All About Estates

Strengthening Caregiving in Challenging Times

In our current economic climate cutbacks for supportive care for seniors is seeing increased responsibilities being shifted onto family members and “informal caregivers”.   The term “formal” care providers  refers to persons who are financially remunerated to care for a person. This can include professionals such as doctors, nurses, social workers, support workers, case managers, speech language pathologists, physical therapists and occupational therapists.

The ‘informal’ caregiver of an elder may experience a number of challenges requiring ongoing adjustments. The daily physical, social and emotional caring make high demands on in the carer’s day. The carer also has to engage in communication, collaboration and coordination with one or more “formal” caregivers in the health system, supporting the person being cared for. This may add hours each day, imposing additional stress for the person who may also be caring for other family members and be in employment.

As Audrey likes to say, caregiving is a dyad and it takes two people, the caregiver and the care recipient. Informal caregivers are often the adult children or another family member. Both parties need to have their needs met.

The opportunity exists to strengthen communication in the relationship between formal and informal caregivers to enhance the support for the ‘informal carer’ and the person needing care.  This ongoing process needs conscious commitment and ongoing effort.  Ideally both ‘formal’ and ‘informal’ providers are open to developing this resource, optimally building trust, confidence and bringing more confident problem-solving to the ongoing situation.  However, a research finding disturbingly suggests that sometimes “formal” caregivers assume that if no difficulties are reported, there are not any. It is only when crisis occurs that services are provided (Harding & Higginson, 2003 as cited in MacKinnon, 2011, p.8). Further, ‘informal’ caregivers may be stressed by pre-existing situation/s, and resort to ‘just getting on with it’ rather than ‘complicating things further’. There may be a perception that “formal caregivers” are busy, that conservation of resources is necessary, and that others need services more.

At present, in a time of insufficient resources in both community and institutional care, a strong relationship between ‘informal’ and ‘formal’ caregivers can grow, based on mutual recognition of the limits of all parties.  Failure to develop this makes possible stressful and antagonistic, conflicted interactions.   The ‘informal’ carer particularly should feel ok to ‘own’ what he/she feels able to do and not able to do in terms of the looking after the person being cared for. Part of this also may mean taking time from employment, asking for help and taking time for themselves. The ‘informal’ carer has their own boundaries and roles, and needs personal time and time to rest. Many juggle different areas in their lives, and struggle to keep daily lives going at the same time as caring for someone who is ill.

Audrey’s earlier blog of March 3, 2016  discusses recent improvements to the Compassionate Care leave. Caregiving is a journey.

Written by Sasha Ruth Adler BA (Hons), MSW, RSW, Elder Caring Inc. associate


About Audrey Miller
About: Audrey Miller, Managing Director of Elder Caring Inc. has over 30 years social work and rehabilitation experience working with older individuals and their families. She advises the financial, insurance, legal and business communities regarding elder care issues. Audrey is a recognized expert in her field. Email: