This paper is based on research, conducted between 1992 and 1995, of forty women who were working full time (or near to full time) and carrying a major responsibility of care for an elderly relative. It was decided to confine the study to women carers both because of the nature of the funding program which supported the research - the Women's Research and Employment Initiatives Program of the Department of Employment, Education and Training -and, more importantly, because women comprise the majority of unpaid carers (67%) (ABS 1993), especially of that group involved in intergenerational care (as distinct from the care of a partner or spouse).

Participants were recruited predominantly from workplaces in the human services and health fields. We focused on this sector of the workforce for three reasons. First, women predominate in this field. In the community service sector, for example, women comprise 64.2% of the work force ( Baxter et al.1990: 64). Second, we were interested to examine how people, who, it could be said, had chosen jobs often characterised as caring, people-oriented work, perceived a situation of dual caring responsibilities and made decisions about both paid and unpaid caring work. Third, because the research had as a major focus actual workplace environments, we were also interested in how these particular 'caring' work places responded to the 'outside-of-work' caring responsibilities of their workers. In addition, we wanted to explore the work practices and workplace cultures of a section of the workforce which has not been extensively studied as a place of work. It is an important and growing area of the paid work force yet it has received little attention as such.

In general, we made contact with participants by advertising through the central bodies of agencies such as Home Care (a state-wide agency in New South Wales providing general housework services, personal care, and in-home respite care) and church based aged care services, and the hospital system. We also extended our sample to include public sector employees, and several from the private sector as well.

The study is an in-depth qualitative study with the detailed accounts provided by these women forming the basis for the analysis. The definition of a major responsibility of care, which was used to recruit participants, was in large measure a self definition and included every caring circumstance from co-resident caring to the care of a relative in a hostel or nursing home.

This project was conducted in the context of increasing concern about that range of issues which fall within the policy arena labelled, 'workers with family responsibilities'. An important assumption underpinning this research is that increasing numbers of workers will find themselves with some level of responsibility for the care of elderly relatives, that this caring is an important and significant part of the family responsibilities that workers carry and that it needs to be recognised and supported both by governments and in the workplace.

This paper takes up a number of specific arguments. Firstly we argue that to work and care is to be involved in two stressful arenas, the stressful nature of each is enhanced and additional pressure in either reverberates in all the other parts of these 'stretched lives'. Secondly, the perceived need to keep separate paid work and family, the public and private lives of workers, exacerbates the stressful nature of the two arenas. Thirdly, this separation has had negative repercussions for workers who carry major caring responsibilities. Fourthly, the costs for workers with major caring responsibilities are considerable and the impact is both immediate, in terms of income and job satisfaction, and long term, into their own retirement and old age. Fifthly, for these workers with family responsibilities to continue to undertake both jobs, there must be support in the form of well funded, reliable and coordinated community services to which these carers have equal access with other carers and, further, that this is astute investment on the part of governments. Finally, we argue that there must be changes in work places as well and that to give legitimacy to the caring responsibilities of workers is in the interests of employers.

'Stretched' and 'Stressed'

We have used the phrase, 'stretched' lives, a phrase used by one of our participants, to describe the impact of attempting to juggle the demands of paid work and caring. To be "stretched' conjures up pictures of tension, of being extended as far as one can go. In the accounts of the participants in this study, this was a particularly apt image. It captures the idea of having reached a limit or being rather close to that point and of the stress and pressure that this creates in every part of one's life.

I think having said to you that I don't acknowledge stress, I acknowledge 'stretch'. I'm 'stretched'!!.... I don't think modern woman says what is enough. We just keep doing a little bit more and a little bit more.

To work and to care is to have one's time and energy consumed by these two preoccupations. To fit in other activities and relationships becomes very difficult and, for some carers and at some times, it becomes impossible. Most other images did not seem able to capture the tension and emotional strain that our participants described. The image of 'juggling' all the competing demands was, however, much closer to the experience. We actually asked our participants whether or not the notion of juggling the various demands was an appropriate image to use.

'Juggling' is the right word. I sort of have this mental picture of about five different things up in the air. Your family, your friends, your job, the person you are caring for, your social life,......you've got all these things up in the air and you can only hold on to one at a time, not two, one. You throw them all up and you (don't always know) which one is going to come down next. So it is literally a juggling act.... It's tiring and it's one of those things that you look at and think, one of these days I'm going to miss and all those balls that are up in the air are going to fall on top of my head and all I'm going to be able to do is go 'help' and cover my head.

Stress, as a phenomenon of caring, was not in itself a major focus of this study. But, inevitably, our participants talked, often at length, of the toll that caring has exacted. In a short article there is not the space to dwell in detail on the nature of the stress that caring entails, however, there are a number of features that stand out.

