 women and 8 men who received home help in the form of food service as of February 21, 2000 in Care Group1.

8 7 Of the 71 who are placed in Care Group 1, 6 % receive food service. Of the 27 men in Care Group 1, 30 % receive food service. Single CG1 with food service Feb. 21, % 100% 80% 60% 40% 20% 0% Women 0% 0% 50% 33% 67% Men 100% 100% 50% 67% 33% Age Women Total of all Men Total of all W % 2 25 % 0% 100 % % 2 25 % 0% 100 % % 1 12,5 % 50% 50 % % 2 25 % 33% 67 % % 1 12,5 % 67% 33 % % % 33% 67 % M SECURITY PHONE 195 single women and 64 single men have security phones. The women dominate in all age groups.

9 8 Single with security phone Feb. 21, % 80% 60% 40% 20% 0% Women 57% 56% 83% 78% 81% Men 43% 44% 17% 22% 19% Age Women Total of all Men Total of all W % 9 14 % 57% 43 % % 17 26,5 % 56% 44 % % 8 12,5 % 83% 17 % % 14 22% 78 % 22% % % 81 % 19% % % 75% 25 % M REALIA The population of Backa in the age group of 20 years and older as of December 31, 1999, was divided into 52.2% women and 47.5% men. If we examine the total number of patients in the same age group in Backa, there were 66% women and 34% men as of February 21, 2000, which was the date for which we gathered all the figures. The population statistics are not available for this

10 9 particular date, however, we estimate that there cannot have been any major change in population from December 31, The percentage of single 20 year-olds and older who received home help was 71% women and 29% men. Based on these figures, we selected a few special services for a closer look, where we believed that there could be differences depending on the sex of the patient. Our thesis was that there is a difference between men and women in requests for assistance with cleaning, food distribution and security phones. It proved to be difficult to determine to what extent the assistance assessors form their opinions based on the individual s needs without being influenced by their own or society s gender values. We have read a great number of reports in order to compare diagnoses and social situations for women and men, but we have not been able to determine whether or not the differences depend on the assistance assessors making different assessments because of the sex of the patient or if the patients request different services because of their sex. We have also noticed that men are more diffuse in their applications, while women are clear and know precisely which services they want to apply for. If we make a comparison with population statistics and look at how many men and women live in Backa, we can see that in comparison with the statistics, women are somewhat over represented and receive more resources than men from Home Help Services in most of the age groups. If we look at the situation for single women and men, we can see that there are more women who receive home help in all age groups compared with the population. Cleaning It is our impression that when women begin with home help, cleaning is often the first service they apply for and this is the service they request the most. They often begin receiving home help in the form of cleaning and then increase their requests for other services. - Do women need help with cleaning at an earlier stage than men because they have a greater need than men to have clean surroundings? - Do women feel expectations from themselves and from those close to them to have a neat and clean home?

11 10 - Does tradition force women to do this? It is our impression that there is an unspoken demand that women of all ages have a well cleaned home. For this reason, women more often than men don t feel well if their surroundings are not neat and clean and when they can no longer clean, they request this service at an earlier stage than men in a corresponding situation. Men are often physically more vital than women when they grow old, and the women can no longer manage to clean. In the reports, we have seen that there is often some woman who helps a single man with running the home, often a daughter, a daughter in-law, a girlfriend or a relative. Food Service - Are men more conscientious about eating a cooked meal every day? - Do women, even in this instance, feel that they are expected to cook food which they have probably done all their lives? - Is it significant that ready to eat food with home delivery is rather expensive? It seems that men apply for food service at a younger age than women and that men often begin with food service in Care Group 1. Are men more used to always eating a cooked meal every day, e.g., from their working life, or because someone has always prepared food for them? In relation to other services, men have more food service throughout their lives. Women begin with food service when they have become older and when their need for care becomes greater. We believe that the price of the food can influence women s interest in the food service. Elderly women, in most cases, have a lower pension than men of the same age, and thus, do not have the financial conditions required to pay the cost of the food service. The food service costs SEK 30 per serving, in addition to which the person pays a special charge for home delivery. Most of the men who apply for the food service say that they have never learned to cook. They simply don t know how. The question is whether or not it is a good idea to teach an 80 year-old person how to cook, if he is not particularly interested in cooking. Security Phone - Why do women express fear more often than men? - Do we see women s fear more than men s?

12 11 - What causes insecurity? - Is it okay to grant a security phone on the grounds of general fear? Women apply for a security alarm quicker than men. We have read reports about people with alarms and have found that women who apply for a security phone often express fear and insecurity as the reason. They express their need in terms of feelings, even if there may be an illness in the background. Men who apply for an alarm have clear diagnoses as the primary reason or else they have previously had an accident in the home. Men seldom say that they are afraid or insecure in their home. PLAN OF ACTION Just by carrying out this project we have awaken new issues within our operation. Equality is not only an objective in itself, but this type of work must continue by taking advantage of ideas and developing skills on issues of gender equality within our own field. Issues of equality should even be an objective in our work with quality. Ideas and suggestions for continued work: Consumer File Under the heading Procedure we wrote that we had certain difficulties gathering statistics since joint applications are always registered in the name of the man in the family. All home help services a family has been granted are registered in his name and it is not possible to distinguish between what type of service the man or the woman receive. This may be an area for further examination. How can we change this so that the services each individual receives are made visible? Modifying the Report Form During the project we also noticed that it was difficult to directly see why certain people received the assistance they applied for. The files on men often showed what their profession had been and which interests he had had and even which interests he currently had. It is important that a report is written in a gender neutral way and that a woman s and man s situation is described in a similar way. One thing that we can work more with is making the grounds for the assessment clear in the report, that the perspective of gender equality distinctly comes forth in the report which is written in conjunction with the application for assistance from Home Help.

13 12 Perhaps the report form can be supplemented with new headings? Execution What is the significance of the fact that women and not men have characterised Home Help Services and continue to do so, both during the investigation stage and during the execution stage? The women we have talked to who work directly with performing the tasks have said that they help men with small extra services in terms of house-keeping, services which they would never do for a single woman if she did not specifically request them, such as putting out a clean tablecloth or removing wilted flowers. We will continue to work with gender mainstreaming by examining whether or not the performance of the services is done in a gender neutral way.