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Informal Caregiving - Policy Recommendations Addressing Informal Caregiving

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A growing body of literature calls for programs to alleviate stress and burden on caregivers, including support groups, day treatment centers, respite care, home health, and housekeeping assistance. Although these programs can extend the length of time in which informal networks can provide care, many gerontologists suggest that they are essentially palliative or band-aid approaches that fail to alter the structural arrangements that produce caregiver burden and stress.

Recognition of the long-term disruptive affects on employment has generated recommendations for caregiving leaves and greater job security. The U.S. Family and Medical Leave Act (FMLA) addresses employed caregivers' need for job protection, but other aspects of the legislation curtail its potential benefits, particularly for women. Small businesses employing fifty or fewer employees are exempt from the FMLA. Over half of all private sector employees, including a disproportionately large number of women, work for such firms. Furthermore, most workers cannot afford to take an unpaid leave from work.

Family-friendly workplace policies are advocated as another approach to alleviating strains of providing family care across the life course, including care for frail elderly relatives. But family-friendly policies are often sold to business as strategies for recruiting and retaining valued employees, strengthening company loyalty, reducing absenteeism, and enhancing work performance (Hochschild). Thus, these policies are designed to help employees find ways to cope with caregiving demands that interfere with job performance. They do nothing to change the features of the workplace that contributes to strain.

Public opinion surveys indicate that most Americans believe that the government has an obligation to finance care for elders who cannot afford to purchase care themselves. However, as Atchley claims, "economically pressured state and federal governments have an interest in shifting as much of this financial responsibility onto the family as possible" (p. 213). Development and provision of formal services reflects a context in which care of the frail elderly is defined as a private responsibility of families, with formal intervention most likely at crisis points or when informal resources are exhausted or unavailable (Hooyman and Gonyea).

ELEANOR PALO STOLLER LISA MARTIN

BIBLIOGRAPHY

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CAGNEY, K., and AGREE, E. "Racial Differences in Skilled Nursing Care and Home Health Use: The Mediating Effects of Family Structure and Social Class." Journals of Gerontology, Series B: Psychological and Social Sciences 54 (1999): S223–S236.

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HOCHSCHILD, A. The Time Bind: When Work Becomes Home and Home Becomes Work. New York, N.Y.: Metropolitan Books, 1997.

HOOYMAN, N., and GONYEA, J. Feminist Perspectives on Family Care: Policies for Gender Justice. Thousand Oaks, Calif.: Sage Publications, 1995.

LEE, G. "Gender Differences in Family Caregiving: A Fact in Search of a Theory." In Gender, Elders and Family Care. Edited by J. Dwyer and R. Coward. Newbury Park, Calif.: Sage, 1995.

LEWIS, J., and MEREDITH, B. "Daughters Caring for Mothers: The Experience of Caring and its Implications for Professional Helpers." Ageing and Society 8 (1988): 1–21.

LOGAN, J., and SPITZE, G. Family Ties: Enduring Relationships Between Parents and their Grown Children. Philadelphia, Pa.: Temple University Press, 1996.

MILLER, B., and MCFALL, S. "Stability and Change in the Informal Task Support Network of Frail Older Persons." The Gerontologist 31 (1991): 735–745.

National Alliance for Caregiving and the American Association of Retired Persons. Family Caregiving in the U.S.: Findings from a National Survey. Bethesda, Md.: National Alliance for Caregiving, 1997.

QUADAGNO, J. Aging and the Life Course: An Introduction to Gerontology. Boston: McGraw-Hill, 2000.

SILVERSTEIN, M., and BENGTSEN, V. "Intergenerational Solidarity and the Structure of Adult Child-Parent Relationships in American Families." American Journal of Sociology 103 (1997): 429–460.

STONE, R.; CAFFERATA, G.; and SANGL, J. "Caregivers for the Frail Elderly: A National Profile." The Gerontologist 20 (1987): 616–627.

WILLIAMS, J. Unbending Gender: Why Family and >Work Conflict and What To Do About It. New York: Oxford University Press, 2000.

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