Re-balancing policy: Informal care relationships underpinning individualised Home Care Packages
Informal carers provide the majority of care to older Australians and play a key role in the co-ordination of formal care services. The role of carers is not only fundamental to those they care for, but for the functioning of the aged care system as a whole. The intrinsic nature of care is relational. Care occurs primarily in the context of long-term, pre-existing relationships. Family ties and emotional attachment feature strongly as reasons Australian carers take on the role of primary carer. The focus of the Home Care Package (HCP) program is on the 'individual' older person who is the 'consumer' directing the care. The older person has 'control' and 'choice' to purchase services from the open market of aged care providers. The HCP Program reform largely ignores the relationship experience, knowledge and key role of unpaid family, friends or neighbours who are providing significant levels of care to maintain the older person in their home. As demand for home based care increases due to an ageing population and further deinstitutionalisation of aged care services, supply of people willing to take on the role of informal carer is diminishing. Re-focusing HCP policy on informal care relationships rather than labelling the carer and the care recipient as separate 'individuals' is the key to improving carer wellbeing and the sustainability of the informal care relationships that maintain older people at home. Based on an international literature review and data from a study of care relationships findings relating to the current 'lived experience' of carers and older people who are HCP recipients will be discussed. The concept of 'informal care networks' will also be explored in relation to the role a range of informal carers play in supporting older relatives / friends to remain at home.