Family, community and government: the value and the limits of local caregiving

More frail elderly, more seriously disabled infants, and more chronically ill persons are part of the contemporary health delivery scene than in times past. Their prime caregivers are family members, most frequently women, whose contribution is limited by the facts of geographic distance, competing pressures, and smaller families to share the burden. Added to the caregiving task are the special needs of individuals at stressful points, which, if unmet, increase the incidence of breakdowns. The support of families is often augmented by local services and by mutual help groups, but the need has far surpassed the resources now, and this has resulted in some unhealthy local competition. The caregiving issue is a matter of national priorities that cannot be solved without a shift from military to domestic spending.