Dorinda Npoinden Nyala


Relationships are formed between formal and informal caregivers as they cater for in-patients. These relationships are formed as they perform their caregiving activities. The various caregiving tasks of formal and informal caregivers tend to overlap, causing conflict in the relationships between formal and informal caregivers. Conflicts between caregivers negatively affect the health care of in-patients. There is therefore the need for caregivers (both formal and informal) to know what their various tasks are, which is a step toward a coordinated working relationship between them. Studies have found that caregiving roles, communication and role expectations and perceptions of formal and informal caregivers determine whether both parties can coordinate their various caregiving tasks. Limited research is also found on how formal and informal caregivers relate with one another in providing care for the elderly and those with specific ailments such as Alzheimer’s disease, dementia and delirium who might not be necessarily hospitalised. Previous studies have not treated the various tasks performed by formal and informal caregivers and the tasks that overlap between them which is the focus of this study. A sample size of 21 study participants, including eight in-patients, eight informal caregivers and five formal caregivers, was used. The study adopted the qualitative research approach using interviews and observation to gather data from formal and informal caregivers. It was found that specialised caregiving tasks were performed by formal caregivers while unspecialised caregiving tasks were performed by informal caregivers. Overlaps in the performance of specialised and unspecialised caregiving tasks were detected when some caregiving tasks that otherwise required unspecialised skills needed to be performed with specialised skills. Where a minimum level of skill was required, informal caregivers were taught a few skills to enable them to undertake those tasks. In order to improve the working relationship between formal and informal caregivers at the paediatric ward of the Cape Coast Teaching Hospital, it is recommended that these minor training by formal caregivers are intensified to improve the working relationship between formal and informal caregivers. Hospitals should also have clearly delineated roles for formal and informal caregivers to avoid overlapping caregiving tasks. This will ultimately enhance the quality of care provided to in-patients by improving communication between caregivers and reducing conflicts.


Article visualizations:

Hit counter


caregiving, caregivers, relationship, paediatric ward, roles

Full Text:



Abekah‐Nkrumah, G., Manu, A., & Atinga, R. A. (2010). Assessing the implementation of Ghana's patient charter. Health Education,110 (3), 169-185.

Abuosi, A. A., Domfeh, K. A., Abor, J. Y., & Nketiah-Amponsah, E. (2016). Health insurance and quality of care: Comparing perceptions of quality between insured and uninsured patients in Ghana’s hospitals. International Journal for Equity in Health, 15(1), 1-11.

Agbelie, J. A. D. (2017). Caregivers’ perception of quality of care at the out-patient department of Princess Marie Louise Hospital, Accra (Doctoral dissertation, University of Ghana).

Alsan, M., Bloom, D. E., & Canning, D. (2006). The effect of population health on foreign direct investment inflows to low-and middle-income countries. World Development, 34(4), 613-630.

Baskin, A., et al. (2016). Informal providers: Understanding motivations and behaviours. Stanford India health policy initiative Institute of Socio-Economic Research on Development and Democracy (ISERDD).

Brannen, J. (2005). Mixing Methods: The entry of qualitative and quantitative approaches into the research process. International Journal of Social Research Methodology, 8(3), 173-184.

Bruhn, J. G. (2016). Who are caregivers? In J. G. Bruhn, After diagnosis: Family caregiving with hospice patients (pp. 1-6). Switzerland: Springer International Publishing AG.

Benoot, C., Hannes, K., & Bilsen, J. (2016). The use of purposeful sampling in a qualitative evidence synthesis: A worked example on sexual adjustment to a cancer trajectory. BMC medical research methodology, 16(1), 1-12.

Büscher, A., Astedt‐Kurki, P., Paavilainen, E., & Schnepp, W. (2011). Negotiations about helpfulness–the relationship between formal and informal care in home care arrangements. Scandinavian Journal of Caring Sciences, 25(4), 706-715.

