Exploring the changing relationship between formal carers, informal carers and carees during the elder-care process

  • Sing Nam HUNG

Student thesis: MPhil Thesis (Lingnan)


There are increasing studies looking at effects of caregiving to the frail elderly in Hong Kong. However, many studies often focus only on a single dimension of caregiving in either informal or formal carers without the focus on the elderly that receiving cares. Few studies have viewed elder caregiving as an integrative and dynamic approach, with limited examination and exploration on the caring processes and interactions between the formal and informal carers and elderly carees, and the reasons for this pattern.

Thus a caregiving triad might be considered as consisting of the elderly caree, the formal and informal carer, and a tripartite model could be adopted to explore the interactions and interrelationship between the three parties.

The present research aimed to explore the changing caring relationships among carers and carees in home-based setting; the meanings behind the different caring patterns amongst the formal informal carers as well as the elderly carees and; to provide suggestions and implications for providing better care services for elderly recipients in home-based setting.

The methods used in the present study are mainly qualitative in approach, with in-depth interviews and focus group discussion. In order to ensure the credibility of the research, triangulation of various data sources is used to provide fuller picture and understanding of the research findings.

Since this is an exploratory study, a small sample was used (N=18). In order to get a deeper understanding of the caregiving process and patterns, in-depth interviews with elderly people, their family caregivers and the formal caregivers were conducted in this study. The interviews were guided by a theoretical framework with interview guidelines. Thematic analysis was used to explore the caring relationships and pattern.

A total of 6 cases with 18 people (6 elderly people, 6 family caregivers and 6 formal caregivers) were successfully interviewed from June to September 2003.

The present study found that between the informal and formal carers, substituting and complementing effect are the most obvious through the interaction pattern. The substituting effect mainly comes from the perception of quality services by the informal carers and they think that professional and advanced care services are better to be provided by formal carers.

Regarding the complementing effect, it is found that sharing of tasks between the formal and informal carers are common through the research. Informal carers might share tasks to formal carers when they did not have time to do. Tangible supports are more often supported by formal carers and both formal and informal carers would provide intangible support.

On the side of carers and carees, both formal and informal carers are found to interact in a form of reciprocal and obligation. The continuation of care of informal carers is mainly due to the martial relationship and filial piety. The caring meanings of formal carers are varies, including the economic reward, gratification and job satisfaction and also the caring can benefit their personal growth and development.

The findings shed some light on the roles played by the three parties. It was necessary for all parties to cooperate in striving for the best quality of care. Hence more information of the perceived roles and expectations among the three parties should be further explored in order to get the optimal caring patterns. Since the optimum form of the caring relationships depends very much on the community resources available and also on the values upheld by the three parties, to achieve the greatest satisfaction of them and enhancing their quality of life, it is advisable to conduct further study on their expectations towards the caring tasks, process, and relationship while advocating their empowerment in the continuum of care.
Date of Award2004
Original languageEnglish
Awarding Institution
  • Department of Sociology and Social Policy
SupervisorCheung-ming Alfred CHAN (Supervisor) & David Rosser PHILLIPS (Supervisor)

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