The framework is drawn from several social psychological theories such as: Reactance Theory; Equity Theory and the Threat to Self-Esteem model, which identifies the psychological and environmental processes involved when people consider giving or seeking care assistance to older relatives. However, from a broader perspective there are a variety of factors which could influence the family care system or reciprocal family care for example, ageing and poor health of some family caregivers, financial wellbeing, and social needs, accessibility and environmental factors such as housing, transport, and cultural antagonism. Yet, the delivery of services; health and social care in particular are intertwined with education, knowledge and awareness of holistic assessment and care management.
In practice, older people appreciate value for money. This has been supported by both practice observations and research findings, which reveals that interdependence between family members in their own home would enhance the existence of care giving. Thus, better understanding is required regarding the impact of prolonged and complex care giving by strangers. In view of that, older people see respect and dignity as issues of great concern when it comes to receiving personal care from caregivers. Practically, older people do not feel comfortable with strangers assisting them with personal care but would accommodate their own family members as they understand their wishes and standard of care they are used to. This view draws reference from “Modernisation of Social Care” which demands proactive action to achieve better governance that is more responsive to the plight of older people. This means raising all services for older people to the standards of the best and recharging social services with fresh vigor, incentives and new ideas.
Older people deserve this right like any other citizen of the state and should receive quality care in their own home without prejudice (irrespective of gender colour of the skin and disabilities). However, in practice there have been wide variations in quality and in some areas ineffective and waste of resources. Thus, family involvements in care needs assessment and care would help to develop a consistent care approach that is based on family values, norms and principles, which could be cascaded from one generation to another. Thus, it is hoped, this practice would potentially ease the shortage of formal caregivers; reduce wastes and duplications in the social market. The family will be the champion of the care systems and support for older relatives. This care model would support personal social services in the wider welfare systems, promoting whole systems frameworks. Involving family members would re-invigorate care in the wider community as well as family networking which is geared toward supporting older relatives. The service framework would offer the opportunity to develop innovative and integrate services that provides greater choice and control of services for the growing older people population.
Involving family members during long-term care would promote users empowerment, which allows them to participate in their own care. Reflecting on practice experience, the presence of family members in care giving is more important to older people, that enable them to regain health and confidence as opposed to when in receipt of professional help. The availability of family support is found to be an important factor in determining whether a service user can be discharged home from hospital, rather than entering institutional care. I believe that family support places a high value on kinship, kindness, caring attitude, reliability, un-hurried care, consistency and continuity of care. This model of care advocates a joint ownership of care management between the family and the service users who supposedly being the overall controller of their care. In most cases, ageing and cognitive impairment have limited the ability of many service users to understand and manage their care packages, without working alongside their families.
By contrast, family care systems could propagate some form of abusive situations during care giving. However, the principles of care needs assessment and care management dictates that the presence of an advocate would deter any act of gross abuse such as: financial; physical; sexual; emotional and neglect to the frail vulnerable older people and this collaborate with the “Department of Health (2000) (No Secret)”. To reduce this incidence, it would be reasonable to have a family caregiver and not necessarily a qualified social worker, someone actually being involved, who also has basic understanding and knowledge of the needs of their older relatives. Families play a crucial role in the lives of older relatives; family involvement is most often interpreted as an indicator of social support rather than an influence on decision-making and protection of the vulnerable older person.
In retrospective the dominant sociological view, for a number of years has been that; older people turn first to their families for help, then to neighbours and finally to the state, because they expect their families to help in case of need. In some cultures, not only does most care come from the family but that most people think that this is where the responsibility should lie. This view is central to the philosophy of community care and more prominently end of life care services for older people in the wider society. In hindsight, there is a need to reinvent family care giving as the norm to enhance older people’s welfare and psychosocial wellbeing during longevity of care in the community.
For further reading see my blog: http://changinglifeparadigm.blogspot.com