Rozario Philip A, Palley Elizabeth
Adelphi University School of Social Work, One South Avenue, Garden City, NY 11530, USA.
Soc Work Public Health. 2008;23(4):49-68. doi: 10.1080/19371910802162207.
Though family caregiving forms the backbone of the long-term care system in the United States, long-term care policies have traditionally focused on paid services that frail older people and people with disabilities utilize for their day-to-day functioning. Part of the exclusion of family caregiving from the long-term care discourse stems from the traditional separation of the private sphere, where family caregiving occurs, from the public sphere of policy making. However, the passage of the Family and Medical Leave Act (FMLA), the National Family Caregiver Support Program (NFCSP) and Medicaid waiver legislation may reflect recent changes in the government's position on their role in addressing issues related to the "private spheres." In this article, we explore the nature of family caregiving in the United States, the divide between the public and private spheres and provide an overview of family caregiving-related policies and programs in the U.S. In our review, we examine the provisions in the FMLA, NFCSP, and Medicaid waiver legislation that support family caregiving efforts. We also examine the roles of family caregiver organizations in making family caregiving an important element of long-term care policy and influencing policy-making.
尽管家庭照护构成了美国长期照护体系的支柱，但长期照护政策传统上一直侧重于体弱的老年人和残疾人用于日常起居的付费服务。家庭照护在长期照护讨论中被排除在外，部分原因源于家庭照护所在的私人领域与政策制定的公共领域传统上的分离。然而，《家庭与医疗休假法》（FMLA）、国家家庭照护者支持计划（NFCSP）以及医疗补助豁免立法的通过，可能反映出政府在其应对“私人领域”相关问题的角色方面立场的近期变化。在本文中，我们探讨了美国的家庭照护性质、公共领域与私人领域的划分，并概述了美国与家庭照护相关的政策和计划。在我们的综述中，我们审视了《家庭与医疗休假法》、国家家庭照护者支持计划以及医疗补助豁免立法中支持家庭照护工作的条款。我们还考察了家庭照护者组织在使家庭照护成为长期照护政策的重要组成部分以及影响政策制定方面所发挥的作用。
