Midlife Issues: Adult Children and Parental Caregiving
Being a parent has a rather strange side when you think about it. After creating children out of love, parents spend considerable time, effort, and money preparing them to become independent and leave. For most parents, the leaving (and sometimes returning) occurs during midlife.
Adult Children: Becoming Friends and the Empty Nest. Sometime during middle age, most parents experience two positive developments with regard to their children. Suddenly their children see them in a new light, and the children leave home.
After the strain of raising adolescents, parents generally appreciate the transformation that occurs when their children head into young adulthood. In general, parent-child relationships improve when children become young adults (Troll & Fingerman,
1996) . The difference can be dramatic, as in the case of Deb, a middle-aged mother. “When Sacha was 15, she acted as if I was the dumbest person on the planet. But now that she’s 21, she acts as if I got smart all of a sudden. I like being around her. She’s a great kid, and we’re really becoming friends.”
A key factor in making this transition as smoothly as possible is the extent to which parents foster and approve of their children’s attempts at being independent. Most parents are like Esther, the mother in the earlier vignette, and manage the transition to an empty nest successfully; many mothers, in particular, use this as a time for growth (Owen,
2005) . That’s not to say that parents are heartless. When children leave home, emotional bonds are disrupted. Parents feel the change, although differently; women who define themselves more in their role as a mother tend to report more distress and negative mood (Hobdy, 2000). But only about 25% of mothers and fathers report being very sad and unhappy when the last child leaves home (Lewis & Lin, 1996).
Still, parents provide considerable financial help (such as paying college tuition) when possible. Most help in other ways, ranging from the mundane (such as making the washer and dryer available to their college-age children) to the extraordinary (providing the down payment for their child’s house). Adult children and their parents generally believe that they have strong, positive relationships and that they can count on each other for help when necessary (Connidis, 2001).
When Children Come Back. Parents’ satisfaction with the empty nest is sometimes short-lived. Roughly half of young adults in the United States return to their parents’ home at least once after moving out (Osgood et al., 2005). There is evidence that these young adults, called “boomerang kids” (Mitchell, 2006), reflect a less permanent, more mobile contemporary society.
Why do children move back? Those that do typically arrive back home about the time they enter the workplace; the increased cost of living on one’s own when saddled with college debt is a major factor. Several demographic and psychological factors influence the decision. Men are more likely to move back than women, as are children who had low college GPAs, low sense of autonomy, and an expectation that their parents would provide a large portion of their income following graduation (Osgood et al., 2005; Mitchell, 2006; Steen & Peterson, 2000). Adult children whose parents were verbally or physically abusive are unlikely to move back, as are those who are married.
The trend for young adults to move back home in the United States differs from the trend in some southern European countries (e. g., Italy), where the trend is for young adults to stay at home until they marry or obtain a full-time job (L’ Abate, 2006). At earlier points in history, young women sometimes returned home to care for sick parents. However, the current trend is very much different, and is a reflection of changing social norms and the economics of becoming an adult more than an altruistic desire to care for one’s parents.
Caring for Aging Parents. Most middle-aged adults have parents who are in reasonably good health. For a growing number of people, however, being a middle-aged child of aging parents involves providing some level of care. The job of caring for older parents usually falls to a daughter or a daughter – in-law (Stephens & Franks, 1999). Even after ruling out all other demographic characteristics of adult child caregivers and their care recipients, daughters are more than three times as likely to provide care as sons (Stephens et al., 2001). This gender difference is also found in other cultures. For example, in Japan, even though the oldest son is responsible for parental care, it is his wife who actually does the day-to-day caregiving (Morioka, 1998).
In some situations, older parents must move in with one of their children. Such moves usually occur after decades of both generations living independently. This history of independent living sets the stage for adjustment difficulties following the move; both lifestyles must be accommodated.
Most of the time, adult children provide care for their mothers, who may in turn have provided care for their husbands before they died. In other situations, adult daughters must try to manage care from a distance. As we will see later, irrespective of the location of care, women are under considerable stress from the pressures of caregiving.
