Family Caregiving: Intergenerational Relationships

Several weeks ago I gave a talk to a group of family members on caring for aging parents. With his family all present that evening, an 88 year old father raised this bold question: “What can I expect from my children?” It was the most poignant and appropriate question of the evening. He got right to the heart of family: what responsibility do we have to our parents? How much can he ask of his children? How can he not feel like a burden? These were the themes of the two articles from the recent Round Table: family obligation, expectation, and burden. One article addressed re-locating to be near family, while the second article spoke of changes in intergenerational relationships due to cultural shifts.

In previous social service language, “in the best interests of the child” and “kinship care”, have typically referred to care of young children. Jennings et al, re-interprets the phrase “in the best interests of the child” and reflects on the child, now as an adult, and poses the question if it is necessarily in the best interests of the adult child to live near to one’s parents.

So many of the choices family members consider are predicated on previous family relationships and the uniqueness of individual psychology. As clinicians, we have worked with and advised families in trying to make these choices. From the observation point of experience we know of many older adults having moved from friends and community only to find themselves unable to make necessary adjustments of reaching out to make new friendships and leaving themselves at risk for depression and isolation. One’s individual psychology and temperament would wisely inform an older adult in making choices to re-locate. What are their present connections in their community and social groups? Does this person have a life-long ability to develop close and intimate relationships or have they generally been private and solitary? What have their friendship and family patterns been?

Perhaps other considerations would motivate an older adult to move or for an adult child to request that a parent move closer by. Perhaps this is for convenience as one anticipates increased and multiple demands being in the sandwich generation, but mending hurt relationships, fantasies, realistic or otherwise, of familial closeness also come into play as part of decision making.

Against the backdrop of demographic changes including re-marriage, step families, sibling size and geographical distance, the Fingerman article reviews several studies on intergenerational relationships specifically highlighting changes for baby boomers. Discussing the Within Family Differences Study that looked at aspects of sibling relationships and questioned which child would most likely become the primary caregiver, the phrase “violated expectations” was used. Certainly unrealistic expectations have difficult consequences for all family members, but the use of the word “violated” I found disturbing. Identifying family history patterns would be more helpful in developing insight into managing the stresses of family caregiving rather than labeling them as violations which may infer mistrust and dysfunction.

While the Fingerman et al article describes cultural shifts and how technology and mobility have affected family relationships, and the Jennings article sensitively speaks to responsibility and obligation in care, neither of the articles fully addressed class distinctions. For upper income families, family obligations may be met by purchasing services, while other families with limited resources don’t necessarily allow for this option. Limited income families have been greatly impacted by the changing economy, with several generations living together by need, not by choice. These financial factors and of course ethnicity and history contribute to a family’s sense of responsibility toward one’s elders.

Expectations, obligation and love are the foundation of caring for all family members. Re-labeling caregiving as kinship care captures that concept and intent.

The Round Table Discussion Group meets monthly for an interdisciplinary conversation with experienced professionals in the field of aging.  Each conversation uses one or two journal articles as reference points.  The articles read for this discussion were:

• In the Best Interest of the (Adult) Child:  Ideas ABout Kinship Care of Older Adults, Tezra Jennings, Tam E. Perry & Julia Valeriani, Journal of Family Social Work, 17:37-50,2014

• The Baby Boomers’ Intergenerational Relationships, Karen L. Fingerman, Karl A. Pillemar, Merril Silverstein, & J. Jill Suitor, The Gerontologist Vol. 52, No. 2, 199-209.