Introduction

The determinants of informal care and its sustainability over time represent an important research question in the ageing society of today given that population ageing has become an urgent topic on the agenda of most West-European countries (Ferring, 2010). As recent studies have shown, the challenge will be to meet the increasing demand for elderly care with a shrinking health budget (Spillman and Pezzin, 2000; Rodrigues and Schmidt, 2010; see also Chapter Twelve). Against this background, the family is increasingly important in providing the necessary – and less cost-intensive – care if the sustainability of public financing is challenged.

When highlighting the importance of the family one has to underline that women are traditionally charged with elderly care within the family. Over the last three decades, lower fertility and higher participation by women in the labour force, marital instability and geographical mobility have reshaped family interactions and the availability of adult children to take on caring responsibilities. Despite these social and demographic changes, there is still strong evidence in the literature that the family remains the first source of elderly care with the specification that wives and adult daughters are no longer the sole care providers (Di Rosa et al, 2011).

In this chapter, a definition of ‘family care for older adults’ will be proposed, and specific indicators that describe this particular family situation will be derived and discussed. The present author takes the – certainly consensual – position that an analysis of the phenomenon and its major characteristics as well as the development of meaningful social policies will be possible only on the basis of a sound definition. Conceptualising care for elderly persons in the family will thus avoid misestimation of the care situations and needs associated with dependent elderly persons in a family. As a first step, a historical perspective will be given by describing some different meanings underlying the care concept.

Family care in the perspectives of medical science and social policy

In the traditional family model, looking after the children, the sick and the elderly members of the family was not considered as a separate ‘care’ activity but as an integrative and ‘natural’ part of the woman's duty. The term ‘care’ itself originates in part from the medical world referring to the professional activities directed to frail or dependent people that were usually performed under medical supervision.