ERIC Identifier: ED279993
Publication Date: 1986-00-00
Author: Libert, Anne Blanford
Source: ERIC Clearinghouse
on Counseling and Personnel Services Ann Arbor MI.
Elderly Parents and Adult Children as Caregivers. Highlights:
An ERIC/CAPS Digest.
Children of infirm elderly have always been a source of assistance to
their parents, despite personal hardship, and continue to be so today. This
digest presents a contemporary description of American elderly and adult
children's caregiving to their parents. This description is based on recent
gerontological literature available in the ERIC database.
A PROFILE OF AMERICAN ELDERLY
Since 1970 the median age of the United States population has been rising and
is expected to continue to rise into the mid-21st century. In this so-called
graying of America, a greater proportion of the population will be over 65. In
1900, one American in twenty-five was age 65 or over; in 1984, one in nine. By
the middle of the next century, one in five Americans will be elderly. The
proportion of oldest-old Americans, those 85 and over, is growing even more
rapidly. This part of the population is expected to triple in size between 1980
and 2020. The oldest-old are especially important to caregiving studies, since
this group of elderly is most likely to have chronic health problems and
children who are elderly themselves.
A recent trend known as "countermigration" supports the importance of family
caregivers. Some retirees who moved to the sunbelt in early retirement are
moving back later to be near their children.
The elderly as a group have economic status similar to the non-elderly.
However, subgroups of the elderly exhibit much lower levels of economic
resources. Older women have dramatically lower incomes than older men, largely
associated with a pattern of lifelong economic dependency on men, and status
changes accompanying old age. Minority elderly have lower incomes than their
On a measure of disability called "activity of daily living limitation," 19
percent of the elderly over 65 have some limitation, while only 3 percent are
severely disabled. However, those over 85 are four times as likely to be
disabled as those 65 to 75. Today, chronic conditions such as hypertension,
arthritis, hearing impairments and heart conditions are the most prevalent
health problems of the elderly. Although older people have fewer mental
impairments than other age groups, a leading reason for institutionalization for
the elderly is cognitive impairment, resulting from Alzheimer's disease or other
Spouses and other relatives provide important assistance to those elderly
with limitations who are not institutionalized. Spouses contibute substantial
amounts of care to each other, especially wives to husbands. As spousal support
diminishes with increasing age, other relatives become caregivers. Children
provide about a quarter of the care to elderly fathers and a third of the care
to elderly mothers. Formal community caregivers provide only about a fifth of
the care. Although only five percent of the elderly are in nursing homes at any
particular time, one in four elderly persons will eventually need long-term care
assistance. In summary, while most elderly are not severely disabled, many do
require assistance because of their limitations. With increasing numbers of
elderly, especially the oldest-old, this need can be expected to rise. (This
profile is drawn from AGING AMERICA, 1985-86.)
CAREGIVING BY ADULT CHILDREN
Traditionally, it has been the duty of adult children to care for their
elderly parents. For previous generations, children served as old age insurance.
Today's elderly may be more financially independent than their predecessors, but
family still plays an important role for the elderly (Shanas, 1979).
How do adult children help? As elderly parents become impaired through
chronic illness, senility, or disability, these elders may lose their ability to
be self-sufficient. Adult children may become caregivers to their parents. For
the severely impaired elderly, adult children as caregivers can provide direct
assistance with activities of daily living such as eating, bathing and dressing
(Clark and Rakowski, 1983). Even those less severely impaired elderly may need
assistance with shopping housework, transportation, home maintenance and bill
An extremely valuable caregiving task adult children perform is to coordinate
and monitor services. This can include locating a nursing home and monitoring
its quality, procuring medical services, arranging public service assistance and
handling finances. The quality of these types of caregiver services rests on the
interest the caregivers have in their tasks. Family caregivers have an emotional
tie and filial duty to procure the best for their parents; a paid coordinator
may settle for adequate services, not the best.
IMPACTS ON CAREGIVING
People are living longer and in greater numbers. As the baby boom generation
becomes old, the number of elderly will rise dramatically. This has particular
impact on the baby boom generation in that they have fewer children who in turn
will be able to assist them in their old age. In a mobile society, adult
children are less likely to live in the same locality as their parents.
High divorce rates and women's participation in the work force have an impact
on caregiving today and will have an even greater impact in the future. Divorced
children tend to provide less assistance to their elderly parents than those
from intact marriages (Cicirelli, 1983). Traditionally, women as daughters or
daughters-in-law have provided the majority of family care (Horowitz, 1985). As
these women become more involved in their job responsibilities, they may have
less time and energy to devote to their elderly parents.
The tasks of caregiving can result in caregiver strain. Elderly parents may
become an emotional burden to their children. In the reversal of roles from
parent as caregiver to child as caregiver, misunderstanding and ill-will can
develop. Adult children may suffer multiple role strain as parents to their own
children, spouses, employees, and caregivers to elderly parents (Cantor, 1983).
Caregivers and care receivers may also suffer from a limited future outlook
(Rakowski and Clark, 1985), or caregivers may simply tire out from the added
duties at a time in their lives when they may have expected to be free from
responsibility, perhaps in their own retirement.
How can family caregiving be protected and strain reduced? Semi-independent
elderly parents can live in companion or congregate housing. Those with greater
impairment can utilize nursing homes. Adult children may find help in support
groups, including groups specifically for family members of Alzheimer's disease
victims (Schmidt and Keyes, 1985). For those children of parents who remain in
the home, outside service provision can be of assistance. Personal care
assistance, chore service, respite care, and day care can relieve the burden on
adult children. Caregivers may also need to use cognitive therapy to relabel
their help as resulting from filial duty, not affection (Jarrett, 1985).
The graying of America forces us to take a look at contemporary family
caregiving and to consider the future needs of American elderly. Family
caregiving has changed through the generations, but is and promises to continue
to be a most valued social resource.
FOR MORE INFORMATION
AGING AMERICANS: TRENDS AND PROJECTIONS (1985-86 ed.). Washington, DC: U.S.
Department of Health and Human Services, 1986. ED 275 928.
Cantor, M. Strain Among Caregivers: A Study of Experience in the United
States. THE GERONTOLOGIST, 23 (1983): 597-604.
Cicirelli, V.G. A Comparison of Helping Behavior to Elderly Parents of Adult
Children with Intact and Disrupted Marriages. THE GERONTOLOGIST, 23 (1983):
Clark, N.M., W. Rakowski. Family Caregivers of Older Adults: Improving
Helping Skills. THE GERONTOLOGIST, 23 (1983): 637-642.
Horowitz, A. Sons and Daughters As Caregivers to Older Parents: Differences
in Role Performance and Consequences. THE GERONTOLOGIST, 25 (1985): 612-617.
Jarrett, W.H. Caregiving Within Kinship Systems: Is Affection Really
Necessary? THE GERONTOLOGIST, 25 (1985): 5-10.
Rakowski, W., N.M. Clark. Future Outlook, Caregiving, and Care-receiving in
the Family Context. THE GERONTOLOGIST, 25 (1985): 618-623.
Schmidt, G.L., B. Keyes. Group Psychotherapy with Family Caregivers of
Demented Patients. THE GERONTOLOGIST, 25 (1985): 347-350.
Shanas, E. The Family As a Social Support System in Old Age. THE
GERONTOLOGIST, 19 (1979): 169-174.