Perceptions of time and identity: informal family carers of people with chronic illness

Abstract

One of the indicators by which efficacy of care is measured in Australian health care services is time use. Increasing the amount of time that health professionals spend with health service users (HSUs) is associated with better care and better health outcomes. However the health care workforce is struggling to meet the increasing demands of Australia's ageing population and increasing burden of chronic illness (CI). To alleviate the pressures on the health system, health care policies and programs are placing greater emphasis on self-management and greater reliance on informal care. Little consideration has been given to the implications this has for informal carers in terms of their time use, perceptions of time and connected constructions of identity. The Serious and Continuing Illness Policy and Practice Study undertook qualitative research, comprising semi-structured in-depth interviews with 10 informal carers and 8 HSU concerning their experiences of complicated CI. Content analysis was undertaken following Morse and Field (1995) and assisted by QSR Nvivo8 qualitative software. Participant stories of chronic illness experiences illustrate complexities that emerge around time and carer identity. Participants suggested that caring is a 24 hour job. Part of this job is measurable through calendar and clock time (CCT), such as how much time a person spends preparing special foods for their care recipient or assisting them with managing medications. But in understanding temporal experiences there remains a cavity unfilled by measures of CCT. Understanding the 24 caring job entails exploration of the psychological and emotional states associated with process, such as worry time. This paper illustrates how CCT and process time contribute to our understanding of how CI can shape the identity constructions of informal carers. The importance of this topic is rooted not only in our understanding the social dynamics of CI, but also the fiscal components and 'lived costs' of CI care.