It is clear is this research as in other research we have undertaken (Watson & Mears 1989) that while the physical demands, the running here and there and attempting to fit all that needs to be done into a limited number of hours, is stressful, it is the emotional demands that are the most stressful of all. The impact of both on the health of the carer can be considerable. Those of our participants who claimed to be in good health physically, were quick to emphasise the emotional toll. None claimed to have survived without some cost to their health or well being. And in most cases the cost was, at least at times, considerable.

It is difficult to separate the physical manifestations of stress from the emotional outcomes. Fatigue tends to be accompanied by a proneness to being weepy or cranky or both. There are likely to be other impacts on health as well. Headaches and migraine are common. Sleep patterns are affected. There are problems with eating and digestion, with gaining or losing weight, with back problems and hernias as a result of lifting and other straining activity, with vulnerability to any infection that is 'going around'. Existing health conditions such as asthma, are likely to be exacerbated.

The emotional or psychological manifestations of stress tend to be the ones that people are most aware of and which they find the most distressing. Depression and anxiety are not uncommon. Others spoke of being 'up tight' or 'on a short fuse'.

I had reached the point where I did need to take some kind of action because I was like a short fuse about to be lit. Like a volcano and I was capping the top of the volcano all the time and as I said to my boss, sometimes I feel like a volcano is inside me and every time I get stressed, I'm putting a plug in the top of the volcano to stop it exploding. One of these days I'm going to cap that. Put a plug in the top of it and it's just going to explode out the side like Mt. St. Helen's. So I had to find a way of being able to defuse that by syphoning it off from the bottom.

Stress was experienced as uncertainty even dread about the future, as a sense of poignancy or as distress.

The relationship with the person for whom you are caring can itself be a source of stress. In most cases a new relationship is having to be worked out. There are many cases where carers experienced a role reversal and some difficulties in that new circumstance. The daughter may feel she has in a sense become the mother, but it is never quite that straightforward. One's mother doesn't cease to be one's mother even if her behaviour has become childlike due to dementia.

Very much the fact that as long as they haven't got dementia, the person that you are dealing with is not a child. But they are dependent and you literally have to learn how to handle them as an adult rather than treating them as a child, because they are an adult. If they've got dementia to a certain extent you can treat them as a child, but when they are fully compos mentis you have to be very aware and that's a stressful thing in itself. Because they are adult and have all their faculties and own ideas about what they want and expect and consequently you had to take that into consideration or find ways to manoeuvre around it. And you have to take into consideration the fact that you don't want the person to feel that you are taking over.

And I think it's just letting go of your ideals as a child and having to cope with them as the child, taking responsibility for people who used to be responsible for you. That complete role reversal is the stressful side of it. And because they were never seen to let you down as a child, the strain of thinking you may be letting them down, and especially during a time where it's, your life where you should be growing and expanding, and setting down your own roots, is another factor that comes into it.

In some cases, the relationships were particularly difficult. In three cases the relationship between mother and daughter had always been strained. There were other instances where the quality of the relationship was less distressing but nevertheless stressful. This was so for a range of reasons - a mother used to getting her own way, a father becoming increasingly dependent and demanding after the mother's death, one parent refusing to accept the extent of decline in their spouse and thus to allow the daughter to provide the care that is needed. Some parents created stress for their carer with a constant barrage of criticism about the way the grandchildren were being reared or in their lack of any understanding about the reasons for the daughter wanting and needing to continue to work.

There is the inevitable stress on a marriage or partnership. For women who had never married or who were divorced, the possibility of developing and sustaining a relationship was immensely difficult. Some described a string of relationships and engagements that had been 'broken off'.

It is, perhaps, inevitable that to both work and care will increase the stress of each experience. But in addition to this, the participants in this study were drawn predominantly from sectors of the work force in which the work might be characterised as caring work or at least as 'people oriented'. Such work is typically stressful in nature. And while there are limits built into the demand placed on the paid 'carer' which make a critical difference to that caring experience, it is, nevertheless, work which requires that the worker give time and attention to the needs of others, that she be available to others. This was so of the work performed by the nurses, teachers, Homecare field and office staff, human resource managers, academics, social workers who comprised the bulk of our participants. Of those who were not working in such fields, none could be said to be working in a relatively stress-free environment although one or two did 'play down' the amount of stress in their own work environment and several had declined promotions or not sought such opportunities because they already had enough stress in their unpaid caring work and preferred to stay in work which had fewer responsibilities.

Cut backs in funding to such services as Homecare had created additional pressure. Not only was there the general pressure 'to do more with less' but the fact that this very often meant curtailment of services to people in similar circumstances to those of the women, themselves. Agencies were having to make difficult decisions about who was 'most in need' of the service. Those who were in paid work were typically perceived to be 'less needy'. And there was another effect that we became very conscious of as we interviewed those working in local agencies. Quite a number had decided to continue to provide services to individual clients after that service had been officially 'cut' because it was the worker's view that the recipient of the service still had need of the service and because the worker had an ongoing relationship with the client which she felt unable to put to one side. Needless to say, such decisions created extra work and some guilt as these actions did not have the approval of their agency.

