The 1990s have been characterised as the decade of caring - of decisions about who will care for whom and how caring will be provided. As Don Edgar observed in his article 'Sharing the Caring' in the last issue of Family Matters, families have become the accepted focus of caring and women are seen as the 'natural carers', a trend that does not reflect the realities of modern family life. In Who Helps: Support Networks and Social Policy in Australia, published by the Institute last year, Peter d'Abbs looks at who people turn to when they get sick, lose a job or suffer emotional upset. Where do they go for help with transport, household repairs, housekeeping, financial support and personal caring in illness? Several sources of support are possible - informal networks of family, friends, neighbours and colleagues, or more formal public and private professional and community services. Who people turn to depends not only on the availability and accessibility of people and services, but also on the nature of the need, people's assumptions about whose role it is to provide care, and concerns about privacy and the ability to reciprocate.

Who Helps? is based on Institute surveys conducted in 1981 and 1983 in Geelong in Victoria, Ashfield in New South Wales, and Darwin and Jabiru in the Northern Territory. A total of 795 respondents were interviewed about the informal and formal sources of help used when they faced particular needs related to illness, unemployment or emotional distress, and about their attitudes to seeking help in these circumstances. Open-ended responses of a random sub-sample of 100 respondents provided the basis for the qualitative analysis.

Underlying these questions is the policy issue of the relationship between informal support and the provision of state-funded formal support services, in particular the degree to which informal support networks can be regarded as alternatives to, or complementary to, formal support services.

Most households in the study (75-81 per cent) had access to some informal support and had also given support to others. Families with young children received more support than other households, Australian-born compared with overseas-born respondents received more informal help, and younger people were more likely than older respondents to receive support.

Geographical proximity to extended family had negligible effects on some aspects of informal support but did influence the availability of support in houseminding and caring in time of illness. The majority of respondents were in frequent contact with close kin (parents, children) even when they lived at a distance, although personal visits were more likely when relatives lived nearby. For example, 31 per cent of Geelong respondents reported visiting kin weekly, compared with 26 per cent of those living in Ashfield and 8 per cent in Darwin/Jabiru. However, higher income families were more able than families on low incomes to maintain frequent contact with a wider range of relatives who were geographically isolated.

The author highlights the important distinction between 'caring about' and 'caring for', the latter implying a more demanding involvement. Approximately 53 per cent of all respondents reported experiencing a serious illness in their household at some time; caring tasks (apart from major medical intervention) are most often associated with family care. In this context, the Institute study confirmed that family care is synonymous with care by female relatives. Personal care in time of illness or confinement for childbirth was provided by kin in 70 per cent of cases in Geelong and 53 per cent in Ashfield. Even when someone other than women in the family (spouses, daughters, daughters-in-law) provided personal care, it was nearly always other women - neighbours or friends, for instance.

As well as emotional support, relatives provided income support and gifts of financial assistance. Friends, on the other hand, usually assisted in the less demanding areas of transport, temporary child care and household tasks and repairs. Neighbours were seldom involved in anything other than minor houseminding or transportation activities. It is evident there is a wish to keep some boundaries around family privacy and autonomy when friends and neighbours are considered as sources of support, and that people are concerned about being able to reciprocate. Overall, the more demanding the support required the more likely it would be family who were called upon.

What are the implications of these findings? Certainly in times of need, family networks, especially female relatives, are a major source of practical and emotional support. This assumes, however, that all families can or should turn to each other rather than seek formal support outside the family circle. It assumes that all families have the financial resources, time and willingness to take on the responsibilities of care. This does not take account of the changing demographics of smaller families, geographically mobile families and the impact of divorce, remarriage and the workforce participation of women.

Comments of participants attested to the rewards as well as pressures associated with caring at the demanding end of the continuum - illness and aged care. The strains of caring were moderated when family support could be shared with professional and community social services.

In this study, respondents indicated that the absence of formal services made it more difficult to mobilise informal supports because the involvement would then be too demanding on the helper. It was easier to ask for help when the assistance requested was not so intrusive on the helper's time or energy. For example, it might be acceptable to ask a neighbour to drive you or your child to a hospital a few kilometres away, but not (as in the Darwin sample) 250 kilometres to a distant medical centre.

As Peter d'Abbs argues, 'a society in which people care about each other, and act accordingly, is a more civilised society than one in which the pursuit of self-interest is all important'. For this reason, he continues, informal networks of support should be encouraged within the family and, by means such as self-help groups, in the community.

The author argues that the public sector should complement informal support networks, where they are available, and substitute for such assistance where it is necessary or appropriate. The study showed that specialist resources provided a buffer or balance between the capacity of families to support one another, issues of equity, and the appropriate responsibility of the wider community to share in caring for its citizens.

The book weaves the theoretical background upon which debate and discussion of caring rests, with the reality reflected in survey respondents comments.