Home sweet hospital: the nature and limits of private responsibilities for home health care.

Family caregivers, often called "informal" caregivers, are the unpaid relatives, partners, or close friends who provide directly or manage the health care for individuals who are seriously ill or disabled. As a result of changes in the American health care system, family caregivers confront increasing responsibilities, burdens, and challenges. However, there are limits to family responsibility for caregiving, and whereas families may take the first step toward accepting responsibility for home care, professionals and institutions bear continuing responsibility. Public policies and programs have an enormous impact on the availability of home care assistance and services, the family's ability to afford and provide home care, and a caregiver's continued participation in the workforce. One of the major goals for the future of home care should be to recognize and respond appropriately to diverse family structures, strengths and limitations, and needs.