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

2. Caregiving is the cornerstone of our long- term care system

3. 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

4. Caregivers by Relationship to Elder Care Recipient

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

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

7. HOURS OF CARE

8. Spouse Emotional Banking House Tasks Errands / Shop

9. Spouse Emotional Banking House Tasks Errands / Shop Personal Care

10. Child Emotional Banking House Tasks Errands / Shop Personal Care

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

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

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

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

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

16. Caregiving Career: Child

17. Caregiving Career : Spouse

18. Comparing Careers CHILD SPOUSE

19. 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.

20. 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

21. 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

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

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

24. Comparing Career Markers CHILD SPOUSE 0 10 20 30 40 50 60 70 01234567 YEARS H O U R S #2 #4 #6 #5 #3 #6 #2 #3 #4 #5

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