Caregiver Identity as a Useful Concept for Understanding the Linkage between Formal and Informal Care Systems: A Case Study
Normand Carpentier
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DOI: 10.4236/sm.2012.21005   PDF    HTML     4,089 Downloads   8,297 Views   Citations

Abstract

Health systems of most Western countries are already severely strained and pressure will likely mount due to population aging and the anticipated increase in chronic illnesses. Interventions of various forms have emerged in response to the needs of older persons suffering from Alzheimer type dementia, but problems subsist in the linkage between formal and informal care systems. The objective of our study is to achieve a better understanding of the limitations of the partnership between the professional and family systems, employing the identity concept as formulated by Harrison White (2008). We used a case history approach and three analysis techniques to accurately outline the complex nature of the notion of identity: social networks, social representation and narrative analysis. We met with a caregiver on three occasions during a trajectory that spanned a seven-year period. The identity concept provides us with possible explanations of families’ attitudes to services. Our findings reveal that the caregiver is partially positioned within the management paradigm defined by the medical model, and strives above all to maintain the continuity of her life in accordance with her identity. Identities seek both social footing and internal coherence that can be obtained by stories. Many challenges remain in terms of incorporating the medical and psychosocial models within an expanded care model for individuals suffering from dementia and their families

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Carpentier, N. (2012). Caregiver Identity as a Useful Concept for Understanding the Linkage between Formal and Informal Care Systems: A Case Study. Sociology Mind, 2, 41-49. doi: 10.4236/sm.2012.21005.

Conflicts of Interest

The authors declare no conflicts of interest.