Caring for one’s parent presents a dilemma, especially for women (Baek, 2005; Stephens et al.,
2001) . Most adult children feel a sense of responsibility, termed filial obligation, to care for their parent if necessary. For example, adult child caregivers sometimes express the feeling that they “owe it to Mom or Dad” to care for them; after all, their parent provided for them for many years, and now the shoe is on the other foot (Gans, 2007). Adult children often provide care when needed to their parents in all Western and non-Western cultures studied (Hareven & Adams, 1996). Viewed globally, all but a small percentage of care to older adults is provided by adult children and other family members (Hareven & Adams, 1996; Moen, 2001). Worldwide, caregiving situations tend to be better when the economic impact on the caregiving family is minimal; for example, rural China supports the view that when middle-aged children care for aging parents, it is the financial impact on the caregivers that matters most (Zhan, 2006). Filial obligation also knows no borders; in an Australian study, middle-aged adults were found to be caring for parents in numerous other countries in Europe, the Middle East Asia, and New Zealand (Baldassar, Baldock, & Wilding, 2007).
Susan’s experience embodies the notion of the “sandwich generation” noted earlier. Her need to balance caring for her daughter and for her mother can create conflict, both within herself and between the individuals involved (Neal & Hammer, 2006). Being pulled in different directions can put considerable stress on the caregiver, a topic we consider in the next section. But the rewards of caregiving are also great, and relationships can be strengthened as a result.
Roughly 44 million Americans provide care for older parents, in-laws, grandparents, and other older loved ones (AGS Foundation for Health in
Aging, 2007). The typical caregiver is a 46-year-old woman who is employed outside the home and who provides more than 20 hours per week of unpaid caregiving. These family caregivers spend on average up to about $4,000 per year in support of their loved one (Gibson & Houser, 2007).
Caring for an older parent is often not easy. It usually doesn’t happen by choice; each party would just as soon live independently. The potential for conflict over daily routines and lifestyles can be high. Indeed, one major source of conflict between middle-aged daughters and their older mothers is differences in perceived need for care, with middle-aged daughters believing that their mothers need care more than the mothers believe they do (Fingerman, 1996). The balance between independence and connection can be a difficult one (McGraw & Walker, 2004); among Japanese immigrants one course of conflict is between older mothers, who give unsolicited advice, and their caregiving daughters (Usita & Du Bois, 2005).
Caregiving Stresses and Rewards. Caregiving is a major source of both stresses and rewards. On the stress side, adult children and other family caregivers are especially vulnerable from two main sources (Pearlin et al., 1990):
• Adult children may have trouble coping with declines in their parents’ functioning, especially those involving cognitive abilities and problematic behavior, and with the work overload, burnout, and loss of the previous relationship with a parent.
• When the caregiving situation is perceived as confining, or seriously infringes on the adult child’s other responsibilities (spouse, parent, employee, etc.), the situation is likely to be perceived negatively, which may lead to family or job conflicts, economic problems, loss of self-identity, and decreased competence.
When caring for an aging parent, even the most devoted adult child caregiver feels depressed, resentful, angry, and guilty at times (Cavanaugh, 1999; Stephens et al., 2001). Many middle-aged caregivers are hard-pressed financially, as they may still be paying child care or college tuition expenses, perhaps trying to save adequately for
their own retirement, and having to work more than one job to do it. Financial pressures are especially serious for those caring for parents with chronic conditions, such as Alzheimer’s disease, that require services that are not covered adequately by medical insurance, even if the older parent has supplemental coverage. In some cases, adult children may even need to quit their jobs to provide care if adequate alternatives, such as adult day care, are unavailable or unaffordable.
The stresses of caring for one’s parent are especially difficult for women. In terms of its timing in the life course, caring for a parent is typically something that coincides with women’s peak employment years of 35-64. Longitudinal research clearly shows that employment status has no effect on women’s decisions to become caregivers (many have little choice), but it has been the case for many years that becoming a caregiver makes it likely that women will reduce employment hours or stop working (Pavalko & Artis, 1997). When you consider that most women caring for parents are also mothers, wives, and employees, it should come as no surprise that stress from these other roles exacerbates the effects of stress due to caregiving (Baek, 2005; Stephens et al., 2001).
