Contested Professionalism Payments for Care and the Quality of Home Care

Abstract

In the recent past, policy makers have emphasized the benefits and positive aspects of direct payments for care of frail elderly people. In this article, the authors present the theoretical framework of “struggling logics of home care,” by means of which they explore the underlying logics of the introduction of payments for care: market, family, and state. More specifically, the authors show the strengths and weaknesses of a fourth logic—professionalism—and expound how this logic is submitted to marketized and familialized payments for care. The authors conclude that there are indeed some positive aspects of the trend toward payments for care. However, (female) professional home care workers benefit hardly at all. On the long term, this could also erode the quality of care provided to recipients.