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Boundaries and Connections Between Formal and Informal Caregivers

Published online by Cambridge University Press:  31 March 2010

Catherine Ward-Griffin
Catherine Ward-Griffin*
Affiliation:
University of Western Ontario
*
Requests, etc., Dr. Catherine Ward-Griffin, School of Nursing, Faculty of Health Science, University of Western Ontario, London, Ontario, Canada N6A 5C1. E-mail: [email protected]
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Abstract

Although the experiences of formal and informal caregiving have been discussed and debated in the literature, more is assumed than is actually known (McDaniel & Gee, 1993). This qualitative study explored both informal and formal caregivers' perceptions of their own caregiving and the views of each other's caregiving. Information was collected through the use of in-depth interviews with 23 family caregivers and 15 nurses providing home care to older persons. Analysis of interview transcripts and field notes reveals that both informal and formal caregivers engage in all facets of caring work – physical, intellectual and emotional care – but that they carry out this work in varying degrees, and for different reasons. The reasons given for these differences, namely the nurses' professional knowledge and higher status designation, are key elements that define the boundaries between professional and family caregiving. However, it is apparent that, over time, this demarcation diminishes as family caregivers' knowledge and skill match those of health professionals. Study findings point to implications for future theory development and research.

Résumé

Bien que le secteur des soins formels et informels ait été examiné sous plusieurs angles et qu'on ait largement publié à son sujet, on nage encore plus dans l'hypothèse que dans la pleine connaissance (McDaniel & Gee, 1993). Cette étude qualitative explore les perspectives des soignants formels et informels, leurs propres prestations et leur vision de celle des autres soignants. Les données ont été recueillies par le biais d'entrevues en profondeur auprès de 23 soignants familiaux et de 15 infirmières assurant des soins à domicile aux aîné(e)s. L'analyse des transcriptions des entrevues et des notes révèle que les soignants formels comme informels s'engagent dans toutes les facettes de soins, physiques, intellectuelles et émotives, mais qu'ils exécutent ces tâches à divers degrés et pour différentes raisons. Les raisons qui justifient ces différences, notamment l'expertise professionnelle des infirmières et le degré élevé du statut, constituent des éléments clés qui définissent les limites entre les soins accordés par des professionnels et ceux qui sont donnés par les familles. Cependant, il ressort clairement qu'avec le temps, cette démarcation s'atténue au fur et à mesure que les soignants des familles acquièrent des connaissances et parviennent à rivaliser avec les soignants professionnels. Les résultats de l'étude permettent de faire ressortir des éléments de théories à établir et de recherches à effectuer.

Keywords

Formal CaregivingInformal CaregivingHome CareLong-Term CareOlder PersonsNursingSoins formelssoins informelssoins à domicilesoins de longue duréeaîné(e)ssoins infirmiers
Type
Articles
Information
Canadian Journal on Aging / La Revue canadienne du vieillissement , Volume 21 , Issue 2 , Summer/Été 2002 , pp. 205 - 216
Copyright
Copyright © Canadian Association on Gerontology 2002

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Footnotes

*This study was made possible by the following funding resources: Health Canada (NHRDP) Research Training Award (#6606-5125-47), Canadian Nurses' Foundation Research Grant, and the Helen Glass Research Award (Sigma Theta Tau Nursing Society, Iota Omicron Chapter). The author wishes to gratefully acknowledge Drs. Victor Marshall, Pat McKeever, and Ann Robertson for their guidance and advice throughout the research project, and to thank Dr. Tony Vandervoort and three anonymous reviewers for their helpful comments on earlier drafts of this paper.

