Thus, the differences between the two care systems with respect to power, status, authority, and resources are rarely considered in these studies. One exception, however, was Ward-Griffin and Marshall [38] who found home care nurses and family caregivers of older chronically ill elders living in Canada engaged in a bidirectional labour process of “work transfer”, one that depended on the “free” labour of family caregivers. Although this particular study sheds light on the complexity and interconnectedness of formal informal care and points to the need to conceptualize elder care as work, regardless of who does it, it did not focus on dementia home care.