On the plus side, caring for an aging parent also has rewards. Caring for aging parents can bring parents and their adult children closer together, and provide a way for adult children to feel that they are giving back to their parents (Miller, Shoemaker, Willyard, & Addison, 2008). Crosscultural research examining Taiwanese (Lee, 2007) and Chinese (Zhan, 2006) caregivers confirms that adults caring for aging parents can find the experience rewarding.
Ethnic differences among U. S. groups in adult children’s experiences of caregiving reflect cultural norms. Compared to European Americans, Latino American family members are likely to be caring for people who are at higher risk of chronic disease and are more disabled (Aranda & Knight, 1997). A focused study of Mexican American caregivers showed that, given time and a supportive context from service providers, they come to accept services from social service agencies within their
cultural norm of providing family care themselves (Crist, Garcia-Smith, & Phillips, 2006). African Americans prefer family caregiving to other options (e. g., placement in a long-term care facility) more strongly than European Americans do; European Americans are more open to having nonfamily members (such as professional paid caregivers) provide care (Foley, Tung, & Mutran, 2002). Latino American and African American caregivers, compared to European Americans, are more likely to be an adult child, friend, or other relative; report lower levels of caregiver stress, burden, and depression; believe more strongly in filial obligation; and are more likely to use prayer, faith, or religion as a coping strategy (Connell & Gibson, 1997). Such differences show that the relation between caregiving and stress is mediated by beliefs in family cohesiveness versus individual independence, as well as one’s socialization. And caregivers also report experiencing rewards (Stephens & Franks, 1999).
From the parent’s perspective, things aren’t always rosy either. Independence and autonomy are important traditional values in some ethnic groups, and their loss is not taken lightly. Older adults in these groups are more likely to express the desire to pay a professional for assistance rather than ask a family member for help; they may find it demeaning to live with their children (Hamon & Blieszner, 1990). Most move in only as a last resort. As many as two thirds of older adults who receive help with daily activities feel negatively about the help they receive (Newsom, 1999).
Determining whether older parents are satisfied with the help their children provide is a complex issue (Newsom, 1999). Based on a critical review of the research, Newsom (1999) proposes a model of how certain aspects of care can produce negative perceptions of care directly or by affecting the interactions between caregiver and care recipient (see Figure 11.9). The important thing to conclude from the model is that even under the best circumstances, there is no guarantee that the help adult children provide their parents will be well received. Misunderstandings can occur, and the frustration caregivers feel can be translated directly into negative interactions.
In sum, taking care of one’s aging parents is a difficult task. Despite the numerous challenges and risks of negative psychological and financial outcomes, many caregivers nevertheless experience positive outcomes. Use the Discovering Development feature to learn more about supports in your community for people caring for their aging parents.
Becoming a grandparent takes some help. Being a parent yourself, of course, is a prerequisite. But it is your children’s decisions and actions that determine whether you will experience the transition to grand – parenthood, making this role different from most others we experience throughout life. Most people become grandparents in their 40s and 50s, though
438 CHAPTER 11
some are older or perhaps as young as their late 20s or early 30s. In most cases, grandparents are quite likely to still be employed and to have living parents themselves. Thus, although being a grandparent may be an exciting time, it is often only one part of their busy lives.
How Do Grandparents Interact with Grandchildren?
Keisha, an 8-year-old girl, smiled brightly when asked to describe her grandparents. “Nana Mary gives me chocolate ice cream, and that’s my favorite! Poppy Bill sometimes takes care of me when Momma and Daddy go out, and plays ball with me.” Kyle, a 14-year-old, had a different view. “My grandparents generally tell me stories of what life was like back when they were young.”
As Keisha’s and Kyle’s experiences show, grandparents have many different ways of interacting