The Other Side of Caring: Adult Children with Mental Illness as Supports to Their-Mothers in Later Life

In recent years, growing attention has been paid to parents caring for adult children with mental illness (Hatfield, 1987; Lefley, 1987; Marsh, 1992). These studies, framed within a caregiving perspective, cast adult children with mental illness as dependent and highly vulnerable individuals whose care causes considerable family stress. Irrespective of their current psychiatric and social functioning, adult children with mental illness typically have been viewed as a family burden whose presence and care heighten the family's vulnerability to life stressors. In contrast, research on intergenerational family relations in the general population has focused on adult children as a resource to their parents in later life. With the loss of a spouse or friends or the presence of chronic health problems, aging parents often turn to an adult child for assistance and support with activities of daily living (Rossi & Rossi, 1990). Most adult children respond by providing considerable assistance and support (Atchley, 1991; Rossi & Rossi, 1990). There are several reasons for hypothesizing that adult children with mental illness, like their age peers in the general population, may also be a source of support to their aging parents. First, there is considerable heterogeneity in the course of mental illness (McGlashan, 1988). Thus, many people whose psychiatric condition stabilizes or improves over the course of the illness may be able to assume normative adult roles, including those related to family life (see, for example, Greenberg, Greenley, & Benedict, 1994). Second, the majority of people with mental illness are neither married nor employed in competitive jobs but are physically able (Tessler & Goldman, 1982). They may be more available, therefore, than their other siblings to assist their aged parents with daily living tasks. Finally, they may be more responsive to their parents' need for support than their well siblings, because their own social networks are likely to be small (Pattison, DeFrancisco, Franzier, Wood, & Crowder, 1975). Despite this potential for some adult children with mental illness to provide parental support and care, little is known about their contributions to the lives of their parents, because researchers have tended to focus solely on the burden on their parents associated with the care of adult children with mental illness. The purpose of the study discussed in this article was twofold: (1) to investigate the degree to which individuals with serious mental illness provide assistance and support to their late-middle-age and elderly mothers and (2) to investigate the relationship between the adult child's provision of assistance and support and the mother's experience of subjective burden. This study focused on the relationship of mothers with their sons and daughters because mothers are the primary caregivers of people with mental illness (Cook, 1988). The study used a general stress framework consisting of three broad domains: sources of stress, resources, and manifestations of stress. In the literature on families caring for people with mental illness, the manifestation of stress, the outcome of the stress process, is typically operationalized in terms of the level of subjective caregiver burden. A large body of research has established that families of people with mental illness experience high levels of subjective burden associated with concerns about their ill relative's future care, feelings of stigma, and sense of loss because their ill relative may never be able to assume normative adult roles (Lefley, 1987; Marsh, 1992). Parents of adult children with mental illness face many sources of stress associated with the debilitating effects of their children's illness. This article concentrates on two major stressors faced by mothers caring for adult children with mental illness. One source of stress is the objective burden of care (Fisher, Benson, & Tessler, 1990), which typically involves monitoring and supervising activities of daily living rather than direct hands-on care (Creer, Sturt, & Wykes 1984; Francell, Conn, & Gray, 1988). …