Caring for the Elderly. The New Generation.

A short while ago, my husband, who is learning Spanish, was reading the book "Como Agua Para Chocolate", written by mexican author Laura Esquivel. This is the story of a young woman who lives all her life without ever really finding love because her mother insists that she stay home to take care of her into her old age. My husband found it very surprising that until very recently - and sometimes even today - it was quite a common assumption in some Latin American countries that the youngest daughter will stay at home to look after her aging parents and basically forget any idea of living her own life. This got me thinking a lot about the idea of caring for our older relatives in the modern world and what my own assumptions are for this period in life that must someday arrive.

One thing that I am very conscious of is that my life is much different than the way my ancestors lived. By the time my parents and those of my husband need care, we will already be educated professionals with careers and very busy schedules. Growing up, my parents never mentioned once, we would be expected to take care of them, and as my grandparents aged and died at home, as children, we could already see a relatively small amount of care provided by family members. That being said, I know my parents would actually be bothered if I would ever consider to give up my career to look after them, as the girl in the story does.

In the past, there were fewer options to send elderly parents away to professional care homes, so between this and the fact that careers have now become so much more important, there is much less chance that we would end up taking care of my parents. But perhaps because I grew up in a more traditional, family-oriented culture, I sometimes think that in later life I may begin to question these priorities. For one thing, even in non-traditional cultures, there is a presumption that women are supposed to provide the majority of the informal caregiving.

Sawatzky and Fowler-Kerry (2006) noted that 75% of the informal caregivers in this country are women, and that the burdens imposed by providing this care essentially made it impossible for many of them to have jobs or even meaningful lives besides providing that care. Again, for myself at this point in life, it would be very unlikely that I would choose to quit my school to provide care for my parents. By this, I don't mean I would not have mixed feelings, but I believe I would probably end up being much more open to the idea of putting either of my parents into care relatively quickly instead of providing informal, intensive care on a long-term basis. I believe that in this case, having been born in the modern world and having gone through university may mean that I am less likely to accept the assumption that I should be willing to drop everything and take care of my parents than if I had been raised even a generation ago when attitudes were even more patriarchical than they are now.

Of course, where all of the above was written about my parents, it would obviously be quite a different story if my husband were to require care when we are much older and retired. In that case, because we would be past the busiest part of our life, I would probably be much more able and willing to provide care for him to a greater degree. Even then, again I would probably be much less likely than my ancestors to hold out as long because I was not brought up with quite the same traditional assumptions about a wife being slavishly devoted to their husbands.

Despite the fact that I feel this way now, however, it is also true that at this point my parents are neither fragile nor dependent. When the moment comes, I am certain that the decision to send them into professional care would probably be incredibly hard. Caron, Ducharme, and Griffith (2006) discussed the process of making this decision amongst people who were providing care for relatives with dementia. I found it interesting that many of these families basically provided care up until the point when they could physically no longer do so safely. I wonder, is this actually best for everyone involved, or is the hardship endured by the caregivers worse than sending the patient to a home earlier on?

At the same time, however, I am conscious of the fact that the modern attitude that I have would definitely seem cold to a traditionalist and even though I think that as a human I have a right to enjoy a fulfilling life, I also know that this could sound harsh and self-centered to many people. I also believe in the importance of discussing different options with our seniors while they are still competant. This could help make it easier both for the family as well as for the client when the times comes to move into care.

Maybe the level of exposure we have to the elderly while growing up is an important factor. As I reflect on my upbringing, I remember having very little contact with most of my older relatives. Visits were very short and quite rare, which I suspect might contribute to me subconsciously tending to see seniors as not a major part of life. In comparison, my cousins who grew up in the same house as my grandparents, tend to have a better appreciation of the elderly and have an easier time relating to them, and therefore, although they are from the same generation would be most likely to provide longer care than I would.

References

Caron, C., Ducharme, F., & Griffith, J. (2006). Deciding on institutionalization for a relative with dementia: The most difficult decision for caregivers. Canadian Journal on Aging, 25(2), 193 – 205.

Sawatzky, J., & Fowler-Kerry, S. (2003). Impact of caregiving: listening to the voice of informal caregivers. Journal of Psychiatric and Mental Health Nursing, 10, 277 – 286.