Byrne, D., Goeree, M. S., Hiedemann, B., & Stern, S. (2009). Formal home health care, informal care, and family decision-making. International Economic Review, 50(4), 1205-1242.

Cantor, M. H. (1975). Life space and the social support system of the inner-city elderly of New York. The Gerontologist.

Carpentier, N., Pomey, M. P., Contreras, R., & Olazabal, I. (2008). Social care interface in early-stage dementia: practitioners' perspectives on the links between formal and informal networks. Journal of Aging and Health, 20(6), 710-738.

Covinsky, K. E. et al. (2013). A survey of nurses’ practices and perceptions of family-centered care in Ireland. Journal of Family Nursing, 19(4), 469-488.

Edelman, P. (1986). The impact of community care to the home-bound elderly on provision of informal care. Gerontologist, 45(2), 74-84.

Egan, K. A., & Labyak, M. (2006). Hospice palliative care: A theory for quality End- of-life Care. In B. Ferrell, & N. Coyle (Eds), Textbook of Palliative Nursing (pp. 13-46). New York: Oxford University Press.

Ghana Health Service. (2015). The health sector in Ghana facts and figures. Accra: MOH.

Given, B., Paula R. Sherwood, R., & Given, W. (2008). What knowledge and skills do caregivers need? Journal of Social Work Education, 44:sup3, 115-123.

Greene, V. (1983) Substitution between formally and informally provided care for the impaired elderly in the community. Med. Care 21, 609±619.

Hagerling, F. L. (2015). Nurse attitudes toward caring for older patients with delirium. Doctoral dissertation, Colorado State University.

Heitmueller, A., & Inglis, K. (2007). The earnings of informal carers: Wage differentials and opportunity costs. Journal of Health Economics, 26(4), 821-841.

Husain, M. J. (2010). Contribution of health to economic development: A survey and overview. Economics, 4(1). 1-37

IFA. (2014). Connecting the dots: Formal caregivers and informal Care. Toronto: SOM.

King, N., Horrocks, C., & Brooks, J. (2018). Interviews in qualitative research. Sage.

Kumpers, S., Mur, I., Maarse, H., & van Raak, A. (2005). A comparative study of dementia care in England and the Netherlands using neo-institutionalist perspectives. Qualitative Health Research, 15, 1199-1230.

US Department of Health and Human Services. (2006). Agency for Healthcare Research and Quality. TeamSTEPPS: Instructor guide.

Lai, C. K. (2003). Formal caregivers, informal caregivers, and carers. Retrieved from reflections on nursing leadership


Litwak, E. (1985). Helping the elderly: The complementary roles of informal networks and formal systems. New York: Guilford Press.

Litwin, H., & Attias-Donfut, C. (2009). The Inter-relationship between formal health care and informal care: A study in France and Israel. Ageing and Society, 29(1), 71-91.

Loghmani, L., Borhani, F., & Abbaszadeh, A. (2014). Factors affecting the nurse-patients’ family communication in intensive care unit of Kerman: a qualitative study. Journal of Caring Sciences, 3(1), 67.

Loghmani, L., Borhani, F., & Abbasszadeh, A. (2014). Determination of the content of communication between the care team and family members of patients in the intensive care unit: The experience of nurses and patients’ families. Journal of Qualitative Research in Health Sciences, 3(3), 257-268.

Luong, V. (2000). Theoretical explanations of differences in community-Based Long-Term care use between black and white elders. African-American Research Perspectives, 6(2), 3-10.

Lustig, N. (2007). Investing in health for economic development: The case of Mexico. In G. Mavrotas & A. Shorrocks (Eds.), Advancing development (pp.168-182). London: Palgrave Macmillan.

Maxwell, J. A. (2012). Qualitative research design: An interactive approach. London: Sage Publication Inc.

Noelker, S. L., & Browdie, R. (2013). Sidney Katz, MD: A new paradigm for chronic illness and long-term care. The Gerontologist 54(1), 13-20.

