1. Introduction
Caregiving for an elderly or chronically ill
relative or friend is increasingly a role assumed
by American families. Contrary to popular
belief, Americans do not abandon their elderly
or chronically ill relatives. Studies of informal
caregiving consistently indicate that 7580% of
care is provided by family members and other
informal providers [l], suggesting that the medical
care system is dependent on both selfcare by
the patient and care provided by families to
achieve optimum well-being for in~viduals with
chronic illness.
The danger is not that families will abandon their ill relatives but that the health care system
will abandon its care-givers. The evolving health
care system, with managed care emerging as a
primary organizing strategy, places increasing
emphasis on controlling utilization and the cost
of care and puts a premium on the time spent by
doctors with their patients. With these changes, it
becomes even more important both for affected
individuals and their families, as well as for the
health care system, to keep chronic illnesses wellmanaged.
Patients and health care consumers need a
place where they will have their questions answered,
where they can seek out needed information,
and where their spirits and motivations
to stay well will be bolstered. A partnership
between family members and formal care providers
is needed to promote the well-being of
chronically ill persons or fraii older adults and to
sustain the family support system. In this article,
we present a family support model and describe
the Legacy Family Support Services program in
Portland, Oregon, which is based on this model.
We discuss why this model is important and how
it can be