ABSTRACT
Health care policy and economics in the late 20th century fueled a major movement of long-term health care services from centralized facilities like hospitals and institution-based care to home-based care in many countries (Alcock, Danbrook, Walker, & Hunt, 1998; Aronson & Neysmith, 1996, 1997; Cameron & Phillips, 2003; Royal Commission on the Future of Health Care in Canada, 2002; Sorochan, 1995). Much of the research and writing on home care is focused on broad issues of policy and on the juxtaposition of formal and informal care provision (e.g., Aronson & Neysmith, 1997; Cameron & Phillips; Hollander & Chappell, 2002; Jamieson, 1991). However, caught in the midst of these policy debates are homecare recipients (most of whom are older adults) and their family members and carers, often struggling to respond to immediate needs in the context of a homecare system that is in flux. Health care providers are added to this mix when they enter homecare settings as case managers, community health nurses, occupational or physical therapists, and, most typically, home support workers (Martin-Matthews, 2007).
