Unequal Lives: Health and socio‐economic inequalities

Abstract

Also, the assumption underlying home care in the US that the individual, rather than the family, is the beneficiary does not apply in Australia, where HACC is explicitly directed at carers as well as at care-recipients, and residential care and hospice care are both more medicalised in the US than in Australia.However, gaps and misunderstandings do occur here, especially in acute care settings, where families may be ignored or seen as interfering rather than as a necessary part of the care system.Unfortunately, the book does not address the situation where professional carers rightly reject the standard of family care provided to the more dependent family members -where there is the potential for abuse of varying kinds, including restricting the ill family member's opportunities for self-care or personal development.Such problems are exquisitely diff icult for professionals to deal with.The concluding chapter, 'Building on Common Ground', sets out some ways forward for reducing the potential for misunderstanding between the various parties involved in care-provision.First there needs to be more research on the different priorities and assumptions that family caregivers and professionals bring to care, and on relationships between formal and informal care providers: in Australia as in the US, there has been little detailed or nuanced research on how each perceives the care provided by the other.Without the evidence-base, we simply don't know how wide the gulf between family values and professional values is in Australia.The second way forward, through education and training of both formal and informal carers, is irrefutable.Family caregivers require not just support but also more preparation for technical aspects of care-provision, including how to get help from the community service system, while professional caregivers need better preparation on the social and emotional aspects of care, especially in settings that do not support these aspects well.The third area is policy.Here, Australia seems well-placed as there is already a large emphasis on supporting informal carers, and our care systems seem less rigid and hospital-like than those of the US.The debates entered into in this book are interesting and thought-provoking.This is an interesting book for researchers, policy-makers and service-providers, and provides a prompt to examine our own practice and procedures.

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