Informal carers are an important part of social care and agencies may have certain obligations towards such informal carers which will have to be identified. The terminology given to carers is also important and the three frames of reference within which the carers are identified could be carers as resources, carers as co-workers and carers as co clients. As the paper has claimed there is much confusion on the position of informal carers within the social care system as services are structured around the dependent rather than the carer and there is also confusion on how the relationship between agencies and carers should be perceived. Carers are also considered as side, by products of the care systems and not central to it and because of the ambiguities involved carers do not have defined relationships with the agencies. Although the frames of reference used vary according to organizational context, the study used applies to the health care bodies, social care agencies and voluntary organizations. The different frames of reference would highlight different implications for policy and intervention.
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The three types of orientation of agencies towards carers could be based on carers being considered as co workers, co clients or resources and the complexity of social care agency would also highlight the interaction of social policy makers and carers. Twigg highlighted that it is the informal sector that predominantly supports the elderly people (Wicks, 1982). There are some concerns on the social and cultural changes and higher rates of female participation in the labour market (Moroney, 1976; 1986; Wicks, 1982; ) and studies by Finch (Finch, 1987) highlight patterns of responsibility and care giving which were used by Twigg.
Recent work on the informal health care sector highlights the importance of long-term social factors that could be responsible for informal caregiving. Social and cultural factors, such as employment or women's expectations could determine the pattern and levels of caregiving availability (Abrams, 1977; Abrams and Bulmer, 1985). However society influences the level of availability of carers and patterns of availability of informal care depends on several factors. Several studies on community action towards informal care have been reported (Allen, 1983).
Twigg suggested that the informal sector tended to provide a separate option or background to agency provisions although the aim of the paper is according to Twigg to overcome the separation of the two sectors and thus to link them. In this the dominant image used is Bayley's metaphor of the 'interweaving' of the two forms of provision or the two sectors (Bayley, 1973), so Twiggâ€™s work has been influenced by Bayleyâ€™s.
However there seems to be essential differences as the two sectors donâ€˜t seem to mesh easily. Abrams, and others, have been cited by Twigg as they explored some of the difficulties in integrating the two sectors (Bulmer and Abrams, 1986; Froland, 1981; Bayley, 1982).
Twigg suggested that 'Social care' lacks the boundary that medical knowledge and professional groupings would normally provide as social care could be wide and more inclusive. Social work definitions could be controversial and open to controversies and criticism. Thus using such models in which co client or co workers are defined could be difficult. In fact in case of spouse carers, these would be distinct group of carers and could be perceived as co workers if they are fit or co clients if they too have problems of age and illness.
The paper sought to study the relationship of carers and social care agencies and suggested that this angle of study is rather rare as care related studies focus on needs of patients rather than carers. The study also sought to understand carers according to three frames of reference and models of relationships seeing carers as resources, as co workers and as co clients were considered. The aim of the study is to establish a model for the levels or types of relationships between social care agencies and carers. The purpose is also to delineate the different perspectives from which carers are perceived.
Study Design .
The study is based on secondary resources and a model on three levels of relationship between social care agencies and clients have been given. The model was framed in accordance with the data obtained through secondary research and several research papers were used that helped the author to categorize the research findings from various sources and establish the model. The research data supported the research model used by the author and the study design as based on extensive secondary research and reaching a conceptual framework was most effective in providing an analysis of the varied findings. The study was divided into three parts of providing a frame of reference model in which the relationship between carers and social care agencies were placed within a framework, the second part distinguishes between the formal and informal care sectors and how they relate to agencies and the third part of the study focuses on providing a definition of carers based on the relationships or frames of reference model.
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The study sample is varied and dependent on the research papers used for the secondary research and analysis to develop the model. The area of focus for the study has been carers of all ages and backgrounds but with a special focus on carers who take care of elderly clients with disabling or long term illnesses. Apart from the carers and the clients, the client spouses considered as co clients, co workers in the form of other carers or social workers, social care authorities including clinical managers as well as younger patients and the care agency workers would be the overall study sample when all research papers used by the author are considered. However as primary data were not obtained the study sample is also implied from the research papers chosen rather than directly used by the author.
