Co-production in coping with care dependency in Germany: How can integrated local care centres contribute?

In Germany, most care dependent people are looked after by family members at home. Professional support can help ease the burden of caring relatives and stabilise home care. Ideally, care then is provided through the co-production of formal and informal caregivers. This article analyses how care dependent people and their family caregivers integrate professional support into their care arrangements. An analysis was conducted using data collected for a qualitative study evaluating integrated local care centres in North-Rhine-Westphalia, Germany. The study is based on episodic interviews with users of these care centres and their family caregivers (N = 26). During the analysis, three interpretive and practice patterns relating to co-production of care were identified. These patterns reveal how the interviewees deal with (increasing) needs for assistance and care while incorporating professional care into their lives. The patterns help differentiate whether the interviewees (a) use developed care skills to contribute actively to the co-production with their layman knowledge, or (b) seek relief of their care responsibilities and withdraw temporarily from the direct sphere of care applying freed capacities to organise family daily life, or (c) use the services of the care centres to meet with other older people and to develop spaces for mutual help and co-production. The interpretive and practice patterns thus differ in the extent to which care users and family caregivers continue to play an 'active role' in the care process and contribute their own knowledge, ideas, expectations and particular care activities. In order to achieve a functioning co-production, professionals face the challenge of understanding these patterns that have been established over many years and of taking them into account appropriately.