References

Anderson, J., & Elfert, H. (1989). Managing chronic illness in the family: Women as caregivers. Journal of Advanced Nursing, 14, 735–745.CrossRefGoogle Scholar
Arber, S., & Ginn, J. (1990). Connecting gender & ageing: A sociological approach. Buckingham, England: Open University Press.Google Scholar
Aronson, J. (1992). Women's sense of responsibility for the care of old people: “But who else is going to do it?” Gender and Society, 6(1), 175–194.CrossRefGoogle Scholar
Aronson, J., & Neysmith, S. (1996). “You're not just in there to do the work”. Depersonalizing policies and exploitation of home care worker's labour. Gender & Society, 10(1), 59–77.CrossRefGoogle Scholar
Bartoldus, E., Gillery, B., & Struges, P.J. (1989). Job-related stress and coping among home-care workers with elderly people. Health and Social Work, 14(3), 204–210.CrossRefGoogle ScholarPubMed
Boland, D., & Sims, S. (1996). Family care giving at home as a solitary journey. Image: Journal of Nursing Scholarship, 28(1), 55–58.Google ScholarPubMed
Bowers, B. (1988). Family perceptions of care in a nursing home. The Gerontologist, 23(3), 361–368.CrossRefGoogle Scholar
Callahan, D. (1988). Families as caregivers: the limits of morality. Archives of Physical Medical Rehabilitation, 69, 323–328.Google ScholarPubMed
Dansky, K., Brannon, D., & Wangsness, S. (1994). Human resources management practices and patient satisfaction in home health care. Home Health care Services Quarterly, 15(1), 43–56.CrossRefGoogle ScholarPubMed
Devault, M. (1987). Doing housework: Feeding and family life. In Gerstel, N. & Gross, H. E. (Eds.), Families and work (pp. 178–191). Philadelphia: Temple University Press.Google Scholar
Duncan, M., & Morgan, D. (1994). Sharing the caring: Family caregiver's views of their relationship with nursing home staff. The Gerontologist, 34(2), 235–244.CrossRefGoogle ScholarPubMed
Fischer, L.R., & Eustis, N.N. (1994). Care at home: Family caregivers and home care workers. In Kahana, E., Biegel, D., & Wykle, M. (Eds.), Family caregiving across the lifespan (pp. 287–311). Thousand Oaks: Sage.CrossRefGoogle Scholar
Fisher, B., & Tronto, J. (1990). Toward a feminist theory of caring. In Abel, E. & Nelson, M. (Eds.), Circles of care: Work and identity in women's lives (pp. 108–131). Albany, NY: State University of New York Press.Google Scholar
Fox, N. (1995). Postmodern perspectives on care: The vigil and the gift. Critical Social Policy, 15, 107–125.CrossRefGoogle Scholar
Glazer, N. (1988). Overlooked and overworked: Women's paid and unpaid labour in the U.S. “Cost crisis”. International Journal of Health Services, 18, 119–137.CrossRefGoogle ScholarPubMed
Graham, H. (1991). The concept of caring in feminist research: The care of domestic service. Sociology, 25(1), 67–78.CrossRefGoogle Scholar
Hasselkus, B. (1989). The meaning of daily activity in family caregiving for the elderly. American Journal of Occupational Therapy, 43(10), 649–656.CrossRefGoogle ScholarPubMed
Hasselkus, B. (1991). Ethical dilemmas in family caregiving for the elderly: Implications for the occupational therapy. American Journal of Occupational Therapy, 45(3), 206–212.CrossRefGoogle Scholar
Hochschild, A. (1979). Emotion work, feeling rules and social structure. American Journal of Sociology, 85, 551–575.CrossRefGoogle Scholar
Hughes, E.C. (1971). The sociological eye: Selected papers on work, self & study of society. Chicago: Aldine & Atherton.Google Scholar
James, N. (1989). Emotional labour: Skill and work in the social regulation of feelings. Sociological Review, 37, 15–42.Google Scholar
Kaplan Daniels, A. (1987). Invisible work. Social Problems, 34(5), 403–415.CrossRefGoogle Scholar
