In closing: Good Bye

I wanted to take the opportunity to say good bye to those of you who have read my blogs. I hope you learned something from them and could apply my blogs to this class. I have enjoyed being able to use the knowledge from our readings, lectures, and videos and apply it to both my professional and personal life while writing my blogs.  I wish you all the best.

Sincerely, 

Heather

From Compassionate Ageism to Intergenerational Conflict

In  NPR news: 
In recent weeks I have heard several shows on NPR talking about the following: 

• President's Budget Deficit Commission;
• what's going to happen when the Republicans take over the house; 
• how surveys say American citizens want to do something to reduce our budget deficit, but no one wants their programs or tax's changed; 
• the tax plan that is being hotly debated now and being filibustered as I write this; 
• future cuts to Social Security and Medicare, 
• and how the baby boomers got us into this financial mess and that they may not end up paying any price for their mistakes. 

Baby Boomers: 
The members of the Baby Boomer generation were born between 1946 and 1964, when the United States population grew an estimated 76 million (U.S. Census Bureau, 1996). The first members of the Baby Boomer generation will turn 65 years old in 2011 (Hartman-Stein & Potkanowicz, 2003). By 2030, more than 70 million people will be over the age of sixty-five (Knickman & Snell, 2002). 

American Ideology: The Swinging Pendulum 

With our recurrent recession and federal deficit in the trillions, what are we going to do when we have 70 million baby boomers to take care of? Dr. Binstock in his article, From Compassionate Ageism to Intergenerational Conflict, discusses this same concern. Dr. Binstock begins by discussing the history of American politics. He discusses how we have always struggled with individualism vs. the collective well-being of everyone. Prior to the Great Depression, it was every one for themselves. There was a sense of individual responsibility. Then we saw the development of New Deal programs, Social Security program, Older American's Act, laws to prevent age discrimination, Medicare, and Medicaid. All of a sudden older Americans were a special group who needed to be protected and taken care of by society (Binstock, 2010).
Then the economic downturn in the late 1970's:
Dr. Binstock describes how the ideological pendulum swung back due to the economic downturn in the late 1970s and early1980s. He reports there was once again a focus on individualism, ending big government, including government regulation and welfare programs (sound familiar?). All of a sudden older adults were being portrayed in the media as "greedy geezers" who were doing better than everyone else in society and they were a "growing burden."  There were also concerns about the voting power these older adults had (sound familiar?). There were some who were pinning older adults against children for resources (sound familiar? I heard this at times this past November when our the Elderly Services Program levy was on the ballet. I heard more than once, they don't vote for our school levies, why should we vote for their program (Binstock, 2010)?

Will the future bring intergenerational political conflict?

Dr. Binstock thinks the likelihood and intensity of potential intergenerational political conflict will be shaped by the answers to two questions. The first question he asks is will we have enough national wealth to put into the social programs that help older adults? The second question  is whether our nation's ideology will support having programs that continue to help protect older adults from poverty and illness? What do you think?
Conclusion:
If as a society, we don't help provide health care and financial support to old adults, who will? Their families? The aging system has already changed so much in the fifteen years since I started my career. I can't imagine what it will look like in another fifteen, especially with the baby boomer generation to care for

Binstock R. (2010). From Compassionate Ageism to Intergenerational Conflict. The Gerontologist, 50(5), 574-585. 


Hartman-Stein, P.E. & Edward S. Potkanowict, E.S. (2003) Behavioral Determinants of Healthy Aging. Good News for the Baby Boomer Generation. Online Journal of Issues in Nursing 8(2), 1-26.

              

                Knickman, J. R. & Snell E. K. (2002). The 2030 Problem: Caring for Aging

Baby Boomers. HSR: Health Services Research, 37(4), (849-884).

U.S. Census Bureau. (1996). Population and housing characteristics of babyboomers 26 to 44 years old: 1990. Retrieved from:

http://www.census.gov/population/censusdata/cph-l-160h.txt

Excerpts from research paper. 

What about men?

Have we focused too much on women in this class? I know at times, I felt like I have been a little harsh on men,  especially when I discussed sibling gender differences in regards to caregiving. We have also discussed and read many studies that point out how women tend to be the kin keepers who maintain relationships with family and friends. I have often thought about some of the widowers I have worked with and widowers who are friends. Many of them have gotten themselves into a lot of trouble after becoming a widower: financially, with risky sexual behavior, becoming victims of elder abuse, and by abusing alcohol and other drugs. Here are a few of their stories:

• One client, I'll call Joe, was homeless when I started working with him. Joe described how after his wife passed he became very depressed and went on an ongoing drinking binge and eventually became homeless. Joe was around 85 when I started working with him. Joe walked into our office and asked for help. Fortunately, we had a collaborative relationship and funding with Interfaith Hospitality Network, so I found him short-term shelter until I was able to get him into senior housing. I remember asking him if he wanted to see the apartment and he said, "Mam, any place would be better than under the bushes." Although, he still goes on drinking binges at times and can get himself into a bit of trouble with his buddies still on the streets, he has maintained his senior housing for over three years. I could never talk him into getting help for his alcoholism. 

•  I visited another gentleman after receiving an anonymous call that an elderly man was sick and in his house with no help.  I did a home visit and found an elderly man, I'll call Ben in his early 60s sitting in his recliner all covered up with blankets. His legs were badly swollen with sores and there was a terrible odor from his infected leg and just filth. Ben had some "friends" who helped him at times or until his check ran out. He was being evicted from his home from non-payment of his taxes. After I worked with him for some time, he also described losing everything after his spouse died became he became so depressed. This made him very lonely and unfortunately an easy target for financial exploitation. 

• Another older gentleman who is a friend of my family described going on a spending spree by remodeling his house after his spouse died. He has also been financially exploited by several people (lady friends) due to being so lonely after his wife passed. He also describes being very depressed and even though it has has been almost twenty years since she passed, he still suffers from depression especially around the time of the year she died.

• A younger friend of the family ( a "young" baby boomer) also went on a spending spree remodeling his house after his spouse died. He also went on a "partying" binge and has gotten himself into many relationships trying to cope with loneliness. 

• As you can see from my stories above, being alone and not having a good support system is one of biggest risk factors for older adults to get themselves into abusive situations.

So what can men do when they are widowed to cope with loneliness rather than drinking or getting themselves involved with women who may have questionable motives? Men don't have a "purple hat society" they can join for socialization and support. There are plenty of other men's clubs,  Masons, VFW, American Legion, Elks, Kiwanis, and Jaycees. However, I don't think many men would get involved in these clubs in-later life. Do they? Some of the more successful widowers I have seen get themselves involved with their community, delivering meals on wheels or playing pool with other widowers at their local senior center. (If a senior center wants to draw more men--- I always recommend they get a pool table). One of my male clients goes to the local senior center three times a week and his sons also keep him active. However, at my last home visit he did have a nice collection of liquor bottles in kitchen, so I wonder if he doesn't "tie one on" when he isn't "busy" and feeling a little down.

Why do so many men not maintain ties with family and friends? Just today, I told my husband that I was going to get together with friends in Kentucky for lunch and shopping later this month. He made the comment how he wishes he had more friends and blamed not living in the area where he grew up. He always complains how he felt he was always the one making the effort to keep in touch with old friends and so just stopped. I said if we lived back in PA, he would probably see them less than we do now (3-4x a year) due to everyone being so busy. Men, can you think of ways you can help yourself in the future and ensure you will not be lonely as you get older and may find yourself a widower? Women, what can you do to help your spouses facilitate relationships with those in your community so if something happens to you your spouse will have support, socialization and friendship if you are no longer around?

Dimensions of Grandparent-Adult Grandchild Relationships: From Family Ties to Intergenerational Friendships

Grandchildren should be a blessing and I appreciated how this article and our class discussion pointed out that all Grandparents are not the same. I had a strained relationship with one set of grandparents (my Dad's mom and step-father). According to my mother, they always had the attitude of, "we raised our children" and my parents never helped facilitate my relationship with them. I had a wonderful relationship with my other set of grandparents (my Mom's parents). I feel, if my grandmother Rochester, my mom's mother had not developed Alzheimer's Disease and passed away when I was 27 year's old that we could have had a very close friendship. As I discussed in class, I wouldn't say my grandfather Rochester and I were friends, but he was rather a very important tie to my family genealogy. My husband on the other hand had one living grandmother when he was young and unfortunately that relationship was not too caring. However, he had two great-aunts who became his psuedo-grandparents. Fortunately, I see my son developing a warm and caring relationship with both sets of his grandparents. As we have read in the past and in this article my husband and I have to work to help facilitate this relationship. Parents are the kin-keepers between their children and other members of the family.

The authors of this article looked at the relationship between grandparents and their adult grandchildren.
The grandchildren were 21 years of age or older. The researchers interviewed a total of 37 grandparents and grandchildren. As discussed above, similar to my relationship with both sets of my Grandparents, the researchers found great differences on how the study participants experienced their relationships. However, the researchers pointed out that were also similarities that emerged. The authors found both grandparents and grandchildren felt their relationship was special and different from other family bonds. The relationship represents a tie to the past and future (Kemp, 2005). I know for my mom being with my son has brought back a lot of memories for when she was in the childbearing and pre-school age children stages of the family life cycle.


The authors also discuss how grandparents can also provide social and material means to their grandchildren. This becomes extremely important, especially if  the middle generations has issues, such as divorce, death, incarceration, and problems with addictions. I have several clients raising their young grandchildren due to the above social issues. I just did a home visit yesterday where an adult granddaughter was taking care of her grandmother. She said, "she practically raised me, now I can help her."

A number of the study participants describe their relationship as a "unique intergenerational friendship."
This sense of "friendship" was more evident when the grandparent and grandchild had spent a lot of time together through out the grandchild's life alone without the presence of the middle generation. This bond only became stronger when the grandchild became an adult.

The last area I'll discuss from this study was a sense of obligation felt by some of the grandchildren to spend time with their grandparents. The grandparents did not express a sense of obligation. However, this sense of obligation was also expressed positively by some of the grandchildren. They were happy to be obligated to spend time with their grandparents and some expressed that they enjoyed spending their free time with them.

In conclusion, many factors go into whether you have a positive or "friend-like" relationship with your grandparents.  For instance, did your parents help facilitate the relationship or did your grandparents help your parents raise you through financial assistance, free childcare or by practically raising you? On another note, but kind of related, do you think parents and children may have a more strained relationship if a child chooses not to have children, thus not giving their parents the opportunity to become a grandparent?


Kemp, C. (2005). Dimensions of grandparent-adult grandchild relationships: from family ties to intergenerational friendships. Canadian Journal on Aging, 24(2), 161-177.

Beyond Parental Status: Psychological Well-Being in Middle and Old Age

Famous and not so Famous "Older" Mothers & Fathers 

• John Travolta, 56, and wife Kelly Preston, 48, welcomed their new son Benjamin.

• Meryl Streep had her 4th baby just before her 42nd Birthday.

• Nicole Kidman had her first child at the age of 41.

• Susan Sarandon gave birth at 46.

• This past weekend I went to a friend's house where I met a women who had her second child at 41. She had her first child in her early 20's and she is now in college. She explained how much harder it is to have a child in your forties due to not having as much energy. Her child's father is in his 50s and also admits their son gets away with a lot more than the children they had in their 20's. 

• I hear through the family grapevine that my cousin who will be 50 this year plans to try for his first  child with his wife who is in her 30's in 2011.

 As someone who was not sure if she wanted children and now has a darling, smart and hilarious three year old son to spend time with, I'm happy for anyone, who successfully has children either naturally, with the help of medical intervention or adoption. Hopefully, they have a loving and affectionate relationship with their child over their life course. 

I'm afraid if my husband and I had chosen not to have children we both would have been similar to the childless women & the women who had poor parent-child relationships in the Koropeckyj-Cox study. The childless women & women with a poor relationship with their child reported more loneliness and depression.  Childless women were 3.8 times as likely to be lonely and 3 times as likely to be depressed as mothers with affectionate relationships with their child.  It appears from this study that I may have been more vulnerable to depression and loneliness than my husband if we were child-free. Also, if he continues to have an affectionate relationship with our son, he may be at a lower risk of suffering from loneliness and depression than childless fathers. However, if either of us develops a poor relationship with our son, we may be at an increased risk of depression and unhappiness. This study did not find the number of children the participants related to their well-being. In summary, having our son does not guarantee psychosocial well-being for my husband and me, but if we continue to have a loving and affectionate relationship with our son it will help as we get older (Koropeckyj-Cox 2002). .

 
Koropeckyj-Cox, T. (2002). Beyond parental status: psychological well-being in middle and old age. Journal of Marriage and Family, 64(4), 957-971.

Information about John and Kelly found @:
http://www.popeater.com/2010/11/24/john-travolta-baby-benjamin/

Other famous "older" mother information, found @:
http://www.mothersover40.com/celebrities.html#anchor_138

Almost the end of my blogs quote:)

I always have this quote hanging up in my cubicle or on my office door (when I was fortunate to have an office with a door) as a daily reminder that our elders should always be respected and well cared for:  

"A test to a people is how it behaves toward the old. It is easy to love children. Even tyrants and dictators make a point of being fond of children. But the affection and care for the old, the incurable, the helpless are the true gold mines of a culture." Abraham J. Heschel

Coping strategies for Caregivers

This is a list of caregiving strategies developed by Lela Knox Shanks in 1994. 

Mrs. Shanks cared for her spouse, Hughes who had Alzheimer's Disease. 

1. Reinforce your identity separate from the patient's identity. 
2.  Always move from your center, not the patient's. 
3. Tap into your unused, unlimited inner strengths and creative resources. 
4. Continually acknowledge all feelings, positive and negative, reinforcing positive feelings. 
5. Be responsible and take control. 
6. Get information and get help. 
7. Work out your own plan for surviving whole. 
8. Accept what you cannot change. 
9. Eliminate the words "blame" and "excuse" from your vocabulary. 
10. Make no promises about the future. 
11. Explore and face the worse possible events in your future. 
12. Use respite care regularly for extended blocks of time. 
13. Develop an emotional detachment from your caregiving tasks. 
14. Train yourself to be pro-active rather than reactive. 
15. Enjoy humor regularly. Humor assists the immune system. 
16. Get a support system that works for you. 
17. Be flexible, willing to learn, to adapt, to change and to grow at any age. 
18. Regroove your brain with positive reinforcement. 
19. Develop an exercise regimen of both kinds, body and soul. 
20. Look for small joys.

Betty White

 

Betty White

Awe... so cute, sweet, smart, funny, respected, and talented (being partly facetious). Who doesn't love Betty White? She has been working for over sixty years in ageist Hollywood and at 88 is still finding work. Wikipedia reports, in May of 2010 she became the oldest person to host Saturday Night Live and their ratings were huge. She won a Prime time Emmy Award for the show. Why did so many tune in to see Ms. White (I'm sure some were also tuning in to see Jay-Z)? Did you tune in? If so, why?

I have to wonder how Ms. White has been able to overcome our society's ageism, especially in Hollywood? Does her image help promote ageism or has she helped change societies views of older adults for the better? I have to admit, I'm a bit torn between the two. Looking at most of her pictures on Google images, doesn't she look like the stereotypical Grandmother? A while ago I saw an image of Ms. White when she was on the red carpet where she was covered from her neck down in a very matronly dress. I had to think of the article we had just read for class, Bat wings, bunions, and turkey wattles: body transgressions and older women's strategic clothing choices. She looked like she was disguising any body flaws that she has now due to age. What if she flaunted her aging body a bit more, colored her gray hair, had a face lift, would she still be getting work? Why can she pull off  "dirty old lady" talk and we laugh? Could she do that if she didn't look so stereotypically like a "nice old Grandma?".

I hope Betty White is still successful at 98, but I do think we should question whether she is helping promote a new image of healthy aging or just promoting society's ageist views. Please enjoy some of links below of Ms. White's comedic work.

Picture of Betty White found at:
http://www.google.com/imgres?imgurl=http://www.reuters.com/resources

Wikipedia information located at:
http://en.wikipedia.org/wiki/Betty_White


Saturday Night Live "Muffin" skit link:
http://latimesblogs.latimes.com/comments_blog/2010/05/facebook-betty-white-snl-ratings-tina-fey.html


Saturday Night Live "Golden Girls remake- Ms White drops the F-bomb"
http://bossip.com/246056/jay-z-performs-on-snl-and-betty-white-skit-video/

 
Betty White on The Daily Show Jon Stewart Link:
http://www.thedailyshow.com/watch/mon-june-14-2010/betty-white

The West Wing: The Long Goodbye

What would you have done if you were C.J. Cregg and were in the middle of a speech to your high school alumni, your father, Tal was deteriorating from Alzheimer's disease with no dependable support, and you were needed back at work? Would your priorities have been different? I guess it helped having her father standing there with his third wife, Molly, but how long is Molly going to stick around? Don't you wonder if she'll run back to her daughter's house again when caring for Tal becomes difficult? I felt sorry for Molly. What a sad love story! She had waited a long time to be with Tal and when she finally has him he's slowly leaving her due to some dam disease. I would be angry, too. I watched my Grandmother die in about six years from Alzheimer's disease. She was able to write a very sweet letter to me in 1995 and by 2001 when she passed, she didn't know who I was. Alzheimer's Disease is a good nickname for a long & often sad good-bye. It is so devastating for families.

So as a professional what would I recommend C.J. do if she called me asking for direction? I don't agree with the advice Tal's doctor friend gave her. Yes, put him on medication(s) to help slow the progression of Alzheimer's Disease, but if she takes him out of his home environment he will deteriorate at an alarming rate.  I have two clients with Dementia where their families are looking at putting them in an assisted living and it breaks my heart, because I know they will deteriorate fast. One of the clients has lived in her home for over thirty years and has has Dementia. However, she is high functioning in her current environment, probably just out of habit formed over decades. The last time I did a home visit she was making coffee. If you move her, she will have difficulty even remembering where the new bathroom is. However, there comes a time when you have to do what is best for you, the caregiver and neither of my clients should be left alone at this point. However, Tal appears to be in the middle stages of Alzheimer's Disease and I feel C.J. should try to keep him at home for a long as its financially feasible and as long as he's safe. I'm not saying he should be alone and please disconnect the stove, take his car keys, and remove all cigarette lighters before something bad happens!

First, C.J. needs to know what his financial situation is. What is his income? Does he have assets? Can he afford private in-home care? Does he have a POA and a living will, while he maybe competent enough to sign these important legal forms. She should contact their local Area Agency on Aging in Dayton and see what resources they have. Do they have waiting lists? She should also contact the local Alzheimer's Association and inquire about their resources. Oh, and she should let them know where she works. I hate to say it, but she will get help fast! I've seen how people jump when a staffer from a state representative's office calls for help. Imagine if it's someone calling from the White House. Does he qualify for a medicaid waiver program, such as PASSPORT or Pace? If she does want to look at a long-term care facility can he afford assisted living? Does he need more care than what an assisted living facility can offer? What does his third wife, Molly want to do? She is entitled to his income and assets as his wife. Does she want to keep him at home and care for him, so they don't go through all of their assets with more formal care? What does her financial situation look for her long-term care needs? Does he have long-term care insurance? Since C.J. has financial resources, she could hire a private case manager to help her get the resources into her father's home to care for him or help her look for a facility. She could also consider moving him closer to her in D.C., especially if his third wife doesn't want to care for him. Is C.J. an only child? If not, she should involve her siblings in any decisions.One last thing I would tell C.J. is if she is looking at an assisted living facility, I would recommend choosing one where they have all levels of care, so once her father needs skilled or intermediate care he can stay there on the grounds and he doesn't have to move to a whole new facility.She should also be sure to involve her father in any decision making.


Boy, I don't know if I'd be much help to C.J.  It's a VERY tough situation to be in. It's not an easy transition from child to being responsible for making decision for your parents. As a professional, you can't make decisions for clients and you should start where your client and their family members are. C.J. and her father  are in the beginning stages in what they are going to do. It is difficult enough to face the diagnosis of Alzheimer's Disease. You can only share your knowledge with clients and their family members and if they use it, great, if not, there is not much you can do. I tend to give clients and their family members a lot of information they can use to base their decisions off of. I guess that is one area where I did agree with Tal's doctor friend's advice. C.J. definitely needs to get her father help now and not wait until after another crisis has occurred.



"The Long Goodbye." The West Wing: season 4, episode 78.  Baitz. Dir. Alex Graves
 NBC, 2003. DVD.

Caregiving: Assisting Parents and In-laws: Gender, Type of Assistance and Couples' Employment

For this paper researchers used data from the 1995 National Survey of Midlife Development in the United States. This study highlighted the importance of looking at both the gender and whether a caregiver and their spouse are both employed. The authors report that research has shown that women spend more time providing care than men. They expanded on this research by looking at different types of support, such as financial or how much time is provided to both parents and in-laws. They also looked at the couples joint employment status and how many hours they work and how their employment status affected their level of caregiving (Chesley & Poppie, 2009).

The authors found the following:

• only partial support that women provide more help to relatives than men; 
• women provided more emotional support to both parents and in-laws;
• providing more emotional support may lead to more psychological distress for women; 
• less time spent caring for in-laws compared to time spent caring for parents; 
• women spent more time than men providing emotional support to in-laws; 
• no difference between women or men and the time spent providing unpaid task assistance to in-laws; 
• more support is provided if only one partner is employed; 
• less support is provided in dual-earner couples; 
• no support of gender differences in financial assistance provided to parents or in-laws; 
• work hours affected the amount of financial assistance provided; 
• having an employed partner reduces the amount of financial assistance provided;
• single earners appear to be able to advocate more financial assistance for their parents; 
• and the average financial contribution to parents was $9.72 and for in-laws was $4.78. 

The researchers admit several limitations to their study. It only included couples, so their findings can not be generalized to singles. They also do not know the gender or marital status of the parent or in-laws being helped. Also, they could not determine when there were no living in-laws, however, they did not feel this influenced in-law estimates substantially.

So, women still provide more care than men, especially with emotional support to both their parents and in-laws. In-laws get less help from their daughter-in-laws and son-in-laws. If only one partner is employed more help is provided. This makes sense. One partner is at home cooking, cleaning and doing the laundry, so this frees up time to care for your parents. If both partners work then they both have equal say in how much financial assistance is provided to aging in-laws and parents. If only one partner is working then they have more control over how much of their families funds go to help their parents. However, the financial contribution still seems very small to me to both parents and in-laws.


Chesley, N., & Poppie, K. (2009). Assisting parents and in-laws: Gender, type of Assistance, and couples’ employment. Journal of Marriage and Family, 71(2), 247-262.

Caregiving: Family Caregiving Systems: Models, Resources and Values

Considerable research has been done on families and caregiving. Unfortunately, the dominant focus on one primary caregiver (PCG) has dominated research and except for gender, has not looked at the role of other siblings. According to Keith (1995), there are several issues with research only focusing on one PCG. The first issue, Keith discusses is not having an accepted definition of the term primary caregiver. For instance, how do researchers differentiate between a sibling who manages their parent’s finances from another who provides the hands-on care? The second issue is collecting data from only a primary caregiver will probably lead to the underestimation of contributions from other siblings. The third problem is by focusing on one primary caregiver, Keith is concerned that this may be viewed as a norm and deter siblings from equitably dividing the care for their parents. Finally, Keith explains while there is often one sibling disproportionately providing the care for their parents, there is growing research that supports adult siblings do work together to care for their aging parents (Keith, 1995).   

Through Keith's qualitative study of thirty-one families, she was hoping to discover new concepts through an exploration of the division of labor by offspring caring for an elderly parent. Each of the families had a mother who had been diagnosed with a cognitive impairment. Ten of the families in the study had one offspring, ten had two and eleven of the families had more. Keith conducted a total of 57 interviews and fifteen of the siblings were not interviewed.

Keith identified three types of family caregiving systems. They are primary caregiver model, the partnership and the team. Each was found to be distinctive in the values that it expresses. The most well-known and researched model is when there is a primary caregiver. In this model there is minimum collaboration among siblings. One person carries all or most of the caregiving responsibilities. In Keith's study, siblings may take turns being the primary caregiver. My mom was the primary caregiver for both of  her parents. Her sister lived six hours away. My aunt did provide my mom with a few weeks of respite care and became their primary caregiver for them when they were at her home. 

The second model is partnership. In this model there is collaboration between two siblings caring for their parents relatively equitably. They are equal in authority and responsibility in making and implementing decisions. Other siblings may be involved in the caregiving but their roles are limited. One of my clients has two son who would fit the model of a partnership. One son does live with the client and provides him with twenty-four hour supervision, but his other son comes by everyday to provide the other son some respite and he also takes care of all of my client's business affairs.

The third model is team. This happens when there is collaboration between multiple siblings. As with the  partnership, the team is distinguished not so much by how tasks are apportioned among the siblings as by the way they perceive their various roles. In this system, siblings perceive themselves to be organized in a planned and integrated manner. I can only think of one of my clients where I see her children working as a team. In her case, I always do a my home visit with at least two of her daughters present. One daughter who is a nurse manages her medications and medical care, her other daughter manages her finances and personal business and her son helps her with shopping and getting to medical appointments since he is retired. Her other daughter is limited in the care she can provide due to disability. They always seem to work really well together and have very effective communication in order to meet their mother's care needs and keep her at home where she wants to be.

There were two factors that affect the caregiving system used by siblings. The first was family composition. Keith found that size of the family and its gender composition contributed to the development of the caregiving system.Obviously an only child can not easily form a partnership or team with another person and none did in this study. Two sibling families could organize as a partnership, but none did in this study. Families with a larger number of siblings could establish any of the three caregiving systems and did. In every one of the sister brother sibling combinations, the sister was the primary caregiver. Gender appears to determine the allocation of caregiving tasks between brothers and sisters. Prior studies have shown that sisters tend to develop a partnership in caring for their parents. However, none did in this study. All of the two sister pairs had developed a primary care system and unfortunately half of these reported bitter resentments over perceived inequities. The only two brother pair established a partnership. Larger families with two or more daughters were more able to develop a  partnership. Only one family in this study exhibited a team system. The authors assume families with a larger number of siblings may use more cooperative style due to less sibling rivalry and less resentment due to the dispersion of responsibility among a number of siblings.

The second factor were values. Four predominant values were identified through analysis of offspring explanations of the caregiving system the families established. These were justice, affiliation, equity and protection of siblings. The author points out that she is not talking about motivations for siblings to provide care to a parent, which she found to be unaffected by family size or composition. She is talking about values that inspire establishment of a particular type of family caregiving system. She found the main motivation was to be considerate towards their other siblings.

The first value that was expressed by the participants was justice.  Keith points out that it should not be confused with fairness. I saw these as societal or family values and beliefs. Justice refers to the allocation of tasks and authority on the basis of such criteria as gender (daughters as the kin keepers are more likely to be the PCG), geographical proximity (siblings who live far away are excused from helping, while the one who lives closer and doesn't help is resented bitterly), and the weight of competing responsibilities (daughters are responsible for the care of their mothers while their brothers are not.). 

The second value as affiliation. When one sibling has a stronger affiliation to the parent it appears to be an influential value in the establishment of the primary caregiver system. Gender appears to explain why daughters assume caregiving responsibilities, while affiliation explains why one daughter rather than another is the primary caregiver.

The third value was equity. Equity was the predominant theme in families characterized by a partnership. There did not need to be an exact division of caregiving work, but reasonably equitable contributions. They were committed to shared, active participation and authority in decision making.

 The fourth value was emotional protection. The predominant motive expressed in the team system was emotional protection of the siblings. They did not want one sibling to carry all or most of the caregiving tasks. The other main theme was to protect other siblings from a parent's excessive demands and criticisms.

I agree with Keith when she states this study can add to understanding of how and why caregiving is distrubuted among family members. However, after rereading Keith's study for this blog I have some new concerns. I'm disappointed that the sample size was so small that only three of the families were defined as having a partnership caregving system and only one as a team caregiving system. Twenty-seven of the families were defined as a primary caregiving system. I don't see how Keith could base all of these factors and values on so few families. I also realized that the siblings were caring for a mother who was diagnosed with a congnitive impairment. Caring for someone with a cognitive impairment is so completely different then caring for someone with a physical impairment that I think you can't begin to look at Keith's findings and apply them to all sibling caregivers. I can also see where the care needs for someone with a cognitive impairment would automatically lead to having a primary caregiving system due to their intense needs.

Keith, C. (1995). Family caregiving systems: Models, resources and values. Journal of Marriage and the

Family, 57, 179-189.

A Distant Closeness: Intimacy Between Parents and Their Children in Later Life

Fingerman reports many older adults are widowed, divorced, or single. The Administration on Aging (2009) reports that nearly 30.5% of all non-institutionalized older adults lived alone. They represented 39.5 of older women and 18.5% of older men. Statistics show that the proportion living alone (widowed, divorced,  or single) increased with advanced age. Half of all women age 75 and over lived alone.  What does this mean to the important parent-child relationship as the parent grows older? It can be a struggle, especially as your parent(s) need more of your help and find themselves a little lonely. How are you going to feel when your 70 year old widowed mother who is living alone is demanding your time away from your family and work obligations? What kind of relationship do you have with her now? Is it respectful? Do you still bring your problems to your parents to solve? Have your parents realized you are an adult and have a life separate from them? What can you do now to help develop a healthier intimate relationship in the future, when you will have more stresses on your relationship?

As you get older, you develop a separate life from your parents and establish thicker boundaries and in some relationships, you may still grow closer to your parent(s). This article discusses the paradox of distant intimacy between aging parents and their adult children. (Fingerman 2001). During early and middle adulthood, Fingerman states your relationship with your parent(s) tend to improve. Having experienced this myself, you realize your parents are human and have personality flaws and issues like everyone else, yourself included. They may realize that you have to lead your own life, so they may not be as willing to jump in to give you direction or help when you face challenges in your life. At the same time, you may be more willing to protect them from worrying about you, so you are careful about what you share with them. I found it interesting that Fingerman did not discuss that parents are also very careful about what they share with their children, as not to cause them concern. I see this with my parents, in-laws and clients all the time.

Not all parents and their children develop an intimate relationship where there is respect, a sense of caring and the relationship is beneficial to everyone. Fingerman states that there are two characteristics that define intimacy between aging parents and their adult children. The first is a recognition of the other person as an individual with strengths and weaknesses and second is a deep concern for the other person's well-being (Fingerman 2001).

At this point in the article, Fingerman lost me. She explained the two characteristics above and then jumps right into discussing self-disclosure, self validation, etc.  I'm assuming these are other aspects of intimacy or in order to meet the characteristics above you must have self-disclosure, self validation, etc?

Anyway, Fingerman states that self-disclosure is often viewed as a means of enhancing intimacy. This self-disclosure has to be respectful. Parents recognize that their children care and are concerned for them and their children recognize that their parents deserve to be worry free. Wow, this is a concept I don't see too often played out in the families I work with. In too many cases, the children bring all of their problems to their parents who in most cases, can't do a thing to help. So many of my clients survive on very meager Social Security income and their children still bring financial issues to them. This just causes great grief and anxiety for the clients I work with. Fingerman states that in more intimate conversations, the topic is kept light, such as about their daily lives, but are careful about what is disclosed out of respect.

Another key aspect Fingerman discusses is self-validation. I think Fingerman is saying the relationship between the parent and child develops over a lifetime and eventually when the child is normally in their thirties both the parent and child have an increasing sense that each possesses a separate identity. Children see their parents as human with all their faults and parents realize their children are adults.

Another area of intimacy is "mutuality" between the parent and the child. In later life, the parent and the child experiences a sense of intimacy from helping each other. Helping the other person is more important then them helping you and you feel they deserve the help. This is increasingly important since your parents may have been able to help you more when they were healthy, but as their health declines you may be giving them more help then they can exchange. Interestingly, hands-on care does not appear to increase intimacy.

Of course, there are so many things that can happen along a family's life course to halt the development of the healthy intimacy that Fingerman discusses in this paper. Parents often have a more favorable view of their parent/child relationship than their children. So many of us don't realize it's normal to start seeing your parents and all of their faults and that it's healthy to develop a friendship with your child as they become adults.


Administration on Aging 2009. A profile of Older Americans: 2009  Facts about Older Americans
Retrieved from:  
http://www.aoa.gov/AoAroot/Aging_Statistics/Profile/2009/docs/2009profile_508.pdf

Fingerman, K. (2001). Distant closeness: intimacy between parents and their children in later life. Generations, 25(2), 26-33.

Snowbird Intergenerational Family Relationships

This was a qualitative study of 25 older adults age 60 and older who flock to warmer climates for at least four weeks during winter. The researchers state outside of marriage, parent-child ties represent the most important aspect of kinship for a majority of older adults (Bjelde & Sanders, 2009).The researchers wanted to see if there was an impact on kin relationships when parents went to warmer climates during the winter.

All of the participants in this study indicated they already had strong family relations with their kin. They went to warmer climates to improve their quality of life. Winter weather is very stressful and dangerous for older adults. Many find themselves home bound, experiencing increased pain from the cold, and are at an increase risk of falls and fractures from snow and ice. I have clients who have already asked me for home-delivered meals and medical transportation in preparation for winter.

