The effect of the provision of inhome services on the elderly person's informal support network

Abstract

This study examined the effect that the provision of formal services had on the informal support network as it related to the care of the elderly. Interviews were conducted with 107 persons over the age of sixty, who lived alone and who were scheduled to start receiving at least two services from a home health agency. The survey instrument included data on the types and frequency of tasks provided by each member of the informal support network, the level of functioning of the elderly person, and the relationship with the primary caregiver. A follow up interview was conducted two months later to determine if there were any changes in time spent by the informal support network in providing instrumental tasks, affective tasks, or those tasks needing specialized skills. This research also studied whether changes in the affective relationship between the elderly person and the informal support system occurred after formal services were provided. It was found that the informal support system decreased the amount of time spent on instrumental tasks or those tasks that did not necessitate emotional involvement. A decrease in time was also found for those tasks requiring specialized skills and affective tasks requiring emotional involvement. The decrease in the provision of affective tasks or the strength of the informal support network did not change the affective relationship between the primary caregiver and the elderly person. Studying the impact that the provision of formal services has on the informal support network allows us the opportunity to determine how the two systems can work together to more effectively meet the needs of the growing number of elderly. Policy planners who are concerned about the substitution effect of formal services need to plan for a balanced and effective mix of care for the elderly person, where the caregiver is given support and respite, and the costs for long term care are controlled.