Care Across Distance

World-wide migration has an unsettling effect on social structures, especially on aging populations and eldercare. This volume investigates how taken-for-granted roles are challenged, intergenerational relationships transformed, economic ties recalibrated, technological innovations utilized, and spiritual relations pursued and desired, and asks what it means to care at a distance and to age abroad. What it does show is that trans-nationalization of care produces unprecedented convergences of people, objects and spaces that challenge our assumptions about the who, how, and where of care.

World-wide migration has an unsettling effect on social structures, especially on aging populations and eldercare. This volume investigates how taken-for-granted roles are challenged, intergenerational relationships transformed, economic ties recalibrated, technological innovations utilized, and spiritual relations pursued and desired, and asks what it means to care at a distance and to age abroad. What it does show is that trans-nationalization of care produces unprecedented convergences of people, objects and spaces that challenge our assumptions about the who, how, and where of care.

Psychotherapy across distance and time, from Freud’s treatments by mail to crisis hotlines, radio call-ins, chatbots, and Zoom sessions. Therapy has long understood itself as taking place in a room, with two (or more) people engaged in person-to-person conversation. And yet, starting with Freud’s treatments by mail, psychotherapy has operated through multiple communication technologies and media. These have included advice columns, radio broadcasts, crisis hotlines, video, personal computers, and mobile phones; the therapists (broadly defined) can be professional or untrained, strangers or chatbots. In The Distance Cure, Hannah Zeavin proposes a reconfiguration of the traditional therapeutic dyad of therapist and patient as a triad: therapist, patient, and communication technology. Zeavin tracks the history of teletherapy (understood as a therapeutic interaction over distance) and its metamorphosis from a model of cure to one of contingent help. She describes its initial use in ongoing care, its role in crisis intervention and symptom management, and our pandemic-mandated reliance on regular Zoom sessions. Her account of the “distanced intimacy” of the therapeutic relationship offers a powerful rejoinder to the notion that contact across distance (or screens) is always less useful, or useless, to the person seeking therapeutic treatment or connection. At the same time, these modes of care can quickly become a backdoor for surveillance and disrupt ethical standards important to the therapeutic relationship. The history of the conventional therapeutic scenario cannot be told in isolation from its shadow form, teletherapy. Therapy, Zeavin tells us, was never just a “talking cure”; it has always been a communication cure.

Often the switch to telecare--technology used to help caretakers provide treatment to their patients off-site--is portrayed as either a nightmare scenario or a much needed panacea for all our healthcare woes. This widely researched study probes what happens when technologies are used to provide healthcare at a distance. Drawing on ethnographic studies of both patients and nurses involved in telecare, Jeannette Pols demonstrates that instead of resulting in less intensive care for patients, there is instead a staggering rise in the frequency of contact between nursing staff and their patients. Care at a Distance takes the theoretical framework of telecare and provides hard data about these innovative care practices, while producing an accurate portrayal of the pros and cons of telecare.

This is an ethnographic account of the transnational caregiving experiences and practices of Australian migrants and refugees, caring for their elderly parents in Europe, the Middle East, Asia and New Zealand. It describes how people respond to unprecedented mobility (both voluntary and forced), globalized job markets and an ageing population.

The rapid growth of home health care has raised many unsolved issues and will have consequences that are far too broad for any one group to analyze in their entirety. Yet a major influence on the safety, quality, and effectiveness of home health care will be the set of issues encompassed by the field of human factors research-the discipline of applying what is known about human capabilities and limitations to the design of products, processes, systems, and work environments. To address these challenges, the National Research Council began a multidisciplinary study to examine a diverse range of behavioral and human factors issues resulting from the increasing migration of medical devices, technologies, and care practices into the home. Its goal is to lay the groundwork for a thorough integration of human factors research with the design and implementation of home health care devices, technologies, and practices. On October 1 and 2, 2009, a group of human factors and other experts met to consider a diverse range of behavioral and human factors issues associated with the increasing migration of medical devices, technologies, and care practices into the home. This book is a summary of that workshop, representing the culmination of the first phase of the study.

Family caregiving affects millions of Americans every day, in all walks of life. At least 17.7 million individuals in the United States are caregivers of an older adult with a health or functional limitation. The nation's family caregivers provide the lion's share of long-term care for our older adult population. They are also central to older adults' access to and receipt of health care and community-based social services. Yet the need to recognize and support caregivers is among the least appreciated challenges facing the aging U.S. population. Families Caring for an Aging America examines the prevalence and nature of family caregiving of older adults and the available evidence on the effectiveness of programs, supports, and other interventions designed to support family caregivers. This report also assesses and recommends policies to address the needs of family caregivers and to minimize the barriers that they encounter in trying to meet the needs of older adults.

Relatively affluent individuals from various corners of the globe are increasingly choosing to migrate, spurred on by the promise of a better and more fulfilling way of life within their destination. Despite its increasing scale, migration academics have yet to consolidate and establish lifestyle migration as a subfield of theoretical enquiry, until now. This volume offers a dynamic and holistic analysis of contemporary lifestyle migrations, exploring the expectations and aspirations which inform and drive migration alongside the realities of life within the destination. It also recognizes the structural conditions (and constraints) which frame lifestyle migration, laying the groundwork for further intellectual enquiry. Through rich empirical case studies this volume addresses this important and increasingly common form of migration in a manner that will interest scholars of mobility, migration, lifestyle and culture across the social sciences.

Global inequalities make it difficult for parents in developing nations to provide for their children. Some determine that migration in search of higher wages is their only hope. Many studies have looked at how migration transforms the child–parent relationship. But what happens to other generational relationships when mothers migrate? Care Across Generations takes a close look at grandmother care in Nicaraguan transnational families, examining both the structural and gendered inequalities that motivate migration and caregiving as well as the cultural values that sustain intergenerational care. Kristin E. Yarris broadens the transnational migrant story beyond the parent–child relationship, situating care across generations and embedded within the kin networks in sending countries. Rather than casting the consequences of women's migration in migrant sending countries solely in terms of a "care deficit," Yarris shows how intergenerational reconfigurations of care serve as a resource for the wellbeing of children and other family members who stay behind after transnational migration. Moving our perspective across borders and over generations, Care Across Generations shows the social and moral value of intergenerational care for contemporary transnational families.