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COMING TO TERMS WITH BURDEN IN HOME CARE *
Author(s) -
Braithwaite Valerie
Publication year - 1987
Publication title -
australian journal on ageing
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.63
H-Index - 34
eISSN - 1741-6612
pISSN - 0726-4240
DOI - 10.1111/j.1741-6612.1987.tb00951.x
Subject(s) - unit (ring theory) , citation , library science , psychology , media studies , sociology , computer science , mathematics education
Nursing home care has come to be seen as the least preferred form of care for the frail elderly from two perspectives. From the government’s point of view, nursing homes are expensive to run, and with the implementation of the McLeay Report (1982), we have seen a determined effort by policy makers to keep the elderly in the community for as long as possible. While the government’s reaction to nursing homes is horror at the expense, the elderly themselves and often their families are afraid of them (Social Welfare Action Group, 1982). Nursing homes, as the community sees them, are institutions which threaten cherished values and basic rights. Institutionalization involves a loss of freedom schedules and rules restrict choice. Institutionalization also involves a loss of individuality one’s possessions are relinquished and one’s privacy is disturbed. Nursing homes also separate the elderly from the community with residents being physically and sometimes psychologically distanced from family, friends, and neighbours. The alternative, of course, is home care, and this is the sort of care received by most frail elderly. There are hidden costs in this practice, however, costs which are borne largely by those people who find themselves in the role of primary caregiver. For those frail elderly who are only slightly handicapped, assistance is likely to come from a number of sources. A neighbour might pop in with the mail or watch to see that a blind goes up first thing in the morning, Meals on Wheels might provide the midday meal, a daughter might deliver the groceries in the afternoon, and a son might ring to check that all is well. As dependency increases. however, the various sources of assistance diminish in number until the provision of care is concentrated in one person. What is more, there is a pattern in the selection of the caregiver. If a spouse is available and able, he or she will become the carer. If not, a child will step into the caregiving role, most commonly a daughter, but sometimes a daughter-in-law. In other words, when the McLeay Report (1982) refers to the desirability of community and informal support rather than institutionalization, what they are talking about in a significant proportion of cases is care by spouses and care by daughters and daughters-in-law. There is a dangerous tendency to assume that care is dispersed among a group of people. Repeatedly studies have shown in both Australia and overseas, that when the going gets tough, one person takes on the responsibility.