Aged care and the business of gift


Carer and elderly woman smile at each otherThe low pay of aged care workers has recently aroused a wide response. The care of elderly relatives after they are incapable of caring for themselves at home touches all Australians at some time in their lives, whether contemplating our own future or working with relatives. The discussion is also of broader importance because it invites us to question how we think of the way we care for the aged and do business.

In our care of the aged, not only their health and security are at stake but also their self-respect and dignity. The carers who help them with their private bodily functions are called on to show deep respect and gentleness. It is impossible not to sympathise with the argument that the high skills this requires should be better remunerated.

The way this argument is formulated, however, is tailored to an audience that rewards measurable skills but disregards the intangible qualities that underpin respect. Respectful care implies a benevolent relationship. Cold or hostile nurses may be skillful, but the way they use their skills will be experienced as invasive and disrespectful. Good care is experienced as a gift, and gifts must express love as well as skill. In the serious business of business and remuneration, however, love is the skill that dares not speak its name.

That is anomalous because companies, even banks and manufacturing companies, rely on the quality of relationships between the people who work in them and also on the relationships between members of staff and suppliers, customers and the wider public. They rely also on the quality of the relationships of workers with things — on their respect for processes, for tools, and for their environment. In enterprises that offer personal service, the quality of the relationships will be central.

In companies, as elsewhere, good relationships cannot be purely contractual. They entail mutual gift. People chip in for one another, work beyond the call of duty when required, are given occasional time off, give themselves more fully to clients than required, take time to sit with workmates in distress. Managers try to keep people employed even when this causes short term loss to the business. The lubricants of any good business are also gifts: a smile, a kindly word, encouragement, flexibility.

Like relationships, companies can never be fully codified in contracts that state what one party owes to the other and make their performance measurable by empirical criteria. Just contracts are indispensable. But if a business sees itself entirely or fundamentally in terms of what is owed, its long term future is eroded. The relationships on which the shared wisdom, flexibility and reputation of the company depend will be neutered because the central elements of gift and love are disregarded.

Company advertising makes evident the contradiction between the qualities that sustain a company and those that are conventionally regarded as determinative. Finance companies that regard employees as expendable depict them in advertisements in a friendly relationship with clients that will take them beyond the call of duty. Gift is advertised in order to make money; to save money gift is discounted.

Thus there is a systematic lack of connection between the qualities that are central to any enterprise and the empirically verifiable standards by which the health of the company is judged.

To recognise and remedy this disconnection would need a change of vision in society. A more realistic perspective would place less emphasis on competition and more on cooperation. It would not measure productivity simply by measurable output per worker but by the contribution each makes to the intangible network of relationships that constitute a company. It would value the enterprise by the quality of its culture and not simply by its short term profitability.

Some modest developments in thinking about policy are encouraging. The United Nations ranking of nations by the human development index in preference to the cruder measurement by GDP calls to mind the importance of other than financial relationships.

The support for the living wage instead of the minimum wage as a basis for remuneration also brings us back to gift. The living wage, which guarantees a decent standard of living and the capacity to plan for the future for oneself and one's dependents, recognises the importance of relationships in remuneration. The minimum wage considers workers only as isolated individuals.

Unsurprisingly, companies that subscribe to the living wage report benefits to employers, employees and the community. They relate to one another through the grammar of gift.

There is nothing surprising in these suggestions. They are simply common sense in any human undertaking. The surprise is that they are so systematically neglected or automatically rejected in business talk. 

Andrew Hamilton headshotAndrew Hamilton is consulting editor of Eureka Street.

Carer image from Shutterstock

Topic tags: Andrew Hamilton, aged care



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Existing comments

I think you have cogently and incisively pointed to the materialistic malaise at the dark heart of our contemporary society, Andrew. Not only that but you have pointed out the solution. Infusing modern life with quality and meaning in relationships is going against the contemporary grain. What I really admire is that you, as a Catholic cleric, did not push a prepackaged "religious" solution. Religion is a bit like yeast in bread. Sometimes it's more like the famed concrete boots Chicago gangsters once dumped people into the lake wearing. One of these days, when I am down in Melbourne, I must come to wherever you are preaching that Sunday. It won't be obvious or heavy handed like some clerics I know, I'm sure. You're great.

