Choice in the Context of Informal Care-Giving

Social Policy Research Unit, University of York, York, UK.
Health & Social Care in the Community (Impact Factor: 0.86). 04/2007; 15(2):165-75. DOI: 10.1111/j.1365-2524.2006.00671.x
Source: PubMed


Extending choice and control for social care service users is a central feature of current English policies. However, these have comparatively little to say about choice in relation to the informal carers of relatives, friends or older people who are disabled or sick. To explore the realities of choice as experienced by carers, the present paper reviews research published in English since 1985 about three situations in which carers are likely to face choices: receiving social services; the entry of an older person to long-term care; and combining paid work and care. Thirteen electronic databases were searched, covering both the health and social care fields. Databases included: ASSIA; IBSS; Social Care Online; ISI Web of Knowledge; Medline; HMIC; Sociological Abstracts; INGENTA; ZETOC; and the National Research Register. The search strategy combined terms that: (1) identified individuals with care-giving responsibilities; (2) identified people receiving help and support; and (3) described the process of interest (e.g. choice, decision-making and self-determination). The search identified comparatively few relevant studies, and so was supplemented by the findings from another recent review of empirical research on carers' choices about combining work and care. The research evidence suggests that carers' choices are shaped by two sets of factors: one relates to the nature of the care-giving relationship; and the second consists of wider organisational factors. A number of reasons may explain the invisibility of choice for carers in current policy proposals for increasing choice. In particular, it is suggested that underpinning conceptual models of the relationship between carers and formal service providers shape the extent to which carers can be offered choice and control on similar terms to service users. In particular, the exercise of choice by carers is likely to be highly problematic if it involves relinquishing some unpaid care-giving activities.

Full-text preview

Available from:
  • Source
    • "Pro - cedural switching costs consist of economic risk , evaluation , learning , and setup costs , and primarily involve the expenditure of time and effort ( Burnham , Frels and Mahajan , 2003 ) . These procedural switching costs are higher for less educated , older and the mentally handicapped ; thereby increasing social inequalities ( Arksey and Glendinning , 2007 ; Lent and Arend , 2004 ) . Meinow et al . "
    [Show abstract] [Hide abstract]
    ABSTRACT: Within this dissertation we have examined the limitations of rational accounts about how citizens behave within liberalised public service markets. By drawing upon behavioural research on individual decision making we offer an alternative view of how citizens actually behave within liberalised public service markets and test it empirically. Concretely, we have investigated whether citizens indeed make rational decisions in public service markets where competition and choice have been inserted. In doing so, we have tested a set of research questions that are of great theoretical and practical pedigree for the way of how contemporary public service delivery is organised.
    Full-text · Book · Jan 2015
  • Source
    • "Respite services are part of social policy intended to relief the burden of care and to support caregivers' coping strategies (Jeon et al. 2005, Lee & Cameron 2005, Arksey & Glendinnign 2007). Previous studies have pointed to the importance for caregivers to have private time and space (Ashworth & Baker 2000, Brown & Alligood 2004, Upton & Reed 2005), have highlighted that respite allows caregivers to re assume a sense of their original lives (Smyer & Chang 1999, Ashworth & Baker 2000). "
    [Show abstract] [Hide abstract]
    ABSTRACT: This paper is a report of a study conducted to uncover the strategies that women caregivers of relatives with advanced dementia use to rest from care-giving. Respite consists of activities and situations that briefly take caregivers away from their care-giving responsibilities. Qualitative studies are focusing on respite as an outcome and are deepening our knowledge about the experience of caregivers' rest. The strategies that caregivers use to relieve the burden, however, are not fully known. A qualitative approach was used influenced by the work of Charmaz's constructivist grounded theory. Twenty-three female primary caregivers of relatives with advanced dementia participated in semi-structured interviews between November 2006 and March 2009 in Spain. Data collection was guided by the emergent analysis and ceased when no more relevant variations in the categories were found. Taking leave from the life of care-giving is the general strategy that caregivers use to rest from their caregivers selves. The key issue is to be able to connect with a different world from that of care-giving. Three strategies that participants use to leave the life of care-giving follow: (1) Connecting with one's own life, (2) building moments of life in common with the sick relative and (3) keeping in touch with care-giving. To have respite from care-giving implies distancing oneself from the care-giving identity and reveals the caregiver's need for alternative selves to have true breaks from caring. Nurses are in a unique situation to foster respite as an inner experience.
    Full-text · Article · Mar 2011 · Journal of Advanced Nursing
  • Source
    • "It is a complex and sometimes stressful relationship that can be sustained through mutual co-operation (Kirk and Glendinning, 1998; Nolan et al., 1995; Pierce et al., 2004). Thus, the faith component of trust in caregiving relationships can be related to a lifetime of mutual commitments that exists between the caregiver and the individual (Arksey and Glendinning, 2007). The mutuality of trust in this relationship could be interpreted as being predicated on the structural understanding of the relationship (Giddens, 1992), the functional trust from past interactions (Putnam et al., 1993) and faith in future expectations of behaviour (Stevenson and Scambler, 2005). "
    [Show abstract] [Hide abstract]
    ABSTRACT: This article introduces the concept of socio-connective trust, the synapse between the social structures and processes that underpin relationships in supportive care networks. Data from an ethnographic case study of 18 informal caregivers providing in-home care for people with life-limiting illness were analysed drawing on theoretical concepts from the work of Giddens and writings on social capital, as well as the construction of trust in the caregiving literature. While conceptions of trust were found to contribute to understanding supportive care relationships, they did not account for the dynamic nature of the availability and use of support networks. Instead, informal caregivers undertook ongoing reflexive negotiation of relationship boundaries in response to their own conception of the current situation and their perception of trust in their relationships with the various members of the support network. The concept of socio-connective trust describes the movement and flow of the flexible bonds that influence relationships among care networks and determine the type and range of support accessed by informal caregivers. Understanding the complexities of socio-connective trust in caregiving relationships will assist health and social care workers to mobilize relevant resources to support informal caregivers.
    Full-text · Article · Dec 2010 · Health
Show more