Article on what drives choices of older users of care in England



User choice in care for older people has assumed that care is like any other commodity; which is in contrast with the strong relational component that is part of care – i.e. caring relationships. Ricardo Rodrigues has just published an article that aims to understand how caring relationships impact the decisions of older users of cash-for-care and their perceived satisfaction. The study used semi-structured qualitative interviews with 24 Direct Payments (DPs) older users, including proxies, in three Local Authorities in the Greater London area. Decisions on and perceived satisfaction with care were both influenced by caring relationships. All users recognized that caring relationships can have instrumental value in improving care delivery or allowing greater leeway in negotiating tasks. Many users placed intrinsic value on continuity of care and the development of close caring relationships and clearly favored employing PAs. The latter involved higher levels of uncertainty, emotional investment and reciprocal gift exchanges. Agencies were often chosen due to users’ preference for more detached caring relationships. The findings confirm that caring relationships involving reciprocal emotional investment are an important outcome of care, with salient implications for user behavior. The article is available for free here