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Older people’s experiences of care at home

Rachel Barken

About the researcher

Rachel Barken is a PhD Candidate in the Department of Sociology at McMaster University. She received her BA in Social Anthropology and French in 2009 and her MA in Sociology in 2011, both from Dalhousie University. Rachel decided to pursue graduate studies at McMaster to work with experts in the field of aging and care. During her time at McMaster, she has benefitted from the opportunity to be involved with the Gilbrea Centre for Studies on Aging, and to plan and attend various community-university events related to aging. For more information about this research, please contact Rachel at or 416 898-1926.

What you need to know

Older people with impairments and chronic health conditions increasingly receive care in their homes, from professional caregivers and family members. People who are receiving care want to maintain a balance between different sources of support while preserving their own independence.

What is this research about?

It is becoming more common for older people to receive care in their own homes, rather than in hospitals or long-term care facilities. Formal home care providers, such as personal support workers, typically offer assistance with bathing and dressing as well as some nursing and medical care. However, family members and friends also provide significant levels of support to older people. In addition to this, older people who are receiving care from others continue to do many things to care for themselves. The purpose of this research is to understand how older people experience and respond to formal and family care, and how their own self-care interacts with care from others.

What did the researcher do?

The researcher conducted 34 interviews with people aged 65 or older in the Greater Toronto-Hamilton Area. The interviews focused on the support older people receive from formal care providers and family/friends, the relationships they have with these caregivers, and the ways they take care of themselves. The majority of  interview participants used the public home care system, though a minority paid for care privately as an alternative to public care, or to supplement it.

What did the researcher find?

Older people attempt to find a balance between different sources and forms of care. Older people want to maintain their independence and avoid placing undue stress on their family. The majority of participants felt they had a balance between sources and forms of care: they had access to support, but also could maintain autonomy without imposing too many demands on their family. Just over 10% of participants felt an imbalance in their care, which occurred when they had needs that exceeded the public care system and little financial means or family support.

It is easier for older people to hold a sense of autonomy in their care when they have access to resources that support self-care. Older people do not want to place unnecessary stress on their family members, and do not want their care needs to affect their family relationships. People with less financial support experience some disadvantages in the current home care system. It is necessary for home care policies to recognize the needs of older people with limited financial or family support. More comprehensive home care services could enable more older people to find a balance in their care.

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How can you use this research?

This research is useful for home care agencies, older people who are receiving home care, and family caregivers. It can be used to advocate for changes in the healthcare system, to ensure that financially and socially disadvantaged older people have access to the care they need and want. Many members of the general public have older family or friends who need home care, and this research can help them understand individual experiences as well as the broader context of home care.


Learn more about Rachel Barken