Orpin, P., Stirling, C., Hetherington, S., & Robinson, A. (2014). Rural dementia carers: formal and informal sources of support. Ageing & Society, 34(2), 185-208.

Quinn, C., Clare, L., & Woods, B. (2009). The impact of the quality of relationship on the experiences and wellbeing of caregivers of people with dementia: A systematic review. Aging and Mental Health, 13(2), 143-154.

Salin, S., Kaunonen, M., & Åstedt-Kurki, P. (2013). Nurses' perceptions of their relationships with informal carers in institutional respite care for older people. Nursing Research and Practice, 2013,1-9.

Schoonenboom, J., & Johnson, R. B. (2017). How to construct a mixed methods research design. KZfSS Kölner Zeitschrift für Soziologie und Sozialpsychologie, 69(2), 107-131.

Schulz, R., Eden, J., & National Academies of Sciences, Engineering, and Medicine. (2016). Family caregiving roles and impacts. In Families caring for an aging America. National Academies Press (US).

Sicotte, C., D’Amour, D., & Moreault, M.-P. (2002). Interdisciplinary coordination within Quebec community health care centres. Social Science & Medicine, 55, 991-1003.

Smith, L. N., Lawrence, M., Kerr, S. M., Langhorne, P., & Lees, K. R. (2004). Informal carers’ experience of caring for stroke survivors. Journal of Advanced Nursing, 46(3), 235-244.

Sudhinaraset, M., Ingram, M., Lofthouse, H. K., & Montagu, D. (2013). What is the role of informal care providers in developing countries? A systematic review. Plos One, 8(2), 1-12.

Toscan, J., Mairs, K., Hinton, S., Stolee, P., & Info Rehab Research Team. (2012). Integrated transitional care: patient, informal caregiver and health care provider perspectives on care transitions for older persons with hip fracture. International Journal of Integrated Care, 12(2), 1-9.

Victor, C. R., Healy, J., Thomas, A., & Sergeant, J. (2000). Older patients and delayed discharge from hospital. Health and Social Care in the Community, 8, 443-452.

Whiting, D. (2020). Epistemic worth. Ergo, 7(3), 15-45. Yaussy, S. L. (2019). The intersections of health and wealth: Socioeconomic status, frailty, and mortality in industrial England. Doctoral dissertation, College of Arts and Sciences, University of South Carolina.

DOI: http://dx.doi.org/10.46827/ejsss.v7i6.1310

Copyright (c) 2022 Dorinda Npoinden Nyala

Creative Commons License
This work is licensed under a Creative Commons Attribution 4.0 International License.

The research works published in this journal are free to be accessed. They can be shared (copied and redistributed in any medium or format) and\or adapted (remixed, transformed, and built upon the material for any purpose, commercially and\or not commercially) under the following terms: attribution (appropriate credit must be given indicating original authors, research work name and publication name mentioning if changes were made) and without adding additional restrictions (without restricting others from doing anything the actual license permits). Authors retain the full copyright of their published research works and cannot revoke these freedoms as long as the license terms are followed.

Copyright © 2016 - 2023. European Journal Of Social Sciences Studies (ISSN 2501-8590) is a registered trademark of Open Access Publishing Group. All rights reserved.

This journal is a serial publication uniquely identified by an International Standard Serial Number (ISSN) serial number certificate issued by Romanian National Library. All the research works are uniquely identified by a CrossRef DOI digital object identifier supplied by indexing and repository platforms. All the research works published on this journal are meeting the Open Access Publishing requirements and standards formulated by Budapest Open Access Initiative (2002), the Bethesda Statement on Open Access Publishing (2003) and  Berlin Declaration on Open Access to Knowledge in the Sciences and Humanities (2003) and can be freely accessed, shared, modified, distributed and used in educational, commercial and non-commercial purposes under a Creative Commons Attribution 4.0 International License. Copyrights of the published research works are retained by authors.


Hit counter