- Title
- The invisible contract: Shifting care from the hospital to the home
- Creator
- Dow, Briony; McDonald, John
- Date
- 2007
- Type
- Text; Journal article
- Identifier
- http://researchonline.federation.edu.au/vital/access/HandleResolver/1959.17/33296
- Identifier
- vital:252
- Identifier
- ISSN:0156-5788
- Abstract
- The ageing population and associated burgeoning health care costs have resulted in a shift of care from institutional settings to home and community-based care. As one example, rehabilitation-in-the-home (RITH) programs are becoming increasingly prevalent. These programs either substitute or supplement in-hospital treatment by providing multidisciplinary rehabilitation and support services in the client's own home. This paper investigates the impact of RITH programs on informal carers. Semi-structured interviews carried out with caregivers and staff revealed a complex and contradictory interpretation of informal caring. Analysis of carers' interviews revealed: an assumption by themselves and others (including RITH staff) that they would provide care; the intimate, arduous and relentless work of caring; lack of consultation about discharge; lack of recognition and reimbursement; and low levels of program support for them as carers. Carers are integral to the successful rehabilitation of the client, but they occupy a marginal status within the program. An invisible contract consigns to them substantial care-work that was previously provided by the hospital. Informal carers in RITH programs can be seen as disenfranchised care contractors. This has implications for policy makers, program managers and researchers.; C1
- Publisher
- Australasian Medical Publishing Company Pty. Ltd.
- Relation
- Australian Health Review Vol. 31, no. 2 (May 2007), p. 193-202
- Rights
- Copyright Australasian Medical Publishing Company Pty. Ltd.
- Rights
- Open Access
- Rights
- This metadata is freely available under a CCO license
- Subject
- 1117 Public Health and Health Services; Randomized controlled-trial; Cost minimization analysis; Stroke; Rehabilitation; Southwest stockholm; Health outcomes; Early discharge; Hip fractures; Follow-up; Patients
- Full Text
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