Between Women: Nurses and Family Caregivers

Abstract

Throughout Canada in recent years, contractionist policies have predominated in a labour market recession with high levels of unemployment. Government-funded health care has become overwhelmingly expensive, hence related policies and programs have undergone rapid and profound transformations (Dominelli, 1991). Correspondingly, there have been major reallocations in health-care work in both the public and private domains (Dowler, Jordan-Simpson, & Adams, 1992; Drover & Kerans, 1993). These changes have been especially dramatic in the burgeoning area of long-term care. "The family" is now held responsible for providing care to even the most severely disabled people, and the household has become the primary site for care delivery (Steel & Gezairy, 1994). Although health-care activities have always been within the realm of domestic responsibilities, the scope and extent of these activities have changed remarkably in the last two decades. These changes have been associated with widespread sentiment against institutional care, the closure of long-term-care facilities (Switzky, Dudinski, Van Acker, & Gambro, 1988), and the increasingly large proportion of very old people in the population (Steel & Gezairy, 1994). In addition, advances in medicine, pharmacology, and biotechnology have led to decreased mortality rates and increased rates of severe chronic illness and disability among people of all ages (Dejong & Lifchez, 1983). Consequently, more people now require care at home that is complex, labour-intensive, and very expensive (Plough, 1981).