Family Social Caregivers

Families provide nearly 80% of the in-home care for older relatives with chronic impairments (U.S. Senate Special Committee on Aging, 1992). The primary forms of assistance to older family members are social, emotional, and financial support, instrumental activities such as meal preparation, shopping, housework, and transportation, personal care (e.g., bathing, dressing, and feeding), and help with accessing social service agencies.

Care is principally provided by a single individual, the primary caregiver, with assistance from one or more others, secondary caregivers. The majority of the primary caregivers for spouses are their wives or husbands (Older Women's League, 1989; Stone, Cafferata, & Sangl, 1987; E. M. Brody, 1981). Most older men are married and thus receive needed care from their wives.

If the older person is not married or the spouse is ill, an adult daughter or daughter-in-law most often assumes the caregiving role, followed by a sister, niece, or granddaughter. This order represents a preference based on the care-giver's relationship with the older person, geographical proximity, and traditional gender roles. Adult children are primary caregivers to older widowed women and older unmarried men and serve as secondary caregivers for married couples.

The type of assistance given is influenced by the older person's functional level, place of residence, and the gender of the caregiver. For example, personal care is most often performed by wives or daughters (Cantor, 1991; Tennstedt, Crawford, & McKinlay, 1993). Over 80% of caregivers to the chronically ill are women. Nearly 29% of primary caregivers are daughters, 23% are wives, and 20% are other relