Family Caregivers of Older Adults: A Life Span Perspective

Abstract: When faced with changes in physical health, cognition, and daily functioning, older adults most frequently rely on family members for instrumental support and more intense care activities. Using a life span perspective as our guiding framework, we identified several developmental themes across the late-life caregiving research including individual well-being, relational effects, and caregiver growth. In addition, we examined the effectiveness of education and intervention programs as well as policy initiatives designed to assist middle-aged and older family members care for their aging relatives. The multiple dimensions of, influences on, and the variability in response to the caregiving experience presents multilayered challenges that can best be addressed through the intentional integration of sound research investigations, practice initiatives, and policy directives. Key Words: aging, community programs, family caregivers, interventions, life span development, social policy. When faced with changes in health and daily functioning, older adults most frequently turn to family members, typically their spouse or adult children, for instrumental support and personal care activities (Cantor, 1983). Family members who provide elder care are likely middle-aged and older women, many of whom are caring simultaneously for children or adolescents and parents or multiple generations of elders (Mack & Thompson, 2004). Almost one in four family caregivers assists a person with dementia, Alzheimer's disease, mental confusion, or forgetfulness (National Alliance for Caregiving/AARP, 2004). When the needs of older adults exceed the capacity of their caregivers, families may incorporate formal services available from professionals employed by local government, nonprofit agencies, and private enterprise as sources of assistance. Yet, even when services are available and accessible, relatively few caregivers look beyond themselves or close family members for help and support (Feld, Dunkle, & Schroepfer, 2004; Jarrott, Zarit, Stephens, Townsend, & Greene, 2005). Scholars studying family caregiving historically have embraced an integrative, multidisciplinary stance that incorporates a bio-psycho-social framework to guide and advance their research and to inform practice and policy. As early as the 1920s, human development and family scientists forged alliances with disciplines such as psychology and sociology to examine issues related to the needs and abilities of children (Grant, 1997). As the United States began to experience significant shifts in its demographic makeup, the focus on families with young children and adolescents expanded to the interdisciplinary study of development across the life span. The work of Havighurst (1948/1972), Erikson (1950), and Neugarten (1969), among others, laid the intellectual groundwork for the emergence of life span perspectives for the study of human development and aging. As an interdisciplinary field of study focused on individual development in a social context, human development and family scholars have sought to identify continuities and discontinuities as individuals negotiate psychological, interpersonal, and sociohistorical changes that occur during late life (Bengtson, 1996). In this paper, we present key findings about providing care for older adults that have emerged from the study of aging within the context of the family. Given the vastness of the caregiving literature, we limited our review to empirical studies of issues and outcomes associated with midlife and older family members serving as primary caregivers (i.e., adult children and spouses who have significant and often full-time caregiving responsibilities) for their older relatives. Using a life span perspective advanced by Bakes (1987) as our guiding framework, we examined the late-life caregiving literature and explored how this body of knowledge contributed to and guided education, practice, and policy efforts. …