Offering Care

Dr Brian Sloan

I’ve spent almost six years of my life, too long perhaps, thinking about the following scenario.  An elderly person is finding it difficult to look after himself.  A family member, friend or neighbour therefore decides to help with things such as shopping and cooking.  In time the elderly person becomes increasingly dependent on his informal carer, who helps him with increasingly personal tasks.  The carer ultimately has to change her working hours in order to look after the elderly person.  Indeed, one estimate suggests that such carers lose an average of £11,000 per year as a result of their caring responsibilities.[1]  The carer also suffers health problems, as many carers do.[2]  The elderly care recipient realises this, and might make some sort of indication that the carer will receive something out of his estate in return for her efforts.  But when the care recipient dies, it becomes clear that the carer has not been left anything in the care recipient’s will.  This could be as a result of a deliberate decision on the part of the care recipient, or it could be accidental.

This scenario is not an unusual one.  The 2011 census recorded 5.8 million informal carers for elderly and disabled people in England and Wales,[3] a significant increase from the 5.2 million recorded just ten years before.[4]  It has been said that we are facing a ‘ticking demographic timebomb’,[5] as more and more people enjoy the blessing of a long life coupled with the burden of declining function.  Informal carers are vital in this context, as state resources are stretched and some older people resist help from those who do have a duty to intervene and are remunerated on that basis.

The particular question I asked in my research was whether the informal carer in our scenario should have a claim against the care recipient’s estate when he dies.  I concluded, maybe unsatisfactorily, that in some cases the answer is ‘yes’, particularly where the care recipient has indicated that the carer will receive something.  To slip into legal terminology, it may be unconscionable for the care recipient to make such a promise and then fail to follow it through by including the carer in a valid and effective will, though of course there are other relevant considerations such as the needs of other people who might have a legitimate claim to the estate.  For completeness, I should say that English Law does share my view to an extent, and it allows a carer to take a slice out of the estate in some circumstances.

When the Chaplain asked me to give this sermon with the title ‘offering care’, having somehow made his way through my recent book,[6] it gave me an opportunity to reflect on my work from a Christian perspective.  I also reflected on what sort of Christian perspective I could possibly offer in any case, as a cradle Catholic who attends Latin Mass, is committed to pluralism, teaches Family Law and votes Liberal Democrat.  But maybe that’s another sermon for another day!

I therefore set about trying to work out whether my justification for private rewards or even compensation for long-suffering informal carers had any support in Christian theology.  I decided to start with the good Samaritan,[7] even if at least one fellow Fellow thought this a rather too obvious place to start.  The Samaritan, like our informal carer, had no obvious legal duty to intervene in order to help his eventual care recipient.  He could simply have passed by on the other side, as those who could have been more readily expected to intervene did.  The Samaritan not only intervened at great personal risk given the dangers of the road to Jericho and the animosity between Jews and Samaritans at the time, but he also ended up significantly out of pocket.  We could again analogise with our modern-day informal carer in those respects.  The actions of both the Samaritan and our carer could barely contrast more with Cain’s killing Abel and then asking God the utterly contemptuous question whether he was his own brother’s ‘keeper’ at all.[8]

In spite of those factual similarities between the story of the Samaritan and mine of the carer, however, the parable doesn’t support my argument very much.  The Samaritan does not seem to receive any worldly compensation for his efforts, even if the legal scholar Jeroen Kortmann has argued that he should have done.[9]  Anyway, the parable is more about for whom we should care than whether we should provide care in the first place or in what sense we should be rewarded for doing so, and it’s told in response to a lawyer who (typically, you might think) wants to know the limits of his liability.  The ‘offer to care’, then, is something implicitly expected from followers of Christ.  Jesus tells his audience that they should follow the Samaritan’s example, and that if they do so they will ‘live’ or, to use the questioner’s words, will ‘inherit eternal life’.  This message is reiterated in the parable of the sheep and the goats,[10] when Jesus seems to tell us – and I’m trying to sidestep theological controversies over faith and works here! – that if we perform a variety of caring tasks for the ‘least of’ human beings, we will gain ‘eternal life’.  But even if there is to be some reward for the carer in Jesus’ teachings, it doesn’t necessarily come in the form of hard cash or other property.  In fact,  if our carer arguably makes a song and dance about her caring by claiming against the care recipient’s estate, there is a risk that she will have received her ‘reward in full’ on earth rather than being rewarded by God in heaven.[11]  If there’s a chance that those who follow Jesus and don’t die as a result have some explaining to do, as mentioned by the Chaplain last week, then that could be even more true for those who are able to claim a reward for ostensibly loving and altruistic endeavours.  Jesus admonished his contemporaries for focussing on earthly matters,[12] and perhaps I have fallen into this trap on the issue of rewards or compensation for carers.