Separation of Work and Care

A recurring theme in this research was the notion that the 'good worker' was one who left her family troubles and preoccupations at home and was focused exclusively on work concerns while at work. This perceived need to keep separate paid work and family responsibilities created additional stress and guilt for our participants. Superficially there appeared to be a contradiction here as the separate nature of paid work was often experienced as a relief, an escape from the strain of caring. One could throw oneself into one's job and so be distracted for the moment from the pressures and anxieties of the caring 'role'. But in reality, it was not possible to achieve the compartmentalisation that was seen as necessary and desirable. This was all the more likely when there was a crisis in the caring situation and the carer found herself having to devote all her energies for a (usually short) time to the care of her elderly relative. There were also times when the pressure at work would be greater than usual and this would rebound on the caring situation. Peter McDonald, writing in an earlier issue of this journal, argues that there is a need for 'future policies with a family focus.... to recognise the interactions between the various spheres in the life of an individual and take account of the interactions within the family' (1993, p.45).

The supposed requirement that work and caring are to be kept separate, has negative repercussions for carers in the paid work force. One of these is the unspoken assumption that major caring responsibilities signal a less serious worker. We would suggest that in large measure we have taken for granted that a characteristic of the 'good' worker is that he or she is 'one hundred percent' dedicated to his or her work and that this dedication is evidenced both in terms of the availability to work when needed and in a lack of domestic distractions, a freedom from the demands that family members may make.

The participants in this study regarded themselves and wanted to be regarded by others, as conscientious workers who took pride in their work, who wanted to be effective and to achieve in their jobs. They were serious workers wanting to be enabled to do their work and to care well at the same time. It is one thing to embrace as a survival strategy the construction of paid work as a separate domain. It is quite another, when this powerful notion is part of an organisational culture operating in workplaces almost everywhere which compels workers to act as though there was no home and family, as though there were no caring responsibilities. This is a very destructive mythology.

This research suggests that one possible attack on this mythology must be through a fundamental reappraisal of what constitutes the ideal worker, and most especially, the ideal 'manager'. This would advantage carers as workers in significant ways but it would also be a positive development for the whole of the work place. Such a reappraisal becomes as well an argument about what really contributes to efficient and productive workplaces. If we pursue the argument concerning what constitutes the ideal worker and manager then it quickly becomes clear that this traditional stereotype runs directly counter to the flexible, cooperative and innovative worker described as essential to the modern manager, employer or business unit. It also becomes clear that this argument taken to its logical conclusion brings us finally to an absurd position. Stated baldly, the proposition is that the ideal or serious worker is someone who is able to separate themselves off from the responsibilities they carry in other parts of their lives. This would seem to imply either that they do not 'feel too greatly' for those that they are close to or that what they have to distract them in their non-work lives is fairly minimal. So, the social construction of the serious or ideal worker is of someone who is not having to care in a major way for the other people in their lives and/or is not expected to care.

In this division of the world, we cordon off from the world of work those skills, competencies, dispositions and values that are particularly associated with the private sphere of the home and most especially with 'caring'. At the same time we accentuate those skills, dispositions and values that have come to be associated with the public sphere of paid work. We devalue the former and over emphasise the latter. We end up with a traditional notion of what is ideal in a worker that is based upon a distorted picture of what is admirable in human beings. In addition, as we state above, this conventional notion of the ideal or serious worker is at odds with what the current literature in management sets out as desirable traits and capacities in a manager. It is as though we cannot or do not want to recognise the contradiction in this set of assumptions and attitudes.

The Importance of Paid Work

One other consequence of this view of the ideal worker is that women with caring responsibilities are confronted with a double difficulty. They are seen by many employers and managers as more likely to take time off to care. This is an another feature of the picture of working carers (and women) as essentially less serious workers. They are also likely themselves to accept the notion that if caring becomes too onerous and it becomes too difficult for them to continue to both work and care, they may have to accept the 'inevitability' of cutting back on their hours of paid work or dropping out of the work force altogether. Assumptions about women's employment have long depicted part-time or casual work as the best means of accommodating their family's needs. In the context of this study it is important to emphasise how few of these women were in fact in a position even to take up the option of part time work.

I'm too frightened to even think about it. I depend on my job because that's the only source of living and I've got three dependents. My twenty year old is still out of work. She got her degree this year, but she's still unemployed and it's really hard. All three of them aren't working, so I really need the money. I couldn't give up my job.

I couldn't do it. (Give up work to care full time.) Financially there's no way I could even consider it.

Some of the women had husbands or partners who were unemployed or retired, or had low incomes or irregular employment. Others were the sole bread winner. A number spoke of the cost of caring for their elderly parent and the need to stay in the work force in order to meet those expenses.

Work was valued for other reasons. Many women mentioned the enjoyment and satisfaction they gained from their jobs. They liked working, felt they were good at their jobs and were making an important contribution through their work.

