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The difference between a formal and informal carer

The definition of to ‘care for' is set out in the Cambridge Dictionary as to to look after someone or something, especially someone who is young, old or ill. Care is often required to varying degrees for the elderly, the sick and the disabled, although the types and intensity of care required will be completely dependent upon the individual, and their requirements.

The different types of care can be seen to involve four main means of involvement; direct services provision, financial assistance, bureaucratic mediation and emotional support. Direct services provision will involve the actual actions of care given, and can include both the provision of aid, and hands-on or practical support. Therefore activities such as personal care and general helping behaviours such as housework will be involved. Financial assistance involves keeping the care-receivers monies in order, and could involve the payment of bills. Bureaucratic mediation involves the carer applying for services or aid that the care-receiver is entitled to, thus acting on their behalf to get benefits, extra care etc. Lastly emotional support will occur through keeping the individual company, giving them someone to talk too and helping them to deal with the difficulties they are facing such as illnesses or disabilities that have led to them requiring care.

The context in which this act of care occurs can be seen to distinguish between categories of formal and informal care-giving, with the nature of the relationship between carer and care-receiver and nature of care-giving tasks usually classifying the type of care. Informal care will usually involve a voluntary aspect and most often will be provided by family and in some cases friends or neighbours. Such care can occur from within the household, such as when the informal carer will live with the care-receiver or vice-versa, and care is subsequently provided 24 hours. However informal care can also occur from outside then household, such as when the care-receiver continues to live independently, but the informal carer will visit often and complete a number of tasks such as housework or cooking. Informal carers will not receive financial payment for their activities, and as a result of this around 75% of informal carers are believed to be involved in some kind of employment (full-time, part-time or self-employed) as well as their caring duties. Informal care therefore involves a mixture of practical support, social interaction and protective supervision.

Formal carers thus differ from informal carers as they are acting in an agency-client relationship with the care-receiver, and are paid and trained to perform their caring role. The amount and types of care a ‘client' will be given is usually determined by an assessment procedure. Such financial implications can therefore be shown to be the first major difference between the informal and formal carer. As informal care is provided for free of any monetary payment, this can be beneficial especially to the families of those caring for elderly relatives where inheritance money is saved from being spent on the expensive provision of agency care. However Governments in particular see the financial benefit of optimizing the informal rather than the formal carer, as in Scotland alone, the financial cost of replacing informal with formal carers (for 28 hours of care per week) would invoke a cost of around £200 million. There are also important implications to both the care-receiver and the carer when informal or formal care is used.
Implications to the patient can be seen to be both beneficial and limiting. The fact that family members take on caring responsibility mean increased interaction and connectedness within the family which can act in a very positive manner and in giving the care-receiver good emotional support.

It has also been frequently cited that continuity gained from care by those who know the individual best contributes to a better quality of life (especially in setting where informal care is provided outside the household such as in a residential home.) Informal carers are thus renowned for being superior to formal carers at providing general tasks and emotional support however care-receivers can also be left in such situations feeling like a burden which will have a damaging effect emotionally and psychologically. However when formal carers are used, the patient will benefit from the training and knowledge that they will bring to the situation. Correct methods and techniques of caring will mean especially technical tasks may be performed better and more efficiently such as lifting and medical/treatment care. Thus on the negative side, the use of informal care will mean that patients may not see the benefit of correct care procedures from the knowledge and skills acquired from training and experience in the care profession, whereas patients using formal care provisioning will not get the benefit of increased contact with their family and as a result may become more socially excluded than those who have care from their families and friends.

These implications do not stop with the care-receiver as the differences between informal and formal caring may be even more prominent for the carer, but mainly in informal situations. As mentioned previously, the majority of informal carers in the UK are also in employment and this could mean a number of things. Stress levels are likely to increase due to the added pressures of caring duties and employment. This dual role of worker-carer will also mean a loss of time for the carer to look after themselves and their own families and between increased stress and tiredness informal carers are believed to often experience a worsening of their own health, or problems with their sleeping patterns. The experience of the caring itself and what it involves, and in cases where there is a worsening of the care-receivers condition can cause emotional turmoil in many people. There are also a number of practical hurdles informal carers can experience such as the health and safety issues of caring for someone in the home - those in caring professions will often experience higher levels of back problems as a result of lifting without proper equipment, for example.

The above points therefore highlight the distinct differences between informal and formal carers, predominantly focusing on the paid aspect of formal work compared to informal work, and the nature of the relationship - being one of caring for ones family versus a client-agency relationship. As to whether this distinction is important, the evidence documented shows this is extremely significant as the range of implications includes positive and negative financial, health and psychosocial consequences for both carer and care-receiver, in both formal and informal situations.