Understanding the family perspective: an ethnographic framework for providing occupational therapy in the home

This article presents a framework for providing occupational therapy services to family members caring for elderly persons in the home that is based on four key principles derived from ethnographic methodology: identification of an informant, use of an emic (insider) approach, engagement in self-reflection, and interpretation of information. The underlying strategy is to use these principles to derive an understanding of the personal meaning of caregiving, the way in which care is provided, and the specific aspects of caregiving that are problematic from the perspective of the family member. Services are then developed that reflect individual need as expressed by the caregiver and that fit the fundamental values and belief system of the family unit. A case example is presented to illustrate the framework in action in a home situation with family members caring for an elderly person with dementia.