Issues in Family Care of the Elderly: Characteristics of Care, Burden on Family Members, and Support Programs

Informal care of the elderly has long been an important theme in gerontological research. It is now, however, the object of renewed interest, as socio-demographic developments present policymakers and service planners with new challenges. It is not only that the growing trend to keep elders in the community whenever possible is greatly dependent on the availability of informal caregivers, but also that the care that they provide is becoming more complex and requires greater understanding, knowledge, and skills in a range of areas. There is, consequently, an increasing tendency to consider the caregivers themselves as a target population for the service system and greater efforts are being made to identify their needs, out of concern for their physical and mental health and with the aim of sustaining this important resource. The report focuses on the system of care of the elderly provided by family members in light of these developments.

The report is based on a few sources of information:

  • A comprehensive survey of the international literature and an integrative examination of data from studies in Israel
  • A survey of information from policy documents and selected programs that have been developed throughout the world, concerning direct support for caregivers
  • Attitudes and perceptions of key players in the service system, based on in-depth interviews.

The report discusses several lessons that should be considered when developing policies and programs for family members caring for elders. For example, there emerges a need to develop better tools for assessing the status of informal caregivers, as a basis for determining intervention programs, identifying groups at risk and monitoring the caregivers’ status over time. The support of informal caregivers entails the development of a range of interventions that reflect the caregivers’ needs in various areas, such as: information, counseling, acquisition of skills, care management, socio-emotional support, options for respite, and financial support. Establishment of priorities for the development of intervention programs should be based on identifying the most prominent gaps. In Israel currently, the greater focus is on providing counseling and information rather than on other areas such as practical training and guidance or on socio-emotional support. Among specific issues that do not receive sufficient attention today are those relating to bereavement and end-of-life care.

When developing the interventions, it is important that the programs be oriented toward the differential needs within the target population (e.g., the needs of someone caring for his/her spouse are different from those of a son or daughter caring for a parent). It is also important to utilize existing infrastructures to provide support for the caregivers. For example, home visits, which are conducted in any case, could be utilized to provide guidance to family caregivers.

The report has been used by JDC-ESHEL and its government partners as background material for its eighth five-year plan, and is already serving as the basis for new programmatic initiatives. The study was financed with the assistance of ESHEL – The Association for the Planning and Development of Services for the Aged in Israel.

Citations in the professional and academic literature

Asiskovitch, S. (2013). The Long-Term Care Insurance Program in Israel: solidarity with the elderly in a changing society. Israel Journal of Health Policy Research2(1), 3.

Dwolatzky, T., Brodsky, J., Azaiza, F., Clarfield, A. M., Jacobs, J. M., & Litwin, H. (2017). Coming of age: health-care challenges of an ageing population in Israel. The Lancet389(10088), 2542-2550.

Halperin, D. (2013). Aging, family, and preferences for care among older Jews and Arabs. Israel Studies Review28(2), 102-121.

Gu, L., Rosenberg, M. W., & Zeng, J. (2017). Changing caregiving relationships for older home-based Chinese people in a transitional stage: Trends, factors and policy implications. Archives of gerontology and geriatrics70, 219-229.

Saraubon, K., Anurugsa, K., & Kongsakpaibul, A. (2018, December). A Smart System for Elderly Care using IoT and Mobile Technologies. In Proceedings of the 2018 2nd International Conference on Software and e-Business (pp. 59-63). ACM.

Nissim, B. D., Daphna, H., Ruth, K., Ariela, L., & Aviad, T. S. (2016). A method for estimating the participation rate of elder care.

Hronová, T., & Souralová, A. (2018). Eldercare agencies and the marketing of care work in the Czech Republic: relieving a family burden?. International Journal of Care and Caring2(2), 235-251.

Gqada, N. C. (2016). The effect of a dance and music programme on the functional ability of the residents of an old age home in Pietermaritzburg, KwaZulu-Natal (Doctoral dissertation).

Shnoor, Y., & Berg-Warman, A. (2019). Needs of the Aging LGBT Community in Israel. The International Journal of Aging and Human Development, 0091415019844452.

Waweru, H. M., & WAMUKOYA, J. M. INNOVATIVE RESEARCH AND KNOWLEDGE.

Even-Zohar, A. (2015). The Contribution of a “Supportive Community” Program for Older Persons in Israel to Their Offspring Who Are Primary Caregivers. Current gerontology and geriatrics research2015.

Andrade, T. B. D., & Andrade, F. B. D. (2018). Unmet need for assistance with activities of daily life among older adults in Brazil. Revista de saude publica52, 75.