For these study participants, the researchers found the following:

• Their strong family relationships appeared to help them maintain close ties  Since they already had strong family ties, everyone made an effort to keep in contact. Many used family plans on cell phones & e-mails. Their children supported their decision to head south for the winter.
• Families who were open to change were more successful since holiday traditions were often changed for some families. 
• Nearly one fourth of the participants wintered near other family. 
• The participants did report that if their health deteriorated they would want to be back home. 
• Family changes did not change seasonal migration, such as divorce or death of an adult child. Nearly 30% of the participants were either widowed or divorced, but had not ended their seasonal migration. 
• More than three fourths of them lived in some type of Sunbelt retirement community. Often celebrating holidays with other residents there.
• The participants enjoyed it when family said,"they had missed them."
• The participants encouraged family to visit them, sometimes making room for them in small accommodations. They went out of their way to make visits enjoyable and did a lot of sight seeing. 
• Families helped them get to their destination. Either by making reservations or driving them.

I think being able to go to sunnier regions during winter for many older adults is the ideal retirement. My Grandparents were fortunate enough to have been considered snowbirds for years and eventually became permanent residents in Florida. They thrived in the sunny and warm atmosphere. My Grandfather could ride his motorcycle year-round, they were not trapped inside due to snow and ice, not at risk of falling and fracturing a hip and had a large social network. I only hope I'm so fortunate to have this experience one day.


Bjelde, K., & Sanders, G. (2009). Snowbird Intergenerational Family Relationships. Activities, Adaptation and Aging, 33(2), 81-95. 

Caregiving: Shared Filial Responsibility: The Family as the Primary Caregiver

In this study, fifty pairs of sisters were interviewed face-to-face and answered questions regarding their parents and how they worked with their siblings to meet their parents' care needs. They all have at least one parent over the age of 75 and only one of the sisters was employed.  The researchers identified five styles of participation and three factors that helped determine which style was used (Matthews & Rosner, 1988).
 
The five styles of participation include:

1. Routine-Some of the siblings provide regular assistance for their parent(s). For instance, the daughter may be routinely call their parent(s) twice a day or take them shopping every Wednesday.
2. Backup-Some of the siblings did not provide routine care, but the siblings who did knew they could count on them if needed.  For instance, one sister does not provide routine care, but when her sisters ask her to pick up mom's prescription, she will do it. However, this sister does not initiate involvement. She waits to be told what to do.
3. Circumscribed-Some of the siblings help with just one area of caregiving and they are not expected to do anything else by their siblings. An example of this is how my father calls his step-father every Monday night to talk and this is all his sisters depend on him to do. Another example, is if a sibling is a physician, they are sometimes only called upon to help with medical advice and that is all.
4. Sporadic-Some of the siblings only provided sporadic care for their parents. For instance, a brother occasionally took their mother out for lunch on Sundays. The siblings who provided more routine care still felt that sporadic care was valuable.
5. Dissociation-Some of the siblings did not help care for their parents in any way. Often, these siblings had dissociated themselves from the whole family. In one situation, a brother no longer had contact with his mother, but did talk to his siblings.

The factors that affected the level of caregiving by participation included, family structure, family history, and extrafamilial ties.

1. Family structure- The number of siblings and their gender affected what kind of style would be adopted and which siblings would adopt it. Twenty-three of the pairs of sisters were the only children and were more likely to use the routine style of care and occasionally used the backup style. In the twenty-seven other families, additional styles were used. Each of the five styles was utilized by both brothers and sisters, but gender affected the likelihood of a particular style. Daughters generally provided more routine care than sons. The back-up style was primarily used by sisters and dissociation style was more common among sons.

2. Family history- Three aspects of family history were discussed. They were seniority, feelings the siblings had for one another and personality characteristics, such as the ability to deal with a crisis. The authors were surprised family history had less effect on the care provided to their aging parents.  Family history issues did affect how the siblings related to one another, but did not appear to deter them from meeting family obligations.

3. Extrafamilial Ties-This factor looked at ties that each sibling had to others, such as employers, spouses and children. The authors broke this down into time available to provide routine care and if the sibling had a spouse this sometimes added more issues to being able to provide care. In regards to time, the authors looked at the geographical proximity of the child and the parent. Travel time was a big factor whether a sibling provided routine care. Employment was also a factor, however it put constraints on when care was provided, but did not necessarily decrease the chances of routine care. Interestingly, one of the most important competing ties that adult children had was to their spouses. Children were not as important, since they were expected to accept their parents' priorities. The 90 sons-in-laws and 21 daughters-in-laws were either actively supportive, indifferent, or antagonistic(Matthews & Rosner, 1988).

Prior research focused on only one child as the primary caregiver for their parent(s). This was one of the first articles to look at how all siblings work together and what factors affect their ability to help care for their parents. Looking at your siblings, can you  guess which styles of participation they will have in the future as you parents age? What style do you think you will have? What factors apply to you and your family?

(Matthews & Rosner, 1988) 

Matthews, S.H., Rosner, T.T. (1988) Shared Filial Responsibility: The Family as the Primary Caregiver. Journal of Marriage and the Family, 50 (1), 185-195.

Caregiving: Sibling Influence on Care Given by Children to Older Parents

This study had a sample of 186 older parents in need of care with at least two adult children. The 186 participants consisted of 66 males and 120 female care recipients between the ages of 63 and 91 who lived independently. The study examined how  siblings' behaviors and characteristics influenced another child's level of care for their parents. The author's discuss how intergenerational solidarity framework is commonly used to explain the determinants of  parent-child caregiving (Tolkacheva, Groenou, & Tilburg, 2010;  Bengtson & Roberts, 1991 ). Some of the determinants discussed included being a daughter, being geographically close, not having a job or other competing family needs, being emotionally close, and having frequent contact with parents predicted how much children assisted their parents (Tolkacheva et al., 2010).

This study tested three hypothesis. The first hypothesis is: To the extent that siblings provide care with higher intensity, an individual child will provide care with higher intensity as well. The authors discuss literature that supports their hypothesis. They discuss how even if siblings do not have direct communication with each other, everyone normally knows what the other siblings are doing for mom and dad. They also discuss the norm of sibling solidarity which creates a sense of mutual responsibility and collaboration for their parents' care.  

Results for hypothesis 1: Their findings suggest the existence of sibling solidarity when siblings are caring for their aging parents. They found that siblings did increase the level of care they provided when prompted either by another sibling or their parent. However, the authors did suggest that the greater the parent's care needs the more difficult it is for the siblings to keep up with the level of care their siblings are providing.


Their second hypothesis is: The more siblings, but in particular the more sisters there are, the less intense each child's caregiving is likely to be, regardless of the child's own gender. Again, the author's discuss literature that supports their hypothesis. Prior research shows that a child has to provide less care for their parent in larger families. As discussed in a previous blog, daughters tend to be the primary caregivers for their aging parents. The more sisters you have the lower the number of hours of care you will have to provide for your parents. However, in only-child or single-gendered families, there appears to be equality of amount of caregiving hours and the kinds of caregiving activities provided. This suggests that both sons and daughters behave differently if there are daughters in the family who can care for their parents.

Results for hypothesis 2: The authors state that this hypothesis was partly confirmed. They did find that a child provides less care when he or she has sisters. However, the number of brothers did not seem to affect a child's caregiving. Caregiving does appear to be dependent on a child's gender. The author's state, "sibling solidarity is therefore shaped by the availability of sisters in the sibling group" (p.753). 

Their third hypothesis is: An individual child provides less care if his or her siblings have characteristics that are more conducive to caregiving. The author's state, "Sibling solidarity can be shaped by the characteristics of siblings" (p.743).  Characteristics are not defined as personality traits (That's what I first thought they were talking about). Characteristics are similar to the determinants used within the intergenerational solidarity framework. For instance an individual child will provide less care if they have siblings who do not have family or job responsibilities, live closer, or have an closer emotional relationship wit their parent.

Results for hypothesis 3: They found a strong correlation between the determinants of siblings with partners and average frequency of emotional support exchanges between siblings and a parent as significant predictors of a child's caregiving. Children appear to take on caregiving responsibilities when their siblings have other demands, such as having a partner or when they have an emotionally poor relationship with a parent. Sibling solidarity appears to corroborated in this situation, however, as the authors point out, some siblings may not feel having a partner or an emotionally poor relationship are reasons to give less care. In this case the other sibling may be providing more care not to help their sibling, but out of necessity to meet their parent's care needs. The authors state in this situation, the sibling would not be providing care due to sibling solidarity, but rather siblings' opportunities. Interesting to me, the characteristics of siblings with jobs, their own children, geographic proximity, seems to be unimportant to an individual child's caregiving. The authors do state that this contradicts previous research where these characteristics were used by children to explain their own caregiving behavior. In conclusion, the author's state, "one's own characteristics are more important than sibling characteristics in the provision of care" (p. 754).

