Intergenerational solidarity and care of older people: Linking families and bureaucracy in context

This presentation examines how the intersection of family and bureaucracy affects intra- and inter-generational solidarity between older persons and their family caregivers.  It is conceptually based on Shanas and Sussman’s typology of dimensions of linkages between bureaucracies and primary groups. Within a large multi-phase study of home (domiciliary) care workers, elderly clients and family carers in Canada, we analyze interviews with 24 dyads of older people receiving home-based health and social care, and their informal caregivers (i.e. spouses and daughters). This allows us both to identify different forms of solidarity in family relations, and to explore how complex systems of care (linking families and both private and public sector workers) influence this solidarity.  

Our analysis of the dyad’s routines of care found that despite the use of private and public services related to the provision of in-home health and social support, solidarity between older people and their family caregivers is not weakened. On the contrary, it remains strong due to the contingent characteristics of the formal home care system. The role of the family is essential to provide and negotiate key aspects of client’s care that are not addressed by the formal care system. In this context, private bureaucracy complements both client’s self-care and family care, serving to compensate for the inconsistencies of the services received.

Although our analysis is based on data from Canada, our reflections include a comparative stance that takes into account how the presence of bureaucracy (both public and private) differentially affects the solidarity between older people and their families. While Canada has a strong presence of bureaucratic institutions, in which the welfare state plays an important role, in other countries like Chile, characterized by its neoliberal policies, the role of the bureaucracy is still marginal and family solidarity almost the only alternative.