Informal Caregiving

Caring for a frail elder can encompass a wide variety of tasks, from occasional help with heavy chores to daily assistance with personal care tasks. Family members provide instrumental assistance and financial management and, along with friends, offer emotional support. Relatives also mediate relationships between their elderly relatives and health care providers or social service agencies. Caregiving continues even if the elder relative enters a nursing home. Informal caregivers, particularly spouses and adult children, provide this complex mix of assistance for relatively long periods of time. One study estimated that caregiving for an elderly parent lasts an average of five to seven years, with caregivers helping the elderly care recipient between six and ten hours per week (Azarnoff and Scharlach). Another study estimated that American women will spend eighteen years caring for older family members, in comparison to only seventeen years for children (Stone, Cafferata, and Sangl).

As with many transitions in the life course of older families, the transition to the caregiver role is an unscheduled one. Sometimes the shift occurs suddenly, as when an older person suffers a stroke. More often, however, the transition begins almost imperceptibly, with caring for an older person at first entailing more a sense of responsibility than tangible assistance. A number of the adult daughters interviewed by Jane Lewis and Barbara Meredith felt they had "just drifted into caring" and were unable to identify the point at which they had assumed a caregiving role.

The types of assistance that gerontologists label as "caregiving" emerge gradually from the intergenerational exchanges that characterize family relationships. For most adult children, reciprocal exchanges of help with their parents are more common than one-way help, with the parental generation providing the bulk of the assistance. John Logan and Glenna Spitze report that elderly parents provide more assistance to their children than they receive in return at least until the parents are seventy-five years old. By that time, over half of elderly parents are receiving help from one or more children, although 30 percent of parents continue to provide assistance to at least one child. Their results do not argue against the importance of informal care to elderly parents encountering illness or disability. Informal caregiving is indeed the first line of defense against institutional placement in very old age. But Logan and Spitze's work reminds us of the importance of considering family care within a life course perspective.