Edward F | 08 May 2013  

Thanks Andy - articulate and perceptive. And something else as well: love-ly.

Pam | 08 May 2013  

Thank you Andrew. Relationships form the fabric of society and are the means ,the nuts and bolts of business ,I would think.Trust is something we all rely on to function as citizens and trust enables us experience love. It is therefore a sign of greed when profit is paramount,human life is first seen as an economic unit and care is seen as a business opportunity. Regulations and laws have not protected the frail and elderly from profit driven business where people,both staff and residents, are commodified, itemised as a product of efficiency, and everything is streamlined to ensure profit remains high. We in western market driven societies have been seduced by extravagance,and aged care is considered just a huge hole in the budget.While the frail and elderly are seen as not contributing to society ,they are not valuable, and deemed useless. It is the heart felt connections and deep respect for all humanity nurses and carers have which keeps society's pulse and where health is truly measured.Cheap lip speak of business fails to see how much everything relies on respect and trust.The elderly reflect our values. Social welfare,not profit, must always be the agenda.'Good will' and reputation must be remembered as a basic tool of good business and supported by strong governance.Until profits are capped business will continue to cut costs, good staff will burn out and care will be rushed, undignified,dehumanised.

Catherine | 09 May 2013  

Thank you for this clear-eyed, compassionate and true reading of the pulse rate and heartbeat of the state of a society's essential well being. How tellingly you perceive and articulate these core issues, which are too often sidelined without protest, or discounted without any moral resistance from a community seemingly anaesthetised to the implications of the erosion of fundamental humanitarian values. I apologise for expressing myself so clumsily; your message goes to the heart of its matter and strikes a profoundly responsive chord.

Jena Woodhouse | 09 May 2013  

Those who work in caring for the elderly or care foe them at home have to pay the same for petrol, groceries,lighting,gas and electricity etc. Therefore their wages or financial support should recognize this. Unfortunately the days of being charitable and caring for little or no reward have long since passed. Rosemary Keenan WA

Rosemary Keenan | 09 May 2013  

Maybe the example should first all come from both the major political parties.

nick agocs | 09 May 2013  

Unlike earlier commenters, I have trouble understanding just what point(s) Andrew is making. Profit, of itself, is not a dirty word. Every business, public, private, or community based, has to make a profit in the sense that its income has to cover all its costs including depreciation and the cost of capital or it will soon go out of business. The term 'not-for-profit' is a misnomer because even NPVs must make a profit. The difference is that NPVs have no shareholders and therefore no requirement to distribute those profits. Making a profit is a pre-requisite, but not the purpose of being in business. Every business, public, private or community, is in business to meet a need. And every business that hopes to prosper knows that the relations that it builds with suppliers, customers, employees, and community are critical to its success. Mutual respect, commitment, and 'going the extra mile', are not traits that are peculiar to the community or NPV sector. Nor should low or unjust pay and conditions be a characteristic of the, largely female, caring work wherever it is carried out - in public, private, or community sectors.

Ginger Meggs | 09 May 2013  

" The term 'not-for-profit' is a misnomer because even NPVs must make a profit. The difference is that NPVs have no shareholders and therefore no requirement to distribute those profits." It's actually called a surplus, Ginger Meggs, and, in a not-for-profit (I do prefer the old "charity", especially as we seem to be departing from any concept of it, whether moral or practical, in modern life.), either goes back into the enterprise or some other social work within the organisation. I, personally, find that highly praiseworthy.

Edward F | 12 May 2013  

Couldn't agree more Edward F - your 'surplus', my 'profit' are the same thing. Neither 'profit' nor 'surplus' are four-letter words. The point I was making was that 'NFPs' or, if you prefer 'charities' or 'community enterprises', have to make a profit/surplus - that is, their income has to cover all their costs or else they fail. And as you point out, that profit/surplus then gets ploughed back into the business/charity/enterprise. We're in furious agreement, aren't we?

Ginger Meggs | 13 May 2013  

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