trends in caregiving

Trends in CaregivingTrends in Caregiving

Rhonda J. V. Montgomery, Ph.D.University of Kansas

Caregiving is the Caregiving is the cornerstone of our long-cornerstone of our long-

term care systemterm care system

We know:We know:Families provide 80% of long term careNursing home is last choice for careMost caregivers are womenNOT ALL CAREGIVERS ARE ALIKE

Caregivers by Relationship to Caregivers by Relationship to Elder Care RecipientElder Care Recipient

Wives23%

Other Female20%

Sons8%

Husbands13%

Other Males7% Daughters

29%

Diversity among CaregiversDiversity among CaregiversGender

GenerationCulture

Caregiving context

Diversity of CaregivingWhat they do

When they do it

How they do it

How long they do it

HOURS OF CARE HOURS OF CARE

3 3 17 5 5

21

9 94 38 6

3 33

11

2

16

2

0

10

20

30

40

50

60

Spouse Daughter Son Second CG

Hours

Financial Transportation Household Other Personal Care

SpouseSpouse

Emotional Emotional

Banking Banking

House Tasks House Tasks

Errands / Shop Errands / Shop

SpouseSpouse

Emotional Emotional

Banking

House Tasks

Errands / Shop

Personal Care

ChildChild

Emotional Emotional

Banking

House Tasks

Errands / Shop

Personal Care

Adult-ChildAdult-Child

Emotional Emotional

Financial

House Tasks

Errands / Shop

Personal Care

CareCare SharingSharing: : WivesWives

PHSB

H

SB

O

80% 20%

Care Sharing HusbandsCare Sharing Husbands

H

SB

O

HSB

PPH 70%70%

20%20%10%10%

Care Sharing: Daughter

70%

30%

BTOHP

H

TB

O

P

Care Sharing: Son

55%

45%

BS

OHP

H

sB

O

P

Caregiving Career: ChildCaregiving Career: Child

010203040506070

0 1 2 3 4 5

Years

HOURS

Bank Shop/Trans Household Other Tasks Personal

Caregiving Career : SpouseCaregiving Career : Spouse

010203040506070

0 1 2 3 4 5 6 7YEARS

HOURS

Bank Shop/Trans Household Other Tasks Personal

Comparing CareersComparing Careers

010203040506070

0 1 2 3 4 5 6 7YEARS

HOURS

Bank Shop/Trans Household Other Tasks Personal

010203040506070

0 1 2 3 4 5 6 7YEARS

HOURS

CHILD

SPOUSE

Basic Premises of Markers Basic Premises of Markers Model of Caregiving CareersModel of Caregiving Careers

1. There is no single, generic caregiver role Caregiving role emerges from prior role

relationships Role influenced by the unique values, beliefs

and circumstances

2. Consequently there are: Consistencies in the caregiving process. Unique adaptations.

Premises of Marker Model Premises of Marker Model

3. Caregiving is a dynamic process that unfolds over time

4. The length of career varies

5. Requires a change in identity

Caregiving Career MarkersCaregiving Career Markers

1. Performing caregiving tasks2. Self-definition as a caregiver3. Performing personal care tasks4. Seeking assistance and formal services5. Consideration of nursing home placement6. Placement in nursing home7. Termination of caregiving

Caregiving career: child

010203040506070

0 1 2 3 4 5

Years

Hours

Bank Shop/Trans Household Other Tasks . Personal

#6#4

#2

#3

#5

Caregiving Career : SpouseCaregiving Career : Spouse

010203040506070

0 1 2 3 4 5 6 7YEARS

HOURS

Bank Shop/Trans Household Other Tasks Personal

#6#5

#4

#2

#3

Comparing Career MarkersComparing Career Markers

010203040506070

0 1 2 3 4 5 6 7YEARS

HOURS

Bank Shop/Trans Household Other Tasks Personal

CHILD

SPOUSE

010203040506070

0 1 2 3 4 5 6 7YEARS

HOURS

#2

#4#6

#5

#3

#6

#2#3

#4#5

Diversity of BurdensDiversity of Burdens

Difficult tasks/Physical Health Time for other responsibilities Task Overload Privacy Loss of Roles Isolation Financial Burden Guilt