C H A P T E R 1 0

OPPORTUNITIES AND CHALLENGES OF INFORMAL CAREGIVING

CAREGIVING

•Caregiving

•the act of assisting people with personal

care, household chores, transportation, and

other tasks associated with daily living

•provided either by family members

without compensation or by professionals

SHRINKING POOL OF POTENTIAL

CAREGIVERS

COSTS AND BENEFITS OF INFORMAL

CARE

•For Society

•Families are expected to provide “high-

tech” and “high-touch” care

•For Informal Caregivers

•Objective Burden

•Real demands that caregivers face:

income loss, job disruption, etc.

•Subjective Burden

•Caregiver’s experience of

caregiver burden

•different caregivers appraise

caregiver stress differently

CAREGIVER GAINS

•Caregiving costs and gains are influenced

by:

•nature of the relationship between

caregiver and recipient

•family support and disharmony

•timing in the caregiver’s life

•gender and race/ethnicity

•social networks

SOURCES OF CAREGIVER STRESS

Emotional

Financial Physical

WHO ARE INFORMAL CAREGIVERS?

•Caregivers are predominantly:

•Adult children

•Followed by partners or spouses

•Women

•“Women-in-the-Middle”

•The “Sandwich Generation

FAMILY CAREGIVERS OF COLOR

•As compared to white caregivers, African-

American caregivers tend:

•To provide higher levels of care

•To have higher levels of self-efficacy

•To be more economically disadvantaged

•To be less likely to have alternative

caregivers

•To be less likely to use formal supports

LEGISLATION TO SUPPORT FAMILY CAREGIVERS

• Family and Medical Leave Act of 1993

• provides job protection to workers requiring short-term leaves from their jobs for the care of a dependent parent or seriously ill newborn or adopted child

• National Family Caregiver Support Program of 2000

• requires state and area agencies on aging to provide services to support family caregivers

SUPPORTIVE SERVICES FOR OLDER ADULTS

AND CAREGIVERS

• Case Management

• coordination and monitoring of services

to meet older adults’ assessed service

needs

• Most family caregivers do not use services

or they do so selectively

• Women and ethnic minority caregivers are

the least likely to turn to formal services

SUPPORTIVE SERVICES FOR FAMILY

CAREGIVERS

• Support Groups for Caregivers

• Psychoeducational Groups

• Respite Care

• Electronic Supports

ELDER MISTREATMENT

Elder Mistreatment

◦ Harmful or hurtful conduct that is willfully inflicted upon an older person

Types of Elder Mistreatment

◦ Physical

◦ Emotional

◦ Sexual

◦ Material or Financial

◦ Medical

◦ Neglect

◦ Violation of rights

◦ Abandonment

PLACEMENT IN LONG-TERM CARE

FACILITIES

• Families often turn to institutionalization after exhausting their own resources

• Decision may be precipitated by a caregiver’s illness, death, or severe family strain

• Many people hold negative attitudes toward nursing homes

• Placement in nursing homes may be seen as a natural transition for the oldest-old

UNDERPAID FAMILY CAREGIVERS:

DIRECT CARE WORKERS

• Direct Care Workers

• nurses' aides, personal assistants, and home

care workers who provide hands-on care in

both private home and institutional settings

• The typical paraprofessional or aide is an

immigrant, single mother, with minimal education

and living in poverty.