As your parents age, do you think you and your siblings will have solidarity when caring for them? If you have a life partner or an emotionally challenged relationship with your parent, do you think your siblings would be willing to provide more care for your parents? If you are the only daughter, are you willing to provide more care than your brothers? If your parents need more help, do you think your siblings will be willing to provide more care?

Bengtson, V. L., & Roberts, R. E. L. (1991). Intergenerational solidarity in aging families: An example of formal theory construction. Journal of Marriage and the Family, 53, 856-870.



Tolkacheva, N, Groenou M.B., & Tilburg, T. (2010). Sibling Influence on Care Given by Children to Older Parents. Research on Aging, 32, 739-759

Caregiving: Collaboration Among Siblings Providing Care for Older Parents

This study focused on forty focus group participants who felt they equitably cared for their parents with their siblings. The hope was to see what they were doing right, so social workers could then help share their practices with their client's children (Dayton, Neal, Ha, & Hammer, 2003). I think this is an area of assessment that is often over looked when working with older adults. So many of my clients have children helping them, but due to relationship issues among their children the care is often not coordinated. Is policy too focused on individuals?

I had two home visits yesterday that illustrated how different your clients' supports can be from their children. One visit was with a couple and their son and daughter were present. They appeared to be very supportive and worked collaboratively to help care for their aging parents. I even overheard them say they needed to call their other brother to make sure he was aware of their parent's situation. On my second visit, my client told me she does not have any contact with a son who lived the closest, her other son lived in another state and her third son was incarcerated. Unfortunately, she was left with very little support from her three sons, so has to pays privately for much of her help.

There were two methods of collaboration that stood out from the participants' discussion. The first was taking turns. There was not one specific way they took turns, but there were a number of different turn-taking strategies that they developed. One strategy was to divide up the time spent caring for a parent or parents evenly among the siblings.  For instance, one participant in the study described how she and her sisters spent the same amount of hours a week caring for their father, so their mother could get some respite time. The second strategy of turn-taking was to trade off on caregiving responsibilities over time. An example given by one participant was how she and her siblings planned to rotate primary caregiving for their father on a three week rotation. A third turn-taking strategy was to divide the primary caregiving tasks between a few of the siblings and the other siblings could be called as a backup. This approach worked well when there were many of siblings and not all the siblings lived close to their parents.


The second method used by caregiving siblings was division of labor by tasks and/or expertise. These siblings divided care based on capabilities or preferences of each sibling. I see this method a lot with my clients. For instance, I have a client who has two daughters and a son. One handles all of her finances, one is a RN, so manages the client's medications and getting her the appropriate medical care. Her son is often the one who helps with grocery shopping and taking her to appointments since he is the only sibling who is retired. With this method the siblings have a clear idea and feeling of competence for their area(s) of responsibility.

So what component did these siblings use to decide on the best method for them to equitably care for their parent(s)? The first component was redefining the caregiving system. For some of the siblings this meant changing their thoughts from being the primary caregiver for their parent(s) to realizing they needed to be part of a caregiving system with their siblings. The second component was that the siblings truly enjoyed each others company and made every effort to spend time together. The third component was sitting down with all the siblings and their parent(s) and developing a plan before a crisis occurred. The final component in successful caregiving was the involvement of their parent(s) and either through the initiation of the parents themselves for by their children making sure their wishes were known and they had a say in their care.

One of the study participants described how her mother arranged her estate plans before becoming ill. Her mother's careful planning has made it easier for her daughters to work collaboratively to care for her. Her mother had actually specifically planned on compensating her children for their care. She specifically stated what caregiving behaviors would be compensated to reduce the potential for conflict among her children. Now that is LOVE! What responsibility does a parent have to ensure the least amount of conflict between their children when they need their care? What planning can they do ahead of time to ensure their is the least amount of conflict or hurt feeling among their children? Some things I can think of includes: Living wills, POA designated, burial plans in place, will, and most of all open communication between all of their children, so they all know their wishes and there does not appear to be any favoritism. If you have siblings, have the decisions and actions of your parents made it easier for you and your siblings to work collaboratively to meet their needs? Over the holidays, do you feel comfortable starting this conversation with your parents and siblings?


I really enjoyed how this article focused on the best practices and positive effects of collaboration between siblings. How refreshing! As funding for formal systems, such as Medicare or tax levies continues to grow tighter,  I feel professionals who work with older adults are going to need to be more creative and help our client's informal support systems work more collaboratively together. Especially if the goal of everyone is to keep the older adult at home and out of  institutional care. 


(Dayton, Neal, Ha, & Hammer, 2003)

(Dayton et al., 2003)

Dayton, B. I., Neal, M. B., Ha, J.H., & Hammer, L. B. (2003). Collaboration Among Siblings Providing Care for Older Parents. Journal of Gerontological Social Work, 40(3), 51-66

Remarriage in Later Life: Older Women's Negotiation of Power, Resources and Domestic Labor

I spent this past weekend at Lake Barkley in southwestern Kentucky, where I witnessed one of my roommates from college marrying her soul mate at the age of 37. This is for both of them their first marriage. They have an interesting story, they briefly dated when they were around age 21 and just reunited on Facebook six months ago. My friend has traveled the world on her own and as a Peace Corps and AmeriCorps VISTA volunteer. She has her master's degree and has been able to support herself working in various state parks and in state government raising awareness of environmental issues through education. She moved to Maryland where her new husband lives and when I asked her if she has had any luck finding environmental work there she said they are planning on starting a family and they plan on her staying home to raise their children. 

This past weekend, I talked to a lot of girlfriends from college who once supported themselves and had careers helping to make the world a better place (i.e. studying decreasing frog populations & educating the public on water conservation). As soon as they had their first child, they put their careers on hold. I have done the same thing. They are now stay-at-home moms who have chosen traditional gender roles, such as raising their children and taking care of the domestic chores (I would like to say this is all our "choice," but there are societal factors, such as the cost and quality of day care available). At the wedding, the moms were running after the children and most of the dads were sitting in lawn chairs at the top of the hill. I'm not saying there is anything wrong with this or we would want it any other way, but I have to wonder what will be the long-term costs of giving up our careers in our thirties to raise our children and to make sure our homes run smoothly? I can already foresee lower salaries and delaying retirement.


This article discusses marital satisfaction for a small sample of 24 women aged 52-90. Through in-depth interviews the women discuss how their often troubled first marriages compare with their second marriages which took place after age 50. Some of the women were divorced from their first husband and some were widowed. 

So what contributed to a happy first and/or second marriage? 

• The women who were able to contribute to the marriage socially, materially and their labor was appreciated by their spouses. 
• The women who felt the household chores were divided more equitably and there was a balanced power distribution. 

I had a very difficult time understanding why the author felt these two marriages were comparable at all. The women's first marriages were so different from their second simply because of the stress of caring for children (I wish the author had discussed how many children the women cared for).  As Clarke (2005) states, "The absence of child-rearing responsibilities in later life may have fostered the appearance of greater equality between the spouses in the later life marriage as compared with first marriages as there were fewer domestic and child-related tasks to fulfill" (p. 39). Since most of the women during their first marriage were probably caring for children, this automatically increased their financial dependence on their spouses and responsibility for the household chores, especially given the historical time.

Being a stay-at-home mom can really be a thankless job and can really mess with your self-esteem, which I feel made some of these womens' first marriages more "unhappy." When they remarried in their 50's they were back in the work place supporting themselves and were not as dependent on their second spouse for support. They weren't socially isolated at home, sleep deprived, covered in spit-up and doing laundry with a screaming infant and toddler like they may have been during their first marriage. They felt more equal to their second spouse and felt more comfortable demanding more equitable distribution of household chores. 


The paper uses the concepts of "marriage culture" and "divorce culture." Clarke states that since the 1970's we have entered into a divorce culture, where divorce is a more socially acceptable option. I'm glad that society does not judge divorcee's as harshly as in the past. However,  I hope my marriage and those of my friends can endure these tough years when we are raising our children. We may not be the once professionally successful, money, and pension earning women we once were. I hope our husbands don't forget that once we didn't need them to financially support ourselves and and once we were doing more worldly things than changing dirty diapers. Our time will come again, but until then I am grateful that we have the choice to be able to stay home and raise our little ones.


