This chapter looks at issues of concern to those working in domiciliary care in Australia. As the Australian population continues to age, older people and their carers will need more formal support and care in their own homes. At present this work is done primarily by home care workers. This sector of the workforce, already growing rapidly, will continue to grow. Recent reports have expressed concern about the low wages paid to these workers, the lack of career structure, the lack of entry qualifications and the paucity of training opportunities and the effect this could have on the recruitment of workers and the quality of care provided in the future. The social and political context is similar to Britain, where the delivery of social care is becoming more and more fragmented and privatised. As this care takes place in the privacy of people's homes, hidden from the public gaze, we do not generally observe care workers going about their daily work. This chapter focuses on these paid care workers and provides some insight into how they provide community care that aims to maintain and enhance community and social connectedness for the older people they are caring for.

Introduction

Historically, in Australia there has been a very heavy reliance on family care for frail older people and those with disabilities, with residential care seen as a last resort. From the 1970s, after much lobbying from groups representing older people and carers, a number of government inquiries were held. The reports from these inquiries recommended radical changes to this system. The most influential was the aptly named report In a Home or at Home (McLeay, 1982). This report recommended a range of policies to minimise ‘inappropriate’ admission to residential care, and to support family carers and older people to live in the community for as long as possible.

In 1985, under the Hawke Labor government, the beginnings of a serious attempt to set up a community care infrastructure came about with the introduction and implementation of the Home and Community Care (HACC) Programme. The main aim of the programme was to keep frail older people living in the community, building up community services to support them and, significantly, their carers in the community.