Defining Eldercare for Policy and Practice: Perspectives Matter

Shauna-Vi Hariton, Norah Keating,** and Janet Fast A Canadian policy paradigm is that informal for older adults is better and cheaper than formal services. We conducted focus groups with older adults, family members, friends and neighbors, volunteers, direct service providers, local and provincial policy makers and federal policy makers to determine whether this view was shared. Stakeholders agreed that the purpose of eldercare was to enhance seniors' independence, but differed on which eldercare services and what source of services (families or public) would enhance independence. There may be high costs to older adults and their of the families first philosophy. Key Words: eldercare, eldercare policy, family caregiving, seniors ' independence. In Canada there is a new policy paradigm in which clientcentered service delivery and partnerships in caring for older adults are emphasized (Keating, Fast, Connidis, Penning, & Keefe, 1997). In this new policy paradigm, older adults are seen as key players in decisions about their care. As well, family members are assumed to be active partners both in decisions about service provision and as providers of services to their older kin. The paradigm is based on the belief that informal care, especially from family members, is both better and cheaper than formal services. The paradigm, and the policy instruments that emerge from it, may profoundly influence the quality of life of older adults needing and the nature of their relationships with family members. The purpose of this study was to inform the policy debate concerning for older adults. We began with the belief that it was important to understand whether the basic tenets of the new paradigm were shared by those who are major stakeholders in the discourse on how to for an aging population. Stakeholders include a broad set of constituents including older adults themselves, their family members, friends and neighbors, those who provide services to older adults and those who develop policies for seniors benefits and services. The main objective of the study was to clarify stakeholder perspectives on what constitutes and who should provide that care. This knowledge is important since stakeholders have differing modes of influence in determining what is eldercare. Policy makers set the guidelines for service. Family members are charged with assuming more responsibility for of their elderly kin as public sector resources are reduced. Older adults may be most knowledgeable about their own needs but are unable to actively meet those needs. The question that arises then, is whether there are shared perspectives on what eldercare services are required and how they should be delivered, or whether one perspective predominates. In our view, perspectives matter because they are likely to determine the efficacy of the delivery and receipt of eldercare. Literature Review Caregiving to Canada's elders has become a central theme in the public policy debate (McDaniel & Gee, 1993). Eldercare has been placed on center stage because of growing needs for by an aging population; and because of economic constraints which are driving a shift from institutional to community-based (Chappell, 1993; Keating, Kerr, Warren, Grace, & Wertenberger, 1994). During this time, federal and provincial governments have been attempting to reduce public sector costs while maintaining or enhancing the quality of (Chappell, 1993). Developing partnerships in service delivery and client-centered are key objectives in the policy paradigm that is the basis for the new approach to for older adults. The idea is that the is responsive to the needs of older adults and that informal caregivers are in an ideal position to provide this responsive since they know the senior (Keating et al, 1997). Since informal is unpaid, this best care is also seen to be the most economical (McDaniel & Gee, 1993; Walker, 1991). …