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“Caregiving is about enduring. It requires presence, openness, listening, doing, and cherishing of people and memories.”
—Arthur Kleinman
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LEARNING OUTCOMES
By the end of this chapter, readers will be able to:
20-1. Describe the trends and rise in caregiving for older adults.
20-2. Discuss the effects of caregiving on both the older adult and the caregiver.
20-3. Identify the levels of prevention that can be applied toward caregiving.
20-4. Explain current policies that support unpaid caregivers.
20-5. Formulate considerations for identifying and assessing caregivers.
20-6. Recognize exemplar interventions that can be used to support caregivers.
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Mini Case Study
Darla is a 76-year-old woman with Alzheimer disease who lives with her wife, Gabriela. The couple have no children and have a limited social network due to being estranged from many members of their families who do not agree with same-sex marriage. Recently, Darla has started wandering from the couple’s home during Gabriela’s daily nap. Darla’s balance has become increasingly impaired, requiring additional assistance with transfers when toileting and bathing. Gabriela experiences significant pain due to her rheumatoid arthritis, and attempting to assist her wife with transfers has increased her pain and made her feel unsafe. She recounts that her pain was once so bad that she had to leave Darla on the toilet for an hour before a neighbor could come assist them. Gabriela is independent in her own self-care tasks but recognizes that she does not have the physical ability to assist with supporting Darla’s self-care needs. Gabriela recognizes that she needs help caring for Darla but has postponed seeking additional support because of fear of discrimination or mistreatment for being in a same-sex marriage.
Provocative Questions
What unique challenges does the case study of Gabriela and Darla highlight for LGBTQIA+ families?
How is this care situation impacting both Gabriela and Darla’s health?
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As adults age, they experience changes to their cardiovascular system, bones, joints and muscles, and memory and thinking skills, among others. These changes increase the risk of injury or onset of a condition or disease that affects the activities in which they can participate. While not all older adults will need care as a result of these changes, many will. Of those requiring care, some may require unpaid care from family members, friends, neighbors, or other support person designated by the older adult care recipient—herein referred to as family caregivers. Although some prefer the terms “care partner” or “informal caregiver,” we are using the term family caregiver to align with published guidance (Stall et al, 2019). Given the suddenness of an injury or gradual onset of a condition or disease, caregiving responsibilities can vary greatly depending on the needs of the older adult. Family caregivers feel the push and pull of providing caregiving responsibilities on their own health and quality of life. As such, there is an opportunity for policymakers, healthcare providers, researchers, and educators to ...