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  • Final Commentary for CJA Supplemental Issue:The Hidden Costs of Care
  • Janet Fast, Jacquie Eales, and Norah Keating

In early 2008, the CJA published a special issue (CJA 26 Supplement 1, 2007) based on the Hidden Costs / Invisible Contributions (HCIC) research program, funded under the Social Sciences and Humanities Research Council (SSHRC) Major Collaborative Research Initiatives (MCRI). The overall purpose of the HCIC program is to create a deeper understanding of the place of older adults and adults with disabilities. In Canada, these groups of adults are often characterized as dependent—costly because of the care they require and because of their lack of societal contributions. Throughout this program, we have interrogated these notions, placing costs and contributions in social, political, historical, and cultural contexts that make explicit hidden assumptions regarding the "dependencies" of older adults and adults with disabilities.

An explicit objective of the MCRI funding program is to "promote broadly based collaborative research as the central mode of research activity—both within and among disciplines, departments, and faculties as well as with other sciences at universities across the country and abroad" (SSHRC, 2007). Members of the HCIC team were chosen because of both their disciplinary expertise and their commitment to active collaboration. We have worked face to face, flown across continents to meet together, and used various communication technologies to achieve this goal. Our student and new professional members have brought new meaning to collaboration, through their workshops and through the articulation of the process itself in presentations and publications.

We believe that the cross-disciplinary mix of HCIC scholars has added greatly to the knowledge-creation exercise in which we have been engaged. Historians on the team have reminded us of the evolution of our contemporary policies and programs. Scholars in English literature have illustrated powerful and pervasive cultural beliefs about families and care. Family gerontologists have challenged our notion that we can understand "family" caregiving by focusing on one individual, with no reference to the families in which that individual is embedded.

Members of the HCIC team who have contributed to the supplement represent a broad set of disciplines in the social sciences, health sciences, and humanities. These include social/family gerontology, human ecology, elder law, literature, nursing, disability studies, social work, history, gender studies, health ethics, and health services administration. Authors come from academic institutions across Canada, the United States, and the United Kingdom. Such interdisciplinary inquiry leads to a broader understanding of critical social issues by uncovering the underlying values, assumptions, and contexts within which both the costs and rewards of care are studied.

Integration of findings across disciplines and across projects is an important objective of both the HCIC research team and MCRI programs in general. The papers in the supplement represent one such integration exercise. They share a common focus on care, the consequences of care, and approaches to supporting caregivers. They represent findings from multiple projects and from multiple disciplinary perspectives. As the French novelist (1871–1922) Marcel Proust (1948) said, "The real voyage of discovery consists not in seeking new landscapes but in having new eyes". These papers reflect our attempt to see care with new eyes.

When the supplement is examined as a body of work, several themes emerge: that policy values underlie approaches to addressing social problems; that costs shift when public policy values change; that care is provided by a complex, shifting network of people; and that rewards and challenges co-exist in caregiving careers. In the first three papers, authors examine public policy through multiple lenses. They bring new insights, refocusing the debate on the core values of community, caring, and connectedness rather than primarily on cost containment. Keefe and Rajnovich illustrate how different countries and communities balance these social values. They show how some countries have similar programs to support family/ friend caregivers, yet differ in their underlying objectives and program implementation processes. They raise questions about the responsibilities of the [End Page 3] state and family for providing care, the commodification of the care relationship, and the potentially conflicting values of individual choice for care receivers and reduced choice for caregivers. They highlight the importance of social values in defining what problems we seek...

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