Care giving: Is it in your future?

You are likely to be part of the sandwich generation, a generation of people caring for aging parents while supporting their own children.

You are likely to be part of the sandwich generation, a generation of people caring for aging parents while supporting their own children.

by Angie Stone, RDH, BS

I fluffed the pillows behind her head and propped her up in the bed. I sat down next to her, swung my legs up on the hospital bed and pulled the covers up over our chests. It was spring in Wisconsin, and Easter was fast approaching. On this particular day, I had decided to read “The Story of the Easter Bunny” to her.

I began, “Chapter One: Early. Once upon a time, there was a little rabbit named Early. He lived with his mother, father, and three brothers - Quicksilver, Clover, and Acorn - in a cozy rabbit hole at the top of a grassy hill.”1

She listened intently to the story from beginning to end. My mother-in-law, Gladys, appeared to enjoy the story just as my children had each year at this time. Not only did she enjoy the story and pictures, she enjoyed the togetherness she and I shared.

When I married Gladys’ son some 20 years before, I neither imagined I would be sitting in a bed in the intensive care unit reading to her, nor did I imagine I would be acting as her primary caregiver during her battle with emphysema. But that is the way things turned out. I was faced with caring for my husband and two children, working, taking care of the household duties, and on top of all of that, caring for an ill mother-in-law. It was a trying two years.

This experience was anything but isolated. Research shows 25 percent of all workers provide some form of eldercare for those 65 and older. According to a 2004 survey conducted by the AARP and the National Alliance for Care Giving, 59 percent of caregivers are employed; 48 percent work full time; and 11 percent are employed part time. A study by these groups projected that by 2007, the number of households providing care to people 50 and older may reach 39 million.2

And it is not likely the increase in the older population will halt. The main reason for this trend is people are living longer than they have any other time. In 1900, the average life expectancy in the United States (i.e., the average length of time one could expect to live if one were born in that year) was 47 years. The average life expectancy is now much longer. Females born in 2000 can expect to reach 79.5, and men age 74.1. Life expectancy in 2050 is projected to be 82.6.3

As people age, they typically become somewhat dependent on others to help with their activities of daily living, or ADL. The majority of long-term care to adults age 65 and older is provided not in nursing homes, but informally and privately, at little or no public cost, within elders’ homes or other community-based settings. In fact, 50 to 60 percent of older adults outside institutional settings who need help with ADLs rely on informal networks that are not supplemented by paid caregivers.3 So, who provides this care? While the eldest daughter still tends to shoulder the heaviest burden of caring for aging parents, more and more adult children are pitching in, says Steven Stern, professor of economics at the University of Virginia.4

Nevertheless, it is well documented in the research that most caregivers are women. As previously noted, the eldest daughter is relied on most. After that, the responsibility is put on other female family members, namely daughters-in-law, nieces, granddaughters, etc. Male family members are seldom heavily relied upon. Female professionals need to be mindful that at some point in their lives, they will probably be called upon to provide care for an aging family member. They are likely to be part of the sandwich generation - a generation of people who are caring for their aging parents while supporting their own children.5

It is difficult to juggle a career, family, and caring for an aging family member. Much like performers who spin plates, caregivers must watch each item they spin. When one responsibility needs tending to, the caregiver must tend to that issue while making sure other jobs aren’t neglected for so long that they spin out of control. Keeping all the plates spinning requires stamina, great organization, dedication, and endless hours of work. Caregivers can keep this lifestyle up for only so long before they collapse from exhaustion and the plates crash to the ground. According to the Family Caregiver Alliance in San Francisco, more caregivers are hospitalized as a result of burnout and stress-related illness than from worsening medical conditions.6 The reason is clear: Caregivers tend to put themselves last. They overlook that if they are not healthy, all the people they care for will suffer. They must take care of themselves.

Caregiving brings with it three basic sources of stress for the caregiver: financial, physical, and emotional. Financial stress is derived from the direct costs of care, missing opportunities for advancement in the caregiver’s career, reduced hours at work, and conflicts between the job and family. Physical stressors include caregiver health problems, sleep disturbances, self neglect, exhaustion, etc. Emotional sources take the largest toll on the caregiver. Care providers experience worry and anxiety. They often feel isolated and disconnected.

The most beneficial resource for caregivers appears to be support groups. These groups provide emotional support and teach coping skills. One area of concern with support groups may be the ability to actually attend the group sessions. It is difficult to find care for the elder while the caregiver spends time in a group session. With Internet resources, however, this obstacle can be overcome in many situations. More chat rooms and Internet resources are becoming available. Psychoeducational groups are also beneficial. These groups focus on education of the illness and social support. Attendees report a value in understanding an illness and learning about valuable resources. Respite care, a resource where care is given to the elder by others while the primary caregiver takes some time off, is another resource.

While several resources exist, they are under-utilized. Caregivers are not aware of resources, they don’t want to ask for help, and getting involved in resources requires time and commitment. If caregivers are not willing to reach out to available resources, there are measures they can take to attempt to take care of themselves. These include learning to accept help when it is offered, taking time for pleasurable and relaxing activities, exercising daily, eating a healthy diet, setting limits on the elder’s demands, and attending to spiritual needs.3

Women must be aware that a caregiver role is likely in their future. If they are aware of this, they can educate themselves early and adapt a lifestyle that focuses on their own well-being. If this type of lifestyle is in effect, caring for another person will take less of a toll on the caregiver.

References

  1. Black S, The story of the easter bunny. New York: Western Publishing Company.1998.
  2. http://www.pueblo.gsa.gov/cic_text/family/aging/lovedones.htm Nov 11.
  3. Hooyman NR, Kiyak HA. Social gerontology. 7th ed. Boston: Pearson. 2005: 12-17, 349-374.
  4. http://www.virginia.edu/topnews/releases2002/aging-parents-june-28-2002.html Nov 11.
  5. http://www.m-w.com/dictionary/sandwich+gener ation Nov 11.
  6. http://healthresources.caremark.com/topic/careself Nov 11.

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