‘Expert carers’: An emergent normative model of the caregiver
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Informal caregivers are increasingly recognised as key providers of care to individuals with long-term conditions. However, caregiving itself is a contested domain and one that is increasingly the object of policy and institutional intervention. A recent development is that of providing formal training to caregivers, to better equip them to carry out what is perceived to be a new and demanding role. A number of such interventions have been developed and evaluated, with mixed results. At the start of a process evaluation of one such intervention, specifically for stroke caregivers, we sought to better understand what implicit model of the caregiver underpins training interventions and how this model might be accounted for. In this article, we aim to address these questions by examining models of the ‘caregiver’ present in different bodies of literature and their relevance for caregiver training. We consider the extent to which this points to the emergence of a normative model of the caregiver. We propose that training caregivers serves to create expert or semi-professional caregivers, through the transmission of technical knowledge and practices from health professional to lay person. We also consider the wider implications this has for informal caregivers and caregiving practices.
Keywordsinformal caregivers caregiver models training interventions stroke long-term conditions expert carers
- Carers UK. (2011) What is caring? http://www.carersuk.org/about-us/what-is-caring, accessed 12 January 2012.
- Department of Health. (1989) Caring for People: Community Care in the Next Decade and Beyond. London: HMSO.Google Scholar
- Department of Health. (1995) Carers (Recognition and Services) Act 1995. London: HMSO.Google Scholar
- Department of Health. (2001) The Expert Patient: A New Approach to Chronic Disease Management in the 21st Century. London: The Stationery Office.Google Scholar
- Department of Health. (2004) Carers (Equal Opportunities) Act 2004. London: HMSO.Google Scholar
- Department of Health. (2007) The National Stroke Strategy. London: Crown.Google Scholar
- Department of Health. (2008a) Carers at the Heart of 21st Century Families and Communities: A Caring System on Your Side, a Life of Your Own. London: Crown.Google Scholar
- Department of Health. (2008b) Confidence in Caring: A Framework for Best Practice. London: Crown.Google Scholar
- Department of Health and Social Security. (1981) Growing Older. London: HMSO.Google Scholar
- Ellis, G., Mant, J., Langhorne, P., Dennis, M. and Winner, S. (2010) Stroke liaison workers for stroke patients and carers: An individual patient data meta-analysis (Review). Cochrane Database of Systematic Reviews (5), Art No: CD005066. DOI: 10.1002/1465/858.CD005066.pub2.Google Scholar
- Finch, F. (1990) The politics of community care. In: C. Ungerson (ed.) Gender and Caring: Work and Welfare in Britain and Scandinavia. New York: Harvester Wheatsheaf.Google Scholar
- Forster, A. (2005) Caregiver burden in stroke. Current Medical Literature 9 (1): 127–131.Google Scholar
- Forster, A. et al (2008) Training Caregivers after Stroke (TRACS), Protocol Version 1. 21 August 2008.Google Scholar
- Foucault, M. (1973) The Birth of the Clinic: An Archaeology of Medical Perception. London: Tavistock Publications.Google Scholar
- Foucault, M. (1988) Technologies of the self. In: L. Martin, H. Gutman and P. Hutton (eds.) Technologies of the Self – A Seminar with Michel Foucault. Amherst, MA: University of Massachusetts Press.Google Scholar
- Griffiths Sir, R. (1988) Community Care: Agenda for Action. London: HMSO.Google Scholar
- Good, B.J. (1994) Medicine, Rationality, and Experience. Cambridge: Cambridge University Press.Google Scholar
- Intercollegiate Stroke Working Party. (2004) National Clinical Guidelines for Stroke, 2nd edn. London: Royal College of Physicians.Google Scholar
- Intercollegiate Stroke Working Party. (2008) National Clinical Guideline for Stroke, 3rd edn. London: Royal College of Physicians.Google Scholar
- Intercollegiate Stroke Working Party. (2009) National Sentinel Stroke Audit Phase II (clinical audit) 2008. Report for England, Wales and Northern Ireland. London: Royal College of Physicians.Google Scholar
- Lewis, G. (2000) A Failure of Treatment. Oxford: Oxford University Press.Google Scholar
- Medical Research Council. (2008) Developing and evaluating complex interventions: New guidance, www.mrc.ac.uk/complexinterventionsguidance, accessed 30 November 2011.
- Traphaghan, J.W. (2007) Moral discourse and old-age disability in Japan. In: B. Ingstad and S.R. Whyte (eds.) Disability in Local and Global Worlds. Berkeley, CA: University of California Press.Google Scholar
- Turner, V. (1988) The Anthropology of Performance. New York: PAJ Publications.Google Scholar
- World Health Organisation. (2009) Stroke, cerebrovascular accident, http://www.who.int/topics/cerebrovascular_accident/en, accessed 1 November 2010.