Hurd Clarke, L. (2005). Remarriage in later life: older women's negotiation of power, resources, and domestic labor. Journal of Women and Aging, 17(4), 21-41.

Caregiving: Gendered stories of parental caregiving among siblings

This study included a small sample of eight pairs of siblings. The pairs included one brother and one sister  per pair. Each sibling pair was caring for at least one aging parent.  The researchers of this study did not focus on one primary caregiver, but wanted to interview a brother and sister sibling pair. The researchers wanted to find out more specifics on how adult children and their parents use gender to divide care responsibilities. Data were collected by face-to-face interviews with each sibling.

Almost ninety-five percent of  the 16 respondents worked full-time and their average age was 47. Eight were currently married, six were divorced and two were never married. All had children except three and 63% had children over 18. All had at least a high school diploma and most had a bachelors or masters degree. A majority of respondents had a comfortable income. Six of the pairs cared for their aging mother, one for their aging father and only one pair cared for their aging mother and father. Six parents lived alone and the other two parents lived with a child or a spouse. Two of the parents needed help with activities of daily living  (ADLs) and all needed help with instrumental activities of daily living (IADLs).  

Not surprising to me, the sisters in all sibling pairs took responsibility for coordinating parental care. Interestingly, the authors compare this to the research done on husband and wives. Even if the household tasks are completed equally between husbands and wives, they still find that wives determine what needs done and when.

They did find that in this study four of the brothers perform more traditional roles, such as managing yard work and fixing things around the house and were defined as helper-brothers. The helper-brothers are similar to husbands who assume more of a traditional role for care of their children. The women are responsible to "do it all." The brothers only lend a hand to help if asked and told what and how to do something for their parents.

The remaining four brothers divided up the care more equitably and were defined as co-provider brothers.
The co-provider brothers are active in the care for their parents. The brothers are willing to take on responsibilities that cross traditional gender roles to help his sister and parents. Their sisters also expressed a willingness to share the responsibility to care for their parents together. These brothers also cited having flexible work and family obligations.


Despite some brothers taking on more care for their parent(s), all the sisters provided a wider variety of care for their aging parents and the care provided was gender-specific. The sisters did more "women's work," such as house work and meals preparation and the brothers were responsible for the "men's work," such as yard work and repairs. Women spent more time caring for their parents then their brothers. I never thought about this, but the author's discussed how much more time consuming and never ending the tasks the sister's would perform would be. For instance, laundry and dishes are never ending, but cutting the grass can be done once every couple of weeks.

Another difference between the sisters and brothers that the study showed was how the sisters' planned and thought about their parents' future care. They were more likely to know about their  finances and what level of care they could afford. The brothers were more likely to wait until a crisis occurred and didn't want to make decisions for their parents.  Planning for their parent's futures is part of the sister's coordination of care responsibilities. 

This division of care was mostly unplanned. Interestingly, many of the sibling pairs did not acknowledge that gender played a role in the care they provided to their parents. Another reason given for following gender roles is requests from their parents. A parent from this older generation may be more uncomfortable asking her son to do what was considered "women's work" to her cohort.

I felt immense respect for the sisters who stood up for themselves and said "No" to being the primary caregiver for their parents. They demanded their brothers actively participated and assigned responsibilities. One sister, Phyllis, discussed having to place "limits on her own contributions to care and demanded that her brothers helped." While this was a small sample and it is difficult to make generalizations to all caregivers, I felt it was not irresponsible to say gender plays a huge role in parental caregiving. I hope more women will be like Phyllis and learn to say "No" when it comes to caring for aging parents. It's only fair, more women are working full-time . If we do not start getting more help from the men in our lives, the increased stress is going to have a negative affect on our mental and physical health. If we are aren't here, who's going to coordinate the care of everyone? (Hequembourg & Brallier, 2005)


Hequembourg, A, & Brallier, S. (2005). Gendered stories of parental caregiving among siblings. Journal of Aging Studies, 19,  53-71

Sexual Function and Aging in Racially and Ethnically Diverse Women

This cross-sectional study had a very large sample size compared to the studies in our previous readings. Approximately 2,000 women participated in this study investigating sexual function and aging. These women were already part of a cohort study looking at risk factors for urinary tract dysfunction in middle-aged and older women at the Kaiser facility. The Kaiser facility is an integrated medical care facility in Northern California. The participants had to be between 45 and 80 years old at the time of their study visit. They had to be enrolled in the Kaiser study since the age of 24 and had at least half of their childbirths at the Kaiser facility. Women of nonwhite race or ethnicity were oversampled and 20% of the women had diabetes.

Data were collected using self-administered questionnaires and in-person interviews. Sexual activity was not confined to vaginal intercourse, but included any behavior that was arousing. Women were asked if they had sexual activity in the last three months and how often. Sexual partners may have been men, women, both men and women, and never had sex with a man or woman. Women who indicated no sexual activity in the last three months were asked to give a reason why, such as lack of a partner, no interest, physical problems with their partner or themselves.

The average age of the participants was 57. More than half were non-whites. 19.6% were black, 17.6% Latina, and 18.5% were Asian women. Some of the findings included:

• African American women were more likely to report a moderate sexual desire or interest compared to white women. 
• Women were less likely to report at least a moderate desire if older or postmenopausal. 
• If the cohort of women were moderately sexually satisfied then they had a stronger sexual desire or interest in sex. 
• Nearly 60% of women reported some sexual activity in the last three months.
• For those women who had not had sexual activity they reported it was due to lack of interest in sex followed by lack of a sexual partner. 
• Married women or living as married were more likely to report weekly sexual activity. 
• Health problems and household income did not appear to affect sexual desire or interest. 
• Expectations about sex may change as you age. 

This study along with our other readings and the film, "Use it or lose it" prove to our youth oriented society that older women remain interested in and are having sexual relations. As we discussed in class, this knowledge needs to become more mainstream, so education can be done with these older adults on safer sexual practices.

Huang, A., Subak, L., Thom, D., Van Den Eeden, S., Ragins, A., Kuppermann, M., et al. (2009). Sexual function and aging in racially and ethnically diverse women. Journal of the American Geriatrics Society, 57(8), 1362-1368.

Lavendar and Gray: A Brief Survey of Lesbian and Gay Aging Studies

This article discusses the small body of research that discusses gay and lesbian issues. This article was written in 1991. The author discusses that there seemed to be the lack of information and interest in this area of gerontology, except by gay gerontologists. Since 1991, I hope gay and lesbians issues have not continued to be overlooked by gerontologists.

Aging Gay Men

Here is an overview of some of the themes discussed regarding older gay men:

• Sex remains important for gay men regardless of age. 

• Older gay men have had to cope with abandonment or conflict with their families their entire lives. 

• Older gay men describe conflict and brutality by law enforcement and other forms of institutional discrimination from the medical community. 

• How military service can negatively impact a gay man's ability to be comfortable with his gay identity. (What impact has the "Don't ask, Don't tell" policy had on gay men in the military? When was that policy implemented?)

• Denial of being gay, especially as a young man. Many of the men had been married. Can you imagine  going through the eight stages of the family life cycle while hiding your true self to those you love? 

• Many of the older gay men discussed having difficulty finding a long-term partner. 

• History of heavy drug and alcohol use.Is this an outcome of denial?

• Older gay men may be more comfortable being gay in our society after a lifelong inner struggle with self-acceptance than younger gay men.

• Many older gay men had gay male friends their own age. However, those with younger gay male friends appeared to have adjusted better to getting older. 

• Some gay men interviewed felt they experienced age discrimination by younger gay men. 

• There is a strain between older gay men who do not understand the young gay movement or how their lifestyle choices are portrayed in larger society. 

One of the issues that struck me while reading this article was when the referenced studies or the papers  were done. The author didn't reference any work past 1989. What affect would HIV and AIDS have on the older gay men interviewed for these referenced works? It wasn't until 1984 and 1986, years after the first reports of disease, researchers discover and name the viruses that are the precursor to AIDS, HIV-1 and HIV-2 (CDC, 1998). By 1989, 1 million persons in the United States were infected with human immunodeficiency virus (HIV) (CDC, 1990). I'm just surprised even though, it was early in the HIV/AIDS epidemic that the topic wasn't discussed.
 

Aging Lesbians 

Here is an overview of some of the themes discussed regarding Aging Lesbians:  

• Older lesbians may still deny they are gay even though they are in a same sex relationship. 