Keefe, J. M. (1990). Shared care: The organization of home care and family caregiving (Vol. 2). Halifax: Mount Saint Vincent University.Google Scholar
Martin Matthews, A. (1992). Final report homemaker services to the elderly: Provider characteristics and client benefit. Guelph: Gerontology Research Centre, University of Guelph.Google Scholar
Mayall, B. (1993). Keeping children healthy - the intermediate domain. Social Science & Medicine, 36(1), 77–83.CrossRefGoogle ScholarPubMed
McDaniel, S., & Gee, E. (1993). Social policies regarding caregiving to elders: Canadian contradictions. Journal of Aging and Social Policy, 5(1/2), 57–71.CrossRefGoogle ScholarPubMed
Merton, R.K., Fiske, M., & Kendall, P.L. (1990). The focus interview: A manual of problems and procedures (2nd ed.). New York: The Free Press.Google Scholar
Miles, M.B. & Huberman, A.M. (1994). An expanded source-book. Qualitative data analysis (2nd ed.). Thousand Oaks: Sage.Google Scholar
Ong, B.N. (1990). Researching needs in district nursing. Journal of Advanced Nursing, 16, 638–647.CrossRefGoogle Scholar
Pohl, J. M., Collins, C. & Given, C. (1995). Beyond patient dependency: Family characteristics and access to elderly patients to home care services following hospital discharge. Home Health Care Services Quarterly, 15(4), 33–47.CrossRefGoogle ScholarPubMed
Richards, T.J., & Richards, L. (1994). Using computers in qualitative research. In Denzin, N. & Lincoln, Y. (Eds.), Handbook of qualitative research (pp. 445–462). Thousand Oaks: Sage.Google Scholar
Saraceno, C. (1984). Shifts in public and private boundaries: Women as mothers and service workers in Italian daycare. Feminist Studies, 10(1), 7–29.CrossRefGoogle Scholar
Schwartz, A., & Vogel, M. (1990). Nursing home staff and residents' families role expectations. The Gerontologist, 30(1), 49–53.CrossRefGoogle ScholarPubMed
Stoller, E. (1993). Gender and the organization of lay health care: A socialist-feminist perspective. Journal of Aging Studies, 7(2), 151–170.CrossRefGoogle Scholar
Thomas, C. (1993). De-constructing concepts of care. Sociology, 27(4), 649–669.CrossRefGoogle Scholar
Trisolini, M., Thomas, C., Cashman, S., & Payne, S. (1994). Resource utilization in home health care: Results of a prospective study. Home Health Care Services Quarterly, 15(1), 19–41.CrossRefGoogle ScholarPubMed
Tronto, J. (1989). Women and caring. In Jaggar, A.M. & Bordo, S.R. (Eds.), Gender/body/knowledge (pp. 172–187). New Brunswick: Rutgers University.Google Scholar
Ungerson, C. (1990). The language of care: Crossing the boundaries. In Ungerson, C. (Ed.), Gender and caring: Work and welfare in Britain and Scandinavia (pp. 8–33). New York: Harvester.Google Scholar
Ungerson, C. (1995). Gender, cash and informal care: European perspectives and dilemmas. Journal of Social Policy, 24(1), 31–52.CrossRefGoogle Scholar
Waerness, N. (1984). Caring as women's work in the welfare state: In Holter, H. (Ed.), Patriarchy in a welfare state (pp. 67–86). Oslo, Norway: Universitetsforlaget.Google Scholar
Ward-Griffin, C. (1998). Negotiating boundaries of eldercare: The relationship between nurses and family caregivers. Unpublished doctoral dissertation. University of Toronto, Toronto.Google Scholar
Ward-Griffin, C. (2000). Relationships between nurses and family caregivers: Partners in Care? Advances in Nursing Science, 22(3), 89–103.CrossRefGoogle ScholarPubMed
Wilson, S.J. (1991). Women, families, and work. Toronto: McGraw-Hill Ryerson Ltd.Google Scholar
Wood, J.T. (1994). Who cares? Women, care and culture. Carbondale: Southern Illinois University Press.Google Scholar