The study being conceptual and thematic, the data collection has been reportedly based on secondary resources rather than primary subjects. The data collection has been presumably done with the help of journal databases, library resources and articles from journals, magazines, as well as medical and other reports from social care and health care organizations. Reports published by social care agencies were also considered as possible resources for this study as also are research papers published through organizations and universities. Data were mainly in the form of research papers related to social and health care and a model on relationships was derived from categorization and analysis of this data. The data were thus based on secondary resources rather than direct primary data collection method and the research papers were used categorically according to the model discussed.
The ethical considerations for the research was mainly the analysis that categorized the three types of carers on the basis of their relationships and the analysis was focused on projecting an unbiased view of the informal sector and to also show the interaction between the social care agencies and the informal carers. Ethically it was necessary to avoid any controversial claims against informal carers and some of the papers chosen were also noted as ethically sound and if elderly subjects or disabled subjects were used as part of the data collection for these papers, ethical procedures related to consent were followed. Ethical consideration for the secondary research papers were maintained as all research papers chosen highlighted the ethical aspects followed and the study by the author also followed ethical dimensions of care and discussed topics such as old age, disability and long term illness with sufficient sensibility.
The data analysis was based on the model framed and the definition of carers given as also the differentiation and similarities of formal and informal sectors in social care. The research papers selected provided the basis for the model used and the data in the papers were categorized to define carers as co workers, resource or co clients. For example data on elderly spouses showed the possibility of defining carers as co clients and the data on female participation in the health care industry for example provided the insights of carers as resources. The data analysis was done according to conceptual model and the three parts of the paper in which a definition of carers was provided in accordance with the findings and model.
Secondary data analysis and qualitative research methodology (Crabtree and Miller, 1992) was used by the author who used several research papers used the information from the studies and categorized them to provide a framework. The research method used is qualitative analysis as in depth analysis of the concepts has been attempted.
The results and secondary research helped in providing a clear definition of carers using the frames of reference model. The author provided the different types of role a carer could play or are perceived as playing and how the interaction between the care agencies and carers could provide insights on the health care sector especially the informal sector. The author emphasized on the importance of carers in the industry and especially importance of the informal carers who have little recognition but play a significant role in health care.
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The data collected from several research papers presented varied information on the role of carers and how they are perceived within social care systems and by social care agencies. The usefulness of informal carers has been highlighted in the discussion as also their potential as carers and the paper seeks to expand the role of carers by giving them roles as co clients, resources and co workers. The discussion and analysis of the paper was divided in a definition of carers, a categorization of the different types of carers or the way they are perceived according to frames of reference and a differentiation of the formal and informal sectors and types of carers.
The discussion was focused on defining carers according to the new model and identifying the differences or similarities of the formal and informal sectors as far as provisions of care is concerned and also describing the inter-relationships between carers and social care agencies.
The discussion tried to draw out contradictions in social policy considering the role of carers and the author suggested that the lack of a definite model about carers have led to neglect of the informal care sector. This was clearly stated in the conclusion.
Conclusion and Recommendation
The conclusion specified that there are many tensions in policy that could be related to informal care and understanding informal care more elaborately could help in reducing gaps in knowledge of social policy. The study highlighted a conceptual problem of definition and categorization and further highlighted the ambiguous position of informal carers in health and social care. The paper tried to emphasise on the contradictions and the series of models available to explain the role of carers in the field. The recommendations of the author was to use an integrated model as given as the three roles according to frames of reference and use this as the basis for social policy on carers.
The paper selected by Twigg ( ) How Do Social Care Agencies Conceptualise Their Relationship with Informal Carers? deals with the relationship between social care agencies and informal carers and describes the models or types of relationships. As the paper has claimed there is much confusion and contradiction on the position of informal carers within the social care system and especially their relationships with social care agencies. Considering that the role of carers has been largely overlooked in social care studies, this paper is an attempt to fill many gaps and highlights the different ways in which carers could be perceived. This obviously leads to problems in ambiguity of position and perception of roles although the author has tried to put this within a framework thus providing some direction according to which social policy and carer roles could be perceived or framed. The paper is a good attempt to study a relatively rare field of carer role perception and suggests new directions in social care studies which is praiseworthy. Despite this the choice of research studies are not adequate so secondary research to support the claims fall short of expectations. Despite the attempt the paper has not been able to surpass the ambiguity in carer role perception though.