I find my working life, basically, almost is me. Because I become very involved with the folk I work for. We had a questionnaire last week asking, 'Do you think you could do better in the future?' and I really don't know that I could do anything better than I'm doing at the moment. I really feel I try and give one hundred percent.

A number of women commented on the different nature of their paid work and their unpaid work and the different needs their paid work fulfilled. For some of the women their jobs provided them with fulfilment that was not generally present in their role as carers.

In a funny sense it helps keep you sane, because it is something you are doing for yourself. You are not just doing it just for the money. Everyone that works there loves what they are doing.

The majority of our participants were unable or unwilling to give up paid work, even if their circumstances changed. They would consider other options first, and hoped they would not have to make this decision. The ambivalence they felt was clearly expressed. They would like to continue to work; they would have to continue to work. If their elderly parent needed more care, they might withdraw from the work force, but for most it would be a very difficult decision to make. There are two apparently conflicting demands and rights. On the one hand, is the obligation to care and the belief in the right of those in your care to have the greatest quality of life it is in your power to provide. On the other hand, there is your own right to income security now and in the future and your entitlement to have rewarding work. This is the perennial dilemma which confronts the carer who works.

It is an extremely difficult question. By choice I'd rather continue working and cope with whatever I have to cope with. If it meant the quality of my mother's life is depleted, well, then I'd be forced into making a decision. Nothing is more important than family and quality time with her is very important. But I'd be looking at all the options.

One woman said she would stop working if she had to, but that it would be, Against my will.

The Costs to Carers

A central argument of this study is that the cost of providing care for vulnerable elderly individuals is borne disproportionately by those who undertake the unpaid caring work. We have in large measure individualised and privatised this form of care. Families are to undertake the care. In relation to cross-generational caring, the focus of this study, it has meant that it is women who bear the greater load. Very often they do so with minimal help from others in the family or from formal services.

For the carer, the cost of their caring work is both personal and financial, both immediate and long term. In personal terms, they find themselves with little time to themselves, few holidays, little regular leisure and, for some, no leisure at all. Our participants spoke of the lack of opportunity to reflect, to do something spontaneous, to be frivolous. Their accounts set out the degree of fragmentation of time and, at times, the difficulty in concentrating on any one task.

Fragmentation of time, the fact that I'm never guaranteed of carrying through and completing anything I start in any type of career... I'm too fragmented. I start something, I start on a train of thought, and a crisis occurs, and a car accident, and I have to go and live there, carting (all my) stuff around (with me). My concentration is fragmented.

Sometimes it just overwhelms you. You can feel yourself start to slip backwards. You say, 'Oh, another bill to pay when am I going to find the time to do this'. I'm far too preoccupied. I'm thinking of too many things. I even find when I'm talking to people I'm saying two words together because I'm trying to get it all out in a rush. So there is too much going on and I don't have time to concentrate to get it all done properly to my satisfaction and they're all demanding things, all demanding. They all have to be done. Most of them have an emotional impact and whether its there and then or whether it's afterwards that it actually hits you......

Other writers have examined this aspect of the 'stretched' lives of carers. The attempt to ensure there is 'quality time' spent with the person, listening, paying attention to them means that the carer 'must be present or readily available'. It requires that they not be 'too preoccupied with their own activities'. It 'fragments time': it 'imposes a severe restriction on the carer's thoughts, let alone their activities' (Land, 1991:12). When you carry a major responsibility of care, you very often lack the power of choice not to be so involved in the time consuming and draining activities described here. And activities such as study, something for one's self but most especially an investment in one's future, are particularly problematic. The consequences in the longer term of this 'putting self last' are again both personal and financial. There are all the lost opportunities that are not easily taken up later when caring is over. And while our participants were, for the most part, ready to emphasise the gains, the feelings of satisfaction, the belief that there was no other course of action open to them, they were also conscious of time passing and the impossibility of going back and making up for what could not be contemplated in the present, while caring continued.

Other factors that involve both immediate and longer term costs to the carer include the impact on relationships with children, with a partner and with other relatives. It can also be difficult to sustain friendships. As mentioned already, the toll on health was often considerable. It represented both an immediate cost and, in some cases, an ongoing cost.

The financial costs that carers sustain are also considerable. Apart from the actual costs involved in providing care, there are the costs in income foregone and opportunities for career advancement and promotion not taken up. Time taken from work, especially a decision to cut back on hours for any extended period, was much less likely than simply a decision to 'stay put' or to accept that they were 'marking time' in their careers. Their career progression was 'put on hold' for the time being. They were prepared to continue with the work they were doing but felt unable or unwilling to put energy into furthering their careers, applying for promotion or changing jobs.

My career comes at the bottom of the list. It's something that I dearly want to do, but I can't because of all the dependants I've got around me.

For many of the women it was further education and training and upgrading their qualifications that were shelved or sacrificed. Others had deliberately chosen to change jobs and sought employment in an area where they knew they would have more flexibility and therefore be able to continue in the paid work force, while continuing to carry fairly onerous caring responsibilities.

