Laura F's against argument: The meaning of the family within community care

Recent policies relating to the care of ‘priority groups’ exemplify the importance of the family and uphold the view that ‘family care is best.’ This has two aspects: first that for dependent individuals care is best provided for ‘at home,’ and second, there is an overriding moral duty for them to provide that care. This argument advocating family care is one which has featured strongly in the deinstitutionalisation debate. The revulsion felt towards the grossest examples of dehumanised care is directly linked with the view that the appropriate alternative in all-cases is family based care. The family, in contrast to the impersonal and cold institution, is viewed as a haven, as repository of warm, caring, human relationships based on mutual responsibility and affection and thus a private protection from the cold, hostile, outside world. The impact of removing a person from the comfort and care of their family can be incredibly strong. Institutionalization deprives people of the invaluable opportunities to develop life skills and meaningful relationships within the community. Institutionalization takes away the rights of those who yearn to participate in society and face the challenges and goals in life. Living in the community allows a person control of their own life and circumstances, and that is indispensible to a patient's personal satisfaction and happiness. It might be argued that institutionalization is actually a way of hiding away those away with physical, behavioural or mental challenges away from mainstream society. Those of us who champion the ‘individual rights’ of people afflicted with such difficulties will surely approve the closing down of such institutions in favour of the more personal, individualised and supportive living opportunities found within families in the community. It might, hence, be inferred that the government does not ‘shift’ care to the families. The family, when faced with the alternative of an inhumane institution, often willingly takes on the role of carer. It is reassuring for the family to know that their loved one is being loved, respected and cared for in comfortable surroundings.
It is relevant at this point to consider the meaning of the family. It has been argued that the family is the ‘social structure that links the individuals in all the known human societies.’ It is perhaps helpful to examine other cultures when looking at the notion of ‘family’. In Asian countries, for example, there is a strong tradition of caring for elderly parents. The elderly live in extended, multi-generational households which rely primarily on their children for personal care and financial support.
In Romania families play a large role in caring for elderly relatives. Grandparents often look after grandchildren as it is usual for both parents to work. It is considered shameful to put an elderly relative in a home for the elderly.
In Spain the family is the long-term provider of care for elderly people. Nearly 70% of Spanish dependent elderly people receive exclusive family care, mainly provided by women and children. There is a preference for care within the family, but this does not disqualify formal care intervention.
We can infer from information such as this that basic family values such as love, caring, warmth and support are not confined to one culture, but permeate through every culture to some extent. They are basic and eternal and intrinsic to the very notion of ‘family’.
The government, hence, does not shift responsibility to the family. The family, I argue, often willingly undertakes the caring role as families feel a commitment and responsibility towards one another, and strive to provide loved ones with the most positive and happy future possible. The key to successful community care is being surrounded by basic family values such as listening, friendship, mutual respect. The individualized one-to-one support found at home far surpasses the impersonal institutionalization that preceded community care. I am not denying that community care is demanding, and government financial and personal support is essential to the wellbeing of both the carer and the cared for. But as the future emerges further solutions to quality of living will evolve and more supportive programs will develop to advance community care even more.