Policy Delusions and Dutiful Daughters: Imagined Versus Real Care Integration for Older People

Policymakers advocate for integrated care as a solution to care fragmentation. In the case of older adults, informal carers (especially ‘dutiful daughters’) play a significant role in integrating and coordinating care. Ludlow and colleagues examine how the role of informal carers in integrating care across services and systems is reflected in policy (the blunt-end of the system) and the experiences of dutiful daughters (the sharp-end) in England and Australia. They present the findings from content analysis of key policy documents, as well as four case accounts of dutiful daughters. The authors found that unpaid carers, and the gender imbalance of caregiving, were largely invisible in the policy documents, accentuating the disconnect between policymakers’ vision for integrated care and the accomplishment of integration on the ground.