Informal Caregiving

Increases in the proportion of elderly persons, particularly those over eighty-five years of age, have lead to forecasts of increasing demands on family members to provide informal long-term care in the future. Changes in medical care mean that older people spend less time in the hospital, often discharged with more intense needs for care.

Meanwhile, there is concern that the availability of family caregivers has declined. Changes in fertility have led to what family sociologists describe as a "beanpole family," with fewer adult children available to assume caregiving responsibilities. The prevalence of divorce and remarriage will be higher in future cohorts of elders. Some studies report a decrease in the exchange of support between divorced fathers and their children, although a similar decline has not been confirmed among divorced mothers and their children. A study by Merrill Silverstein and Vern Bengtson found that children of divorced parents express a lower sense of obligation to parents than do children from intact families. Labor force rates among women raise concerns about the ability of adult daughters to continue to provide the majority of home care for parents requiring personal care. In addition, divorce impacts the number of available caregivers, because daughters-in-law often provide care to their husbands' parents.

Women's multiple responsibilities for paid and unpaid labor raised concerns regarding what became known as "women in the middle" or "the sandwich generation." Women in the middle are middle-aged and occupy the middle position in multigenerational families. Responsible for homemaking and paid employment, these women were caught between demands of caring for young children and caring for their frail elderly parents. Despite the intensity of demands on women occupying these multiple roles, recent research indicates that the prevalence of the phenomena may be less widespread than initially believed. Occupying multiple roles of spouse, parent, adult child of an elderly parent, and employed worker is relatively common among people in their forties and fifties. But the parents of people with dependent children are likely to be relatively healthy. By the time most adult daughters face caregiving demands from their elderly parents, their own children are usually living independently, thus reducing the likelihood of experiencing simultaneous demands from both older and younger generations.

Logan and Spitze found little evidence to support fears that demographic trends such as the aging of the population, increased divorce rate, declines in family size, or increasing labor force participation rates among women are disrupting family networks and shifting elder care responsibilities to public institutions. Contrary to the myth that family resources disappear when public supports become available, research on informal caregiving indicates that local networks dominated by geographically proximate kin provide the vast majority of long-term care to frail elders and families, turning to supplemental formal assistance only when the elderly relative's needs exceed the resources of informal caregivers. Nevertheless, the availability of formal support services is crucial to the ability of families to care for frail elderly relatives within community settings.