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Who Cares? Moral Obligations in Formal and Informal Care Provision in the Light of ICT-Based Home Care

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Abstract

An aging population is often taken to require a profound reorganization of the prevailing health care system. In particular, a more cost-effective care system is warranted and ICT-based home care is often considered a promising alternative. Modern health care devices admit a transfer of patients with rather complex care needs from institutions to the home care setting. With care recipients set up with health monitoring technologies at home, spouses and children are likely to become involved in the caring process and informal caregivers may have to assist kin-persons with advanced care needs by means of sophisticated technology. This paper investigates some of the ethical implications of a near-future shift from institutional care to technology-assisted home care and the subsequent impact on the care recipient and formal- and informal care providers.

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Notes

  1. The technology discussed facilitates home care and can be used both by care recipients themselves (self care) and by formal and informal care providers offering care and assistance to the patient in his or her home. This paper focuses on the informal care providers´ situation in light of ICT-based home care.

  2. Genet et al. [21] provide an overview of studies conducted on home care in Europe and conclude that the scientific literature available do not cover core aspects of home care. Likewise, informal care is poorly researched.

  3. The Future of Retirement: The New Old Age, HSBC and the Oxford Institute of Ageing, 2007, 2006, 2005, http://www.hsbc.com/1/2/retirement/future-of-retirement.

  4. UN Report World Population Aging 1950–2050 http://www.un.org/esa/population/publications/worldageing19502050/.

  5. EC Demography Report, 2008, World Population Prospects—The Revision 2008, UN, [57] http://www.oecd.org/dataoecd/20/23/2431724.pdf.

  6. http://ftp.jrc.es/EURdoc/eur22352en.pdf.

  7. http://www.oecd.org/document/61/0,3746,en_2649_33929_45501565_1_1_1_1,00.html.

  8. http://www.epha.org/IMG/pdf/e-health_action_plan.pdf.

  9. Furthermore, health-related data can be transferred electronically to informal- as well as to formal care providers. Electronic health up-dates may not only improve the quality of diagnoses and the security of care recipients but also be of great comfort to relatives living at a distance from an elderly person in need of attendance.

  10. Importantly, “home care”, “formal care” and “informal care” are notions that are used in many different ways without clear demarcation-lines that causes confusion, not the least in relation to responsibility ascriptions. As understood here, “home care” may include but is not equivalent to home help service (HHS). Home Help Service is provided in order to assist individuals in need of support to remain in their own homes and to avoid institutionalized long-term care. Emerging home care includes HHS, medical care and long-term care. Long-term care exceeds medical care and nursing care and includes assistance with long-term disabilities and chronic illness. Here, home care serves as an umbrella term for the many different types of care that are provided in the home care setting by means of ICT-devices. In below, it is primarily family care that will be discussed under informal care.

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Acknowledgment

This paper is written within the project Personalized Health Monitoring Ethics (PHM-Ethics) funded by the European Commission (contract number 230602).

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  1. Centre for Applied Ethics, Linköping University, 581 83, Linköping, Sweden

    Elin Palm

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Palm, E. Who Cares? Moral Obligations in Formal and Informal Care Provision in the Light of ICT-Based Home Care. Health Care Anal 21, 171–188 (2013). https://doi.org/10.1007/s10728-011-0199-3

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