Balancing formal and informal care for older persons: How case managers respond

Allie Peckham, A. Paul Williams, Sheila Neysmith

Research output: Contribution to journalArticlepeer-review

19 Scopus citations


This study examined how front-line home and community-care (H&CC) case managers view the role of informal caregivers, and the factors that contribute to H&CC managers' resource allocation decisions. The study research used two methods of data collection: (a) secondary analysis of the results from balance of care (BoC) simulations conducted in nine regions of Ontario, and (b) in-depth follow-up interviews with participating BoC case managers. Results suggest that case managers unanimously agree that the unit of care in the H&CC sector is not confined to the individual, as in acute care, but encompasses both the individual and the caregiver. We found, however, considerable variation in the mix and volume of H&CC services recommended by case managers. We conclude that variability in decision making may reflect the lack of regulations, best practices, and accountability guidelines in the H&CC sector.

Original languageEnglish (US)
Pages (from-to)123-136
Number of pages14
JournalCanadian Journal on Aging
Issue number2
StatePublished - Jun 2014
Externally publishedYes


  • aging at home
  • balance of care
  • case managers
  • home and community care
  • informal caregiver
  • street-level bureaucracy

ASJC Scopus subject areas

  • Health(social science)
  • Gerontology
  • Community and Home Care
  • Geriatrics and Gerontology


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