I couldn't continue tertiary education. When degrees were being offered and we could take credits for being a RN (registered nurse), I was only 40 and I worked out where a lot of the girls around my age were starting it. I knew that I couldn't cope. It was too much of a burden for me to cope, because I've also got an 82 year old Mother-in-law living beside me. So my responsibilities were just too high.

I'd love to go on and do further training courses at night and weekends which I can't. Caring has interfered there. I've had to give up my 'Lifeline' work; I can no longer do that. Nor participate in on-going education, the workshops and things of that nature which were very helpful.

I've remained in my current position because I know the hours that I work and where I am with holidays so I felt that it was better that I keep that side of my life stable while ever I had the demands of my father going in and out of hospital and so on. So I've kept to that and I've also postponed my study because I felt that again it was taking away from time that I could be spending with him and to be really honest he resents that dreadfully. He does not encourage my university life.

I would quite like to have done some further study at this point, I just don't have the energy to do that because weekends I also usually give her one day at the weekend, whether it be going and getting her and washing her hair or doing the washing, taking her for a drive or just having her at home.

I probably should say that the prospect of finishing my PhD is at risk. And, if it is, my future employment is at risk - either casual teaching or, at the best, hanging in as a tutor.

It is important to make clear that the women in this research downplayed the consequences of their decisions in relation to their careers and were philosophical about the future. As those who had children argued, caring for young children had been a stage in their lives when they had to make choices and compromises in regard to work and family responsibilities. The same applied to this stage of their lives and now it was caring for elderly relatives that was a priority. For the present these responsibilities were uppermost, careers could be resumed later.

The likely consequences in the long term of the choices the women have made, are not clear. Some research has been done on the 'costs' of career breaks for childcare. We can speculate that similar disadvantages will accrue for these women who have made similar 'choices' in regard to care of elderly relatives. We need more specific research to determine the long term effects of these 'choices'. It is clear, nevertheless, that even those carers who remain in the work force may incur significant costs which have not been properly acknowledged. Dropping out of paid work is costly; staying in employment but foregoing salary increases or promotion and restricting one's career choices, is also costly.

Foregoing Degrees of Independence

The women in this study of carers were all in paid employment, most in full time jobs. They would thus be characterised as part time carers (a description which we suspect most of these women would have regarded with a certain degree of perplexity) who have, as a result of their continued work force participation, retained financial independence. They have not relinquished paid work to care full time. However, they have, as we state above, foregone the possibility of advancement in their jobs and so of increase in their incomes. We have used the term 'degrees of independence' to describe the loss of financial independence they have incurred compared with the salary they might otherwise have enjoyed. This might be described as, the opportunity costs associated with caring even when the carer remains in full time paid employment. Our argument is that there are degrees of independence. In this sense, and we are arguing this is an important re-conceptualisation of independence, the carers in this study have given up a claim upon a higher degree of independence and security both in the immediate future and, perhaps more importantly, in the long term, into their retirement and old age. Given the increased expectation and pressure to provide for our own retirement, these women in their later years may see their financial resources more 'stretched' than might have been the case had they not had to curtail their earning capacity as a result of their caring responsibilities.

We would add a footnote here concerning the kinds of work in which these women were typically engaged and the sectors of the work force in which they were employed. A number of the women in our study who were working in the community sector, spoke of their choice to work in a sector that is not characterised by high salaries, job security or assured and predictable career progression. It is also stressful work. There are, however, real attractions to work within this area. The preference for work in the context of small, usually local organisations which offer some flexibility, work autonomy, flatter structures and small team work, clearly held appeal although there was no extensive discussion of these concerns in our study.

It is, however, important in a discussion of foregone opportunities for advancement and career progression to acknowledge that for many women, given the nature of the work they do, these options may not exist or, at least, are likely to be very restricted. Areas of the work force, such as the community sector, have traditionally been seen to provide little in the way of career structure. We would, however, register a note of caution here. We may well need to re-examine this assumptions, an assumption which community workers themselves accept in large measure. There is some evidence that most workers in this sector do have some real options for progression in status, job security and salary. Recent exploratory research by Onyx and Maclean on career progression in the New South Wales community sector has suggested that we may need to reassess our assumptions about the lack of possibilities for career advancement in this sector (1995: 55-70). If they are right, then this adds further weight to our thesis that the cost to workers in terms of a curtailment of their immediate and future independence is very real and must be recognised. In any event the choice to work in certain areas of employment, to do 'women's work', will usually entail a cost especially in terms of the salaries these workers are able to attract.

Working Carers and Community Services

In examining the contribution made by formal services to the support of informal caring, this research provides a number of useful insights. Two particular features of the research design have been of significance. The first was the decision to seek a large number of our participants from the community sector and hospital system. This meant that many of our participants were well informed about the sector and the range of services available, something which was not so apparent in our previous research on carers (Watson and Mears 1989). The second significant feature of the research design was the wide ranging definition of a major caring responsibility which we adopted. This enabled us to highlight the very different access to services of co-resident carers and their dependent relatives compared with those carers whose elderly relatives lived in their own homes, hostels or nursing homes. There is not the room here to discuss the findings in any detail, however, we note a few of the more salient insights.