References

[1] Abell, P. (2009). A case for cases: Comparative narratives in sociological explanation. Sociological Methods Research, 38, 38-70. doi:10.1177/0049124109339372
[2] Adams, T., & Gardiner, P. (2005). Communication and interaction within dementia care triads. Dementia, 4, 185-205. doi:10.1177/1471301205051092
[3] Alzheimer’s Disease International (2009). World Alzheimer Report 2009. URL (last checked 2 December 2009) http://www.alz.co.uk/research/worldreport/
[4] Bond, J. (2001). Sociological perspectives. In C. Cantley (Ed.), The Handbook of Dementia Care (pp. 44-61). Buckingham: Open University Press.
[5] Brittain, K., Corner, L., Robinson, L., & Bond, J. (2010). Ageing in place and technologies of place: The lived experience of people with dementia in changing social, physical and technological environments. Sociology of Health & Illness, 32, 272-287. doi:10.1111/j.1467-9566.2009.01203.x
[6] Brodaty, H., Thomson, C., Thompson, C., & Fine, M. (2005). Why caregivers of people with dementia and memory loss don’t use services. International Journal of Geriatric Psychiatry, 20, 537-546. doi:10.1002/gps.1322
[7] Bury, M. (1982). Chronic illness as biographical disruption. Sociology of Health and Illness, 4, 167-182. doi:10.1111/1467-9566.ep11339939
[8] Carpentier, N., & Ducharme, F. (2005). Support network transformations in the first stages of the caregiver’s career. Qualitative Health Research, 15, 289-311. doi:10.1177/1049732304270813
[9] Carpentier, N., Ducharme, F., Kergoat, M.-J., & Bergman, H. (2008). Barriers to care and social representations early in the career of caregivers of persons with Alzheimer’s disease. Research on Aging, 30, 334-357. doi:10.1177/0164027507312113
[10] Carpentier, N., Bernard, P., Grenier, A., & Guberman, N. (2010). Using the life course perspective to study the entry into the illness trajectory: The perspective of caregivers of people with Alzheimer’s disease. Social Science & Medicine, 70, 1501-1508.
[11] Daiute, C., & Lightfoot, C. (2004). Narrative analysis: Studying the development of individuals in society. Thousand Oaks: Sage.
[12] Dubet, F. (2009). Le travail des sociétés. Paris: éditions du Seuil.
[13] Edvardsson, D., Winblad, B., & Sandman, P. O. (2008). Person-centred care of people with severe Alzheimer’s disease: Current status and ways forward. The Lancet Neurology, 7, 362-367. doi:10.1016/S1474-4422(08)70063-2
[14] Erikson, E. (1959). Identity and the life cycle. New York: International Universities Press.
[15] Finn, R., Learmonth, M., & Reedy, P. (2010) Some unintended effects of teamwork in healthcare. Social Science & Medicine, 70, 1148- 1154. doi:10.1016/j.socscimed.2009.12.025
[16] Giddens, A. (1991). Modernity and self-identity. Self and society in the late modern age. Stanford: Stanford University Press.
[17] Glendinning, C. (2003). Breaking down barriers: Integrating health- care services for older people in England. Health Policy, 65, 139- 151. doi:10.1016/S0168-8510(02)00205-1
[18] Godbout, J. T. (2000). Le don, la dette et l’identité. Montréal: Découverte.
[19] Grant, D., Morales, A., & Sallaz, J. (2009). Pathways to meaning: A new approach to studying emotions at work. American Journal of Sociology, 115, 327-364. doi:10.1086/599252
[20] Gross, D. L., Temkin-Greener, H., Kunitz, S., & Mukamel, D. B. (2004). The growing pains of integrated health care for the elderly: Lessons from the expansion of PACE. The Milbank Quarterly, 82, 257-282. doi:10.1111/j.0887-378X.2004.00310.x
[21] Hayes, J., Boylstein, C., & Zimmerman, M. K. (2009). Living and loving with dementia: Negotiating spousal and caregiver identity through narrative. Journal of Aging Studies, 23, 48-59. doi:10.1016/j.jaging.2007.09.002
[22] Kitwood, T. (1997). Dementia reconsidered: The person come first. Buckingham: Open University Press.
[23] Kodner, D. L. (2002). The quest for integrated systems of care for frail older persons. Aging Clinical and Experimental Research, 14, 307- 313.
[24] Kumpers, S., Mur, I., Maarse, H., & Raak, A. V. (2005). A comparative study of dementia care in England and the Netherlands using neo- institutionalist perspectives. Qualitative Health Research, 15, 1199- 1230. doi:10.1177/1049732305276730
[25] Lyons, K. L., & Zarit, S. H. (1999). Formal and informal support: The great divide. International Journal of Geriatric Psychiatry, 14, 183- 196. doi:10.1002/(SICI)1099-1166(199903)14:3<183::AID-GPS969>3.0.CO;2-J
[26] MacRae, H. (2010). Managing identity while living with Alzheimer’s disease. Qualitative Health Research, 20, 293-305. doi:10.1177/1049732309354280
[27] Mauss, M. (1954). The Gift forms and functions of exchange in archaic societies. Glencoe, IL: Free Press.
[28] Miller, E. A., Booth, M., & Mor, V. (2008). Assessing experts’ views of the future of long-term care. Research on Aging, 30, 450-473. doi:10.1177/0164027508316607
[29] Moody, M. (2008). Serial reciprocity: A preliminary statement. Sociological Theory, 26, 130-151. doi:10.1111/j.1467-9558.2008.00322.x
[30] Nolan, M., Lundh, U., Grant, G., & Keady, J. (2003). Partnerships in family care: Understanding the caregiving career. Maidenhead: Open University Press.
[31] Parker, J. (2001). Interrogating person-centred dementia care in social work and social care practice. Journal of Social Work, 1, 329-345. doi:10.1177/146801730100100306
[32] Pescosolido, B. A. (1994). Society and the balance of professional dominance and patient autonomy in medical care. Indiana Law Journal, 69, 1115-1122.
[33] Price, S. J., Price, C. A., & McKenry, P. C. (2010). Families & change: Coping with stressful events and transitions (4th ed.). Thousand Oaks: Sage.
[34] Ragin, C., & Becker, H. (1992). What is a case? Exploring the foundations of social inquiry. Cambridge: Cambridge University Press.
[35] Starr, P. (1982). The social transformation of American medicine: The rise of a sovereign profession and the making of a vast industry. New York: Basic Books.
[36] Stryker, S., & Burke, P. J. (2000). The past, present, and future of an identity theory. Social Psychology Quarterly, 63, 284-297. doi:10.2307/2695840
[37] Sulik, G. A. (2009). Managing biomedical uncertainty: the technoscientific illness identity. Sociology of Health & Illness, 31, 1059-1076. doi:10.1111/j.1467-9566.2009.01183.x
[38] Taylor, D., & Bury, M. (2007). Chronic illness, expert patients and care transition. Sociology of Health & Illness, 29, 27-45. doi:10.1111/j.1467-9566.2007.00516.x
[39] White, H. C. (2008). Identity and control: How social formations emerge. Oxford: Princeton.

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