Trends in Caregiving Rhonda J. V. Montgomery, Ph.D. University of Kansas

Caregiving is the cornerstone of our long- term care system

We know:  Families provide 80% of long term care  Nursing home is last choice for care  Most caregivers are women  NOT ALL CAREGIVERS ARE ALIKE

Caregivers by Relationship to Elder Care Recipient

Diversity among Caregivers  Gender  Generation  Culture  Caregiving context

Diversity of Caregiving  What they do  When they do it  How they do it  How long they do it

HOURS OF CARE

Spouse Emotional Banking House Tasks Errands / Shop

Spouse Emotional Banking House Tasks Errands / Shop Personal Care

Child Emotional Banking House Tasks Errands / Shop Personal Care

Adult-Child Emotional Financial House Tasks Errands / Shop Personal Care

Care Sharing: Wives P H S B H S B O 80% 20%

Care Sharing Husbands H S B O H S B P P H70% 20% 10%

Care Sharing: Daughter 70% 30% B T O H P H T B O P

Care Sharing: Son 55% 45% B S O H P H s B O P

Caregiving Career: Child

Caregiving Career : Spouse

Comparing Careers CHILD SPOUSE

Basic Premises of Markers Model of Caregiving Careers 1. There is no single, generic caregiver role  Caregiving role emerges from prior role relationships  Role influenced by the unique values, beliefs and circumstances 2. Consequently there are:  Consistencies in the caregiving process.  Unique adaptations.

Premises of Marker Model 3. Caregiving is a dynamic process that unfolds over time 4. The length of career varies 5. Requires a change in identity

Caregiving Career Markers  1. Performing caregiving tasks  2. Self-definition as a caregiver  3. Performing personal care tasks  4. Seeking assistance and formal services  5. Consideration of nursing home placement  6. Placement in nursing home  7. Termination of caregiving

Caregiving career: child #6 #4 #2 #3 #5

Caregiving Career : Spouse #6 #5 #4 #2 #3

Comparing Career Markers CHILD SPOUSE YEARS H O U R S #2 #4 #6 #5 #3 #6 #2 #3 #4 #5

Diversity of Burdens  Difficult tasks/Physical Health  Time for other responsibilities  Task Overload  Privacy  Loss of Roles  Isolation  Financial Burden  Guilt