How does the type of care that family
members provide to an elderly relative differ
depending on the caregiver's gender?
Although men and women both feel a sense of
obligation to provide care to their aging parents,
women are more likely to be the primary caregivers
to the frail elderly and to provide the
greatest amount of care. Men and women also
tend to perform different tasks. Daughters typically
provide hands-on care such as feeding,
dressing, or bathing. Sons are more likely to
help with household chores, financial management,
and yardwork.
How do the responsibilities of caregiving
affect a family member's work and personal
life? Although the majority of caregivers
are not in the labor force, approximately one-third
are employed. Caregiving affects work in
several ways. Even if employed caregivers continue
working full-time, caregiving responsibilities
may force them to work fewer hours,
rearrange schedules, and take time off. Some
caregivers quit work or retire earlier than
planned if their caregiving responsibilities create
conflicts with their ability to perform their jobs.
The psychological toll that caregiving takes on
caregivers is measured in terms of stress and
burden. Surprisingly, although women employed
outside the home seemingly have a higher
burden than nonemployed women, they report
less stress. It may be that satisfaction from work
and contact with the outside world reduces
stress, despite greater responsibilities from dual
roles.
How does an aged person's need for care
affect family relationships? Caregiving may
strain family relationships, but it may also enhance
them. A child may be disturbed by personality
changes in an aging parent or by the
role reversal that may occur when the parent
becomes dependent. Siblings may quarrel over
the division of caregiving tasks. Marriages may
be strained when spouses have less time for each
other because of caregiving burdens. When the
burden is shared equally, however, family members
may appreciate each other and feel that familial
ties have been strengthened.
What kind of home and community-based
services are available to the frail elderly?
Home and community-based services help the
frail elderly remain in their own homes. Among
the services most commonly provided are personal
care, housekeeping, and case management.
Some communities also provide respite
care for caregivers, adult day care, medical or
rehabilitative care, and hospice services.
Can private long-term-care insurance help
families to manage the expense and burden
of caregiving? Although currently only 2.5 percent
of long-term-care costs in the United States
are paid by private insurance, this percentage is
increasing as people learn that the government
does not pay for most services. Yet there are
many problems to be resolved before long-term-care
insurance fills the long-term-care needs for
most Americans. One problem is that many
older people cannot afford to pay the premiums
for long-term-care insurance. Many let their
policies lapse and lose thousands of dollars in
payments. Another problem is that private insurers
often turn down people who need insurance
the most, those with major health problems.
How have government regulations and the
rise of for-profit nursing home chains affected
the availability and quality of nursing
home care? A growing number of nursing
homes are owned by for-profit multinational
chains that operate facilities in the United States
and in other countries. These chains are businesses
that are responsible to shareholders to
show a profit. Research shows that the best care
is provided by nonprofit homes, especially those
that are attached to a religious group.
What is life in a nursing home like for the
frail elderly? People dread the thought of moving
to a nursing home, and the adjustment to institutional
life is difficult. The monotonous daily
routine demanded by bureaucratic procedures
reduces the quality of life for residents and
places pressure on the aides who provide care.
Residents are often denied the small pleasures
that make life worthwhile by aides who are required
to maintain a dehumanizing schedule.
Patient abuse is a continuing concern in nursing
homes. Although physical abuse is rare, psychological
abuse is unfortunately more common.
Not so much intentional, abuse results from the
frustrations of overworked and underpaid aides.
