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

Caregiving is the cornerstone of our longterm care system Caregiving is the cornerstone of our longterm care system

We know: ØFamilies provide 80% of long term care ØNursing home is last choice We know: ØFamilies provide 80% of long term care ØNursing home is last choice for care ØMost caregivers are women ØNOT ALL CAREGIVERS ARE ALIKE

Caregivers by Relationship to Elder Care Recipient Caregivers by Relationship to Elder Care Recipient

Diversity among Caregivers ØGender ØGeneration ØCulture ØCaregiving context Diversity among Caregivers ØGender ØGeneration ØCulture ØCaregiving context

Diversity of Caregiving ØWhat they do ØWhen they do it ØHow long they do Diversity of Caregiving ØWhat they do ØWhen they do it ØHow long they do it

HOURS OF CARE HOURS OF CARE

Spouse Emotional Banking Errands / Shop House Tasks Spouse Emotional Banking Errands / Shop House Tasks

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

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

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

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

Care Sharing Husbands B S H P 10% 70% B S O H 20% Care Sharing Husbands B S H P 10% 70% B S O H 20%

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

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

Caregiving Career: Child Caregiving Career: Child

Caregiving Career : Spouse Caregiving Career : Spouse

Comparing Careers CHILD SPOUSE Comparing Careers CHILD SPOUSE

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

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

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

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

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

Comparing Career Markers 70 60 CHILD H O U R S #4 50 #5 Comparing Career Markers 70 60 CHILD H O U R S #4 50 #5 #6 #3 40 30 #2 20 10 0 0 1 2 3 4 YEARS #6 #4 SPOUSE #3 #2 #5 5 6 7

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