Toward an Integrative Theory of Care: Formal and Informal Intersections

Abstract

Researchers have categorized the complex phenomenon of care into two distinct types: formal and informal. According to this accepted dichotomy, informal care is generally provided by untrained social network members (family or friends), usually in the absence of any monetary compensation (Walker, Pratt, & Eddy, 1995). Paid, professionally trained care workers, on the other hand, typically provide formal care. This two-dimensional classification of care does not adequately capture, however, the full spectrum of caregiving scenarios. Some formal caregivers work in institutions, others in home or community settings. Some receive their pay within the framework of taxes and social security, others as cash in hand. Most informal care takes place in the home of the care recipient or caregiver. However, informal caregivers can also play an important role in institutional long-term care settings where they offer companionship, emotional support, and assistance with daily activities (e.g., feeding). This chapter focuses on the care of older people because they are the fastest growing segment of the population and have a higher level of care needs than other age groups. I theorize primarily about home and community contexts since the number of older people receiving care is increasing more rapidly in this sector than in institutional settings. Formal and informal care occurs in tandem more prominently in the community context.