Caregiver Identity as a Useful Concept for Understanding the Linkage between Formal and Informal Care Systems: A Case Study

Health systems of most Western countries are already severely strained and pressure will likely mount due to population aging and the anticipated increase in chronic illnesses. Interventions of various forms have emerged in response to the needs of older persons suffering from Alzheimer type dementia, but problems subsist in the linkage between formal and informal care systems. The objective of our study is to achieve a better understanding of the limitations of the partnership between the professional and family systems, employing the identity concept as formulated by Harrison White (2008). We used a case history approach and three analysis techniques to accurately outline the complex nature of the notion of identity: social networks, social representation and narrative analysis. We met with a caregiver on three occasions during a trajectory that spanned a seven-year period. The identity concept provides us with possible explanations of families’ attitudes to services. Our findings reveal that the caregiver is partially positioned within the management paradigm defined by the medical model, and strives above all to maintain the continuity of her life in accordance with her identity. Identities seek both social footing and internal coherence that can be obtained by stories. Many challenges remain in terms of incorporating the medical and psychosocial models within an expanded care model for individuals suffering from dementia and their families