Negotiating care of frail elders: relationships between community nurses and family caregivers.

Recent changes in patterns of care of the elderly in Canada, including the withdrawal of formal home-care services and increasing reliance on family caregivers, call for a critical analysis of the relationship between formal and informal caregivers. The purpose of this study was to describe and analyze the relationship between nurses and female family members caring for frail elders in the home. Using a critical ethnographic method in a socialist-feminist framework, separate in-depth interviews were conducted with 23 nurse-family caregiver dyads. Analysis of interview transcripts and fieldnotes revealed that relationships were characterized by uncertainty and tension. While both nurses and family caregivers functioned within and resisted current home-care arrangements, they engaged in an ongoing process of negotiating cultural assumptions about "private" and "public" caregiving. The findings point to implications for nursing practice, education, and policy.