The most important of these findings is that the individuals who 'fell through the net' were the working co-resident carers.

The fact that I'm working and living in the same home, because I know Homecare's policies as far as that goes, which is, if you're working full-time then you turn to private help. I wouldn't qualify, I don't think. If my mother was living by herself, it's different. Obviously Homecare's resources are limited so I know the story there. Even mowing lawns. The fact that I'm living there, she could have someone mow the lawns for example from Home Care but I wouldn't qualify.

And, from another carer, a succinct summing up of the situation...

There is absolutely nothing for working carers.

If the elderly were living in their own homes they were generally eligible for community services, but if they were living with their carers, the carer's status as 'employed' almost always excluded both carer and 'caree' from access to some support services. In this instance it would appear that a wider definition of 'need' should be employed. For instance, to provide services to one elderly person living in her own home, with a working carer living separately, and to exclude another from access to services on the basis that she lives with her carer, a working women, seems grossly unfair.

The research also highlighted the difficulties faced by carers whose relatives refused or were very reluctant to accept the services that are available. On the one hand, the carer saw herself as responsible for the care of the elderly parent or grandparent, and felt that she knew her relative well and was in a good position to judge whether or not services were required, yet she had no control over whether or not the services were accepted.

In a number of instances, the carer had recognised that her relative was not managing well and required services and support beyond that which the carer could provide. She had organised the appropriate service, only to have the elderly person refuse it.

There appear to be a number of reasons for such behaviour. One explanation that the women we interviewed offered was that their parent was reluctant to admit she or he was not coping and might need some assistance.

No, she won't use them, she just won't. I've tried it. There are so many services. There's the day care service. She won't have anything to do with it.

There are a lot of good services out there, I just wish that she would use them, to give me a break..... She wouldn't use them, I don't need them she'd say. She doesn't think she has a problem.

They'd done all their little assessments and things, physio and OT, social work and nursing, doctors and all that stuff. So they had a really good idea of what she was capable of and what she wasn't and our problem was when she chose to disobey the professional advice.

A not uncommon situation was the refusal of the elderly person to accept any form of respite care, leaving the carer unable to take a break. Another common difficulty was the refusal on the part of the elderly person to accept any assistance with personal care, sometimes insisting the carer do the job. It is, perhaps, understandable that people resist an arrangement that would involve having 'strangers' carrying out very personal tasks and seeing one in situations which one finds embarrassing or humiliating, but it did not make the job of caring any easier. Some of the elderly relatives had gradually withdrawn from social activities, depending solely on the carer for social contact. Attempts by the carer to involve the elderly in social activities were resisted.

The problem is complex. It is not just a matter of providing appropriate, needed and suitable services and supports, vital though that be. There is a strong belief that accepting services from strangers or the state is somehow not appropriate. The expectation that we (especially women) should provide care for family members is strong; 'family' are perceived as the appropriate carers (Finch 1989; Edgar 1995).

Some carers were able to negotiate at least a partial, although not very satisfactory, acceptance of services. For others the refusal of services remained absolute even when this refusal was clearly jeopardising health and well being.

How should we deal with people who need support services to maintain their health and well being, yet refuse to accept these services? After all, most of us have been imbued throughout our lives with an ethic that places value on independence and self reliance, and would have sympathy with a refusal to have strangers undertaking intimate and personal tasks. On the other hand, what do we do when this refusal means a carer is shouldering unreasonable burdens or, indeed, if the health or safety of the elderly person is compromised? There may even be a case to be made, as one of the participants stated, for compelling some people to accept at least some level of intervention and monitoring of their health and well being to ensure that personal safety and health are not compromised even if by so doing the person's independence is undermined. In this context, questions of rights, of whose rights should be respected, are not easily answered. The rights of carer and 'caree' are not always the same and may, in fact, be antithetical.

This dilemma and resulting problems, gives heightened significance to the responses of the carers who found the most useful services were those that monitored the health and well being of the elderly relative. Knowing that someone was visiting the elderly and ensuring they were all right, contributed markedly to the carer's peace of mind.

As the provision of good quality childcare has come to be accepted as being crucially important in enabling the fuller participation of women in public life, so good quality support services for the aged in our society are also critical. Wide ranging services that are well run, well coordinated and well funded are vital both to the elderly in our society who need this support and to those who care for them. Such provision is also of importance to those who do not yet and who may never have call upon these services. For all of us they represent a security, a protection, an important counter to that anxiety about our own and our parent's future that is felt, in some measure, by everyone.