• Older lesbians in a relationship don't play roles. The author is surprised by this due to butch/femme roles (Do you think these were common terms to describe lesbians in 1989? They seem very derogatory to me.) in pre-movement days. 

• Older lesbians face discrimination by institutions, especially the medical establishment. 

• Strong friendship ties replaced weak kinship ties.  These friendships were helpful to successful aging.

• Sex remains important for lesbian women regardless of age. 

• Older lesbians realize they are in a minority group and face much discrimination. They realized the important of having wills in place since their relationships are not legally recognized.  

• Traditional senior programs do not meet their needs and there is a fear of discrimination.

 At the end of the article, the author discusses how the studies she discusses tries to paint a different image of the lonely gay man and lesbian. One theme that came up from both men and women was feeling more comfortable with who they are as they get older and less denial of being gay or a lesbian. I hope young gay men and lesbians today don't have to wait until they are older to have this comfort level to be themselves.


Cruikshank, M. (1991). Lavender and grey: A brief survey of lesbian and gay aging studies. In J. A. Lee (ed.), Gay midlife and maturity, (p. 77-87). Binghamton., NY: Haworth. 


Centers for Disease Control and Prevention. October 1998. Human Immunodeficiency Virus Type 2.  Retrieved from:
http://www.cdc.gov/hiv/resources/factsheets/hiv2.htm


Centers for Disease Control and Prevention. February 1990.  Current Trends Estimates of HIV Prevalence and Projected AIDS cases: Summary of a Workshop, October 31-November 1, 1989.
Retrieved from:

http://www.cdc.gov/mmwr/preview/mmwrhtml/00001564.htm

Daughters-in-law and Mothers-in-Law Seeking Their Place Within the Family: A Qualitative Study of Differing Viewpoints

After reading this article, I wonder how much more pressure society can place on women? The author's state that women are the kinkeepers between generations. As a kinkeeper we are suppose to create bonds and maintain traditions for both our family of origin and our family of procreation. Is that all? Oh, my gosh what role do the men in the family have with fulfilling this role? It would be very difficult to fulfill this societal expectation if you do have conflict wit your in-laws.

I have to say, I'm fortunate. I have an awesome mother-in-law. We have a lot of the same interests, which has helped. I also think it helps that she lives seven hours away and she did not have a very nice mother-in-law, so I'm sure to an extent she is mindful of her actions towards me. However, she is also a very kind, capable, independent and fun person whom I have a lot of respect for. At Thanksgiving a few years ago,  my mom, aunt, and a friend of the family were talking about some of their worst experiences with their mother-in-laws.  I could tell there was still a lot of pain even though it had been decades since these incidents occurred. It was interesting to see how the three of them bonded over this common experience and I'm glad I didn't have anything to contribute to the conversation.

The sample was small in this study. They interviewed 23 daughters-in-laws and 19 mothers-in-laws using   focus groups or one-on-one interviews. Not surprising to me, all of them entered this new role thinking it would be a positive experience. However,  there was some trepidation the mothers-in-laws and daughters-in-laws expressed that they didn't completely trust the relationship. Why? I'm assuming that means they felt one event or one misinterpreted action by either of them could create conflict.

This article discusses how vulnerable a mother-in-law may feel when her son gets married, especially if she doesn't have a good relationship with her daughter-in-law. She may fear losing her son and at the same time fear that she may not be able to see her grandchildren as often as she wants. Do you think "children marry" could be a stage to add to the the family life cycle?  I think this is a significant enough transition that affects both the children and parents.

The researchers discuss previous research that showed how a woman may become closer to her own family of origin, especially once she has had a child. This could leave her husband's family feeling left out. I hope I'm not in this situation one day since I have a son. A friend of mine, who has a boy and a girl, recommended that my spouse and I try for a another child, with the hopes of having a girl, so that we will have someone to take care of us when we get older. She said, "Boy's leave home and don't look back." I told my friend, there is never a guarantee that your children will take care of you as you get older even if you have a girl. I see that every day in my work with older adults.

What about the daughter-in-law who is adjusting to being a wife, part of a new family, developing her independence from her family of origin and maybe becoming a mother, too? She has a lot of fear of not being accepted by her new family and as the study participants discussed , they were just as sensitive and insecure as their mothers-in-laws. I think that society puts so much pressure on both women to get along for the best of the family. It's an unfair situation for both woman to be in. As the study says both women are extremely vulnerable, especially if a conflict does arise.



Families are complicated and as this study shows the relationship between a daughter-in-law and mother-in-law is one of the more complicated family roles and greatly affects the rest of the family. Doesn't all conflict appear to go back to having open communication and having some empathy for the other person's situation?  The painful events the study participants discussed are probably the same types of experiences my loved ones talked about on Thanksgiving. It is so sad and hurtful when you don't feel accepted and loved. Unfortunately, in a lot of situations the other person is probably oblivious to how they may have hurt you and did not do it intentionally. If women are the kin keepers between generations having a negative in-law relationship can affect a family for generations.

 
Turner, M., Young, C., & Black, K. (2006). Daughters-in-law and mothers-in-law seeking their place within the family: a qualitative study of differing viewpoints. Family Relations, 55(5), 588-600.

Intimacy, commitment, and adaptation: Sexual relationships within long-term marriages

Since the 28 study participants were living in the U.K. here's a little bit of British slang for fun: 

So, your a tidy (handsome) young man and it's Saturday night in England. You go out on a bender (drinking session) with friends. While out you chat up (make conversation with someone of the opposite sex with the intention of endearing yourself to them) a tart (party girl) you fancy (like) with hopes that you get to go home and give her a nice snog (kiss) and a shag (have sex).

Does the United Kingdom, especially the English, have a reputation for being a bit too reserved about sex? Do Americans and the French feel the British are not comfortable with the topic of sex? The authors of the study admit that the study of sexual relationships in long-term marriage has been neglected in the U.K. Why? Do the British think older adults stop having sex once a couple gets past a certain age?

While the authors give credit to American studies in this area, I think Americans are just as guilty as the British of not thinking that older adults are sexually active. It may also be the fact that not many people are comfortable discussing sex (me included). Of course, the gross factor enters into the situation when people are forced to admit that their aging parents and grandparents are still sexually active. I remember talking to one of our senior center managers when I worked in Kentucky. I encouraged her to put on a training by the Health Department on AIDS/HIV. I will never forget her reaction. She looked at me in disgust and said, "these people don't have sex." I replied, "Oh yes they do and since they did not come of age during the onset of HIV/AIDS,  they probably didn't attend or pay attention to the whole awareness programs stuff.  They are probably not using condoms and putting themselves and their partners at risk." So, I'm glad to see this study being performed to raise the U.K public's awareness that older adults do have sex.  It is probably going on here in the U.S., too. 

The study had 28 participants, age 50-86 years, who had been in "happy" long-term marriages for a minimum of 20 years and were still engaging in sexual relationships (what a surprise!).  Now, the sexual relationship may have changed over the years. Six of the participants were no longer able to have intercourse due to health issues and had to redefine what "sex" meant to them as a couple. They can still be intimate by cuddling, kissing and showing physical affection other ways. The participants who were in long-term marriages still felt sex was beneficial to their marriages. Some of the benefits included showing love, trust, respect and increased self-esteem.

The article discusses how sexual relationships change over the course of a long-term marriage, but as the study participants discuss, it is still a very important part of the relationship. Some of the changes were due to life transitions, such as childbearing or health issues that arise as the couple ages. The study participants also discuss positive changes that occur in long-term marriages as the couple learns each other's likes and dislikes and the familiarity that comes with a long-term marriage.

One area where there appears to be a lot of unanswered questions was the affects of a couple spending their leisure time together and especially increased time together once a couple retires. The authors alluded that when couples can spend more time together that it may be just as rewarding to them as sex. They also discussed a previous study that found when couples spent more time together that they had more sex. 

This study is a first step for the U.K. to start studying sex and older adults. It would be nice to see a study interviewing a larger more diverse sample, both partners in a marriage, and older adults who are single. The authors also admit that all of the couples reported being in happy marriages, I wonder what happens in an unhappy marriages? This study is so small, it would not be appropriate to generalize the study's results to all older adults.


Hinchliff, S., & Gott, M. (2004). Intimacy, commitment, and adaptation: Sexual relationships within long-term marriages. Journal of Social and Personal Relationships, 21(5), 595-609. 

British Slang and definitions found at: http://septicscompanion.com/showcat.php?cat=sex