Three: Unpaid informal carers: The ‘shadow’ workforce in health care

Much of the international literature on health human resources focuses on highly trained, regulated and visible professionals with exclusionary social closure in neo-Weberian terms, such as doctors and nurses. However, researchers and policy makers are now paying more attention to the increasingly important role played by less well-trained, often unregulated, and less visible occupations such as personal support workers. Beyond these categories of paid workers exists another mostly uncharted health human resource: unpaid, little trained, largely unregulated and invisible informal carers. They include the family, friends and neighbours who provide the bulk of everyday care required to support the well being and independence of growing numbers of people facing multiple chronic health and social needs in community settings. Focusing on Canada, this chapter documents the characteristics and contributions of informal carers, and highlights the challenging realities of informal caregiving – both from the perspective of carers and policy makers considering how best to support and encourage unpaid, informal carers without driving up formal health system costs.

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