Workplaces and Change

In the same way, introducing changes within the workplace of a kind that will benefit carers, are likely to advantage all of us whether or not we have major caring responsibilities at the moment. If caring responsibilities are acknowledged, given legitimacy and not depicted as an unfortunate feature of a worker's life which must signal their status as a less serious worker, this is in all our interests. Such a transformation of workplace cultures would be a recognition both of the interactions between the various spheres in the life of an individual and the complexity of contemporary family life.

The response of their workplaces to the caring responsibilities of our participants was a major focus of this study. It is important to note that none of the workplaces included in this research had enacted formal policies which addressed the caring responsibilities of their workers. Where work environments were supportive, it was as a result either of an understanding management or of immediate colleagues or both. This kind of support and understanding was of enormous significance for the women concerned.

Understanding in the workplace

Most participants said that what they really wants was a recognition that those caring for elderly relatives had competing obligations to their families as well as to their employers, fellow workers and clients. Allied to this recognition was the hope that there would be an acknowledgment from employers and fellow workers that fulfilling family responsibilities was a legitimate activity.

I think that they should listen to women who have had this experience, just listen.

First of all by allowing women space to explain their situations, because I think there's an actual lack of understanding of the implications. Even people who make sympathetic noises don't know. ... The fact that you can be on such a tight leash and have so little capacity to re-schedule, so that if there is a staff meeting and you are expected to vote and people muck around and talk it over and don't get to the point and you have to jump up and leave.... It's just general incomprehension and also people think they understand but don't.

In a general way it's understanding, being made aware of what the actual carer is carrying. They need to be made aware of actually what responsibilities you do have, other than your work.

Understanding. And I don't mean a superficial understanding, a cursory understanding.

If they help, you're half way there. The war is won, if they meet you half way. It's not as big a hurdle. You find yourself getting anxious and nervous. 'I won't be able to make it, Mum is going to be alone five or ten minutes.' You worry. But if they do understand which they have so far, and I haven't been in a position where mum is sick and I've had to ring up and say look my mother is sick, that's why I've kept my sick days.

Understand that women have many roles and many responsibilities and support them..... Being flexible.

Just understanding from the workplace that leaving elderly and vulnerable people at home on their own for long periods until you return is bad form.

I can't think of anything except for it to be okay to not feel guilt if you are looking after a parent. For somebody in the workplace to say we understand this, we know that it is a long term thing. It may mean that your career has to take a different path, but how can we help? How can we adjust things so that you are not feeling that you are not giving it your best?

Much the same I suppose they are being forced to acknowledge the needs of child care. The government is not going to support people in nursing homes and those sort of institutions. Basically it will be individuals that are going to have to support their elderly relatives and wanting and needing to be in the work force.

Changes needed

Responses to the question of what needed to change in the workplace so that caring responsibilities could be accommodated were of a modest nature, with no-one expecting major adjustments or provisions. There was a call for much greater flexibility in the ways managers organise work and schedule employees, and for a recognition that the requirement to vary arrangements and make allowances for the pressure on employees caring for an elderly relative are usually of a minor nature.

More flexible working hours which reflect the reality of women's lives and their care responsibilities. Work is still constructed around a male nine to five worker with a wife at home. Most families don't operate like that. People don't have care needs which are pre eight am and post six pm. My mother-in-law's needs were from eight to eleven and then from three to five. Which is precisely when I wasn't around, and we couldn't get services to come at those times.

I'd certainly like to come to a more equitable arrangement whether it be shorter working hours or whether I can work (all the hours I can) when I have the opportunity, 'Can I work longer hours to work up a bank', like working flexitime... 'look you've got all these hours out of me so when I take a morning off to take her to the doctor'.

Where the variation needed is more far-reaching, then it is usually for a short period and to accommodate a temporary crisis. One woman recounted the way her own employer had behaved during the time she was burdened with particularly onerous caring responsibilities.

I think that employers could do what my employer did. They knew the situation, they knew the problems and accepted that it was going to get better, it's not going to get worse. He did improve from the stroke, so things have got easier for me and I'm coping better.

A number of women mentioned, as a priority, access to carer's leave to enable them legitimately to take time to attend to doctor's appointments or to work from home for short periods.

I would say that carers' leave is really essential. I needed carers' leave desperately during the stage when my mother-in-law was having her first stroke. Carers' leave would have made all the difference to me rather than doing what I did which was, when she was asleep, hopping onto the word processor, moving my office down to her flat, sitting by her bedside marking essays and so on. That was crazy. Carers' leave would have really made a difference.

Carers' leave. Knowing if I go there and ask her as a favour, I have to think about it ten times before I do it and feel bad enough to have to say it. I feel I would get the support, but it's a favour.

Among other provisions suggested was the idea that more flexible pensions be made available for short periods of caring when a crisis arises.

