Self-, informal and formal care: Partnerships in community-based and residential long-term care settings

Increasing emphasis is being placed on the need to have older adults, their families and formal service providers work together collaboratively or "in partnerships" to provide long-term care, both in community and residential care settings. There is therefore a need to determine how such relationships are currently structured. This paper systematically reviews the results of studies published from 1985 through 1998 on relationships involving self-, informal and formal care within these settings. The findings suggest that formal services are not used to displace or substitute for informal care but rather, that formal services tend to be used to supplement and complement the care provided by the informal network. This is true both in community and residential care settings. Exactly how these partnerships are structured and the relationships between self-care and both informal and formal systems of care are less clear. The findings point to a need to refocus attention away from the creation of partnerships and protecting against unnecessary substitution, towards broader concerns with supporting the partnerships that already exist.