Previous research on home support has identified that
one of the challenges for home care workers is forming
and maintaining relationships with clients and their family
caregivers [25, 26]. Although the formal sector relies heavily
on familial caregivers (families and friends) to provide the
vast majority of care to persons with dementia, there has
been little investigation of the relationship between the
formal and informal home care networks. The few studies
that have been conducted on home care [9, 27–30] have
revealed an “uneasy alliance” and power struggles between
the family caregivers and providers. Analysis of focus groups
of 46 American home care clinicians revealed five inherent
conflicts affecting family caregiver-clinician interactions:
unrecognized family involvement; competing priorities and
little time; lack of appropriate services to meet family needs;
dual obligation of patient advocate and service gatekeeper;