Conclusion

Like most research that examines complex areas of human experience, this research not only raises a range of issues, it also in itself constitutes several different studies and projects. For example, in presenting the findings of this research in the way we have - a lengthy and very detailed report (Watson & Mears 1995) - we have attempted to ensure that all the participants can see not just their own experience portrayed with care and attention but find reassurance that others have experienced the same things and often responded in the same way. Overwhelmingly, however, 'this research is an argument about how as a society we should respond to the fact that all individuals for some periods of their life will be dependent: it is a significant element of the human condition. Part of that argument, a major part, is about how we support those who take on a major responsibility of care for dependent individuals, whether for a short time or whether for 'the long haul'. We have examined only one area of care and by one particular group but the argument is a general one even while it must take account of the diversity within the population of carers.

'So this is social policy research rather than an ethnographic study even though it has elements of the later approach. It is concerned with how we go about creating the 'good' society and so it must also be concerned with what 'good' means. The assumption underpinning this research is that caring is not a peripheral activity for which only some have a responsibility. On the contrary, it is pivotal not only in analytical terms (Graham 1983) but because the capacity to respond to another who is dependent and has some claim upon us is critical in achieving the 'good' society. Social policy research, in this sense, is always a moral discourse as well as a more practical exploration of ways of understanding an issue and of attempting to respond to it' (Ibid, p.149).

If we accept that critical to any debate about the 'good society" is the question of how we respond to those who are dependent, then there are two main issues which we would want to emphasise in relation to care of the elderly. And here we return to the six general arguments we outlined earlier and which constitute the focus of this article. To undertake a major responsibility for the care of a dependent elderly relative (or friend), the carer needs to be supported by well 'resourced', well managed, reliable, flexible community services. Critical among those services are those that, in the case of a lighter caring demand, provide a monitoring role and, in the case of more demanding care, provide the carer with respite (both day care and longer term respite care). Such support needs to be available for all carers whether or not they are in the workforce. It is unfair and inconsistent to provide services to an elderly relative living in her own home, which might be next door or very near her carer, but deny those services to a elderly person and her carer because the relative is living with the carer and the carer has paid work. Many such carers, like many women workers, are not in particularly well paid jobs. They cannot afford to pay for many services. Some privately provided services would be completely out of their reach.

Further, it is unreasonable to require that citizens take greater responsibility for funding their own retirement but base caring policies on an assumption that people (and this is most likely to apply to women) will reduce their working hours or leave paid work altogether to care or, if they are unwilling or unable to do that, place the elderly relative in a nursing home or hostel. Many people want to provide care for their parents and grandparents but they do not feel they can place them in a home (and may in any event have difficulty in finding a suitable, affordable home near to where the carer lives) and they cannot afford to leave work or even reduce their hours. If they have access to good services, working carers are enabled to maintain both the quality of care they want to provide for their parent and to be an effective and reliable worker not unduly distracted by anxiety about the welfare of their elderly relative. In addition and most importantly, their skills and experience are retained in the paid workforce

The second major argument concerns the workplace. Workplaces must change. They cannot go on operating, as many still do, as though the typical worker is a male worker who has a wife at home taking full and sole responsibility for looking after all the family, children and elderly relatives, and running the home. Nor is it appropriate or in the interests of workers or management to deny the valuable skills and experience workers have developed in the 'private sphere'. Feminist researchers having been making this point for a long time (Cox & Leonard 1991). And Australian work environments need those kinds of skills.

This research also raises the wider question of what it is that really reduces productivity in the work place. We would suggest that what this research demonstrates is how few demands working carers actually make on their places of work and of how 'responsibly' they behave in relation to work place obligations. They do so often at considerable cost to themselves.

This prompts us to make two concluding comments, one that flows directly from the study and the other a more general reflection about work environments and management. The first comment is that the modest suggestions for reform of work environments that our participants made could be implemented without great expense or inconvenience and that what is required on the part of management is a willingness to recognise the gains they would make in instituting such reforms. Secondly, what this research prompts is a questioning of what are really the 'time wasters' in most work places. We did not, of course, set out to explore this question directly in this study and cannot claim that the research provides direct evidence of waste and poor management in particular work places. Nevertheless, as our participants talked about their work environments and some described the lack of support and even the vindictive behaviour of one or two 'bosses', it was hard to avoid the question of how it is that working carers can be defined as a 'problem' while such appalling behaviour seemingly goes unnoticed or, at least, unremarked. As researchers and workers ourselves, we were prompted to reflect on the fact that individuals seem remarkably tolerant of the lack of people skills on the part of some managers. This would suggest the need for much greater honesty about what takes from productivity in the world of paid work. We are much less critical about badly chaired or unnecessary meetings or the pressure to protect egos that result in poor decisions and similar bad practices than we should be. The lack of a readiness to apply truly honest analysis to what goes on in most work places disadvantages carers but it is a cost to us all.

What is clear in this research is that responding to the needs of carers can result in changes that are of advantage to all of us. Reform of work places to acknowledge and legitimate caring responsibilities will serve us all, regardless of whether or not we are undertaking any caring responsibilities at the moment. In the same way, adequate government funding of the community services sector not only supports present carers, it provides reassurance and security both to potential carers and the potential elderly and that, after all includes everyone of us.

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