I wonder, however, whether the concept of ‘heavenly reward’ might provide something of an illegitimate cop-out for the rest of us, and possibly even for the care recipient.  If the carer is securing her place in the Kingdom of Heaven through her efforts, the argument might go, why should we worry if she does suffer disadvantages while performing God’s work on earth?  Indeed, by virtue of the controversial allegorical interpretation of the parable of the good Samaritan taken by scholars such as St Augustine, our informal carer tending to the needs of the care recipient could be identified with Jesus Himself tending to the needs of humanity.[13]  But surely that is simply too easy, and if we saw suffering for God as a universal good we would never try to stop the persecution of Christians, for example.  We would be failing in our own Christian duty.

Writing from a completely different perspective, the American feminist writer Martha Fineman claims that we in wider society are ‘free-riders’, appropriating the unpaid labour of the informal carer for our own ends, and that we all owe a social debt to such carers.[14]  She also argues that society tends to ignore the fact that the choice to care, or the ‘offer’ of care in the language of today’s sermon title, ‘occurs within the constraints of social conditions, including history and tradition’.  While it might seem surprising, I think there’s a link between Fineman’s concerns and the notion of ‘heavenly reward’.  If we see the offer and performance of informal care solely as something that is expected, a part of life, unseen, or a duty imposed by God, we risk continuing to allow the burdens of care to fall disproportionately on those kind enough to provide it, while the rest of us (rather like the Levite and the Priest, as it happens), pass by and get on with our lives. 

If, however, we identify value inherent in the carer’s help for the care recipient, then surely it follows logically that there is value in our helping the carer.  It may be significant that, immediately before the parable of the good Samaritan in Luke’s Gospel, Jesus sends out the seventy-two (or the seventy) and says that those who do His work deserve their pay, i.e. that they deserve the hospitality and support of the people whom they are helping through Him.[15]  Coming back to Fineman, moreover, informal carers are helping all of us.   

In the end, we might disagree about how best to address the difficulties faced by the informal carer, and even if I’ve convinced you that law and/or society should do something, it doesn’t necessarily follow from a Christian point of view that we should allow a claim on the care recipient’s estate by the carer.  Fineman, for example, advocates extremely large-scale structural changes in society in order to improve the position of carers.  You might think it is simply too mercenary and inconsistent with the very nature of altruism to suggest that a carer should have a claim against the care recipient’s estate, particularly since the care recipient is himself vulnerable.  Perhaps I’m just thinking too much like a secular lawyer in doing so.  But as a Care Bill passes through Parliament and attempts to shape the landscape of care for decades to come, informal carers and those for whom they care should never be far from our thoughts and prayers.

 

[1] House of Commons Work and Pensions Committee, Valuing and Supporting Carers (2007–08, HC 485), [102].

[2] Department of Health, Carers at the Heart of 21stCentury Families and Communities: ‘A Caring System on your Side. A Life of your Own’ (2008), ch 5.

[3] Office for National Statistics, ‘More than 1 in 10 Providing Unpaid Care as Numbers Rise to 5.8 Million’ (2013).

[4] Office for National Statistics, ‘Focus on Health’ (2004), 10.

[5] Local Government Association, ‘LGA Response¾“Which?” Investigation into Home Care’ (16 March 2012) <www.local.gov.uk/web/guest/media-centre/-/journal_content/56/10171/3375393/NEWS-TEMPLATE>, quoting the chairman of the Local Government Association’s Community Wellbeing Board, Councillor David Rogers.

[6] B Sloan, Informal Carers and Private Law (Oxford, 2013).

[7] Luke 10:25-37.

[8] Genesis 4:8-10.

[9] J Kortmann, Altruism and Private Law: Liability for Nonfeasance and Negotiorum Gestio (Oxford, 2005).

[10] Matthew 25:31-46.

[11] Matthew 6:1-4.

[12] See, e.g., Matthew 6:19-21.

[13] See, e.g., GB Caird, The Language and Imagery of the Bible (London, 1980), 165.

[14] MA Fineman, The Autonomy Myth: A Theory of Dependency (New York, 2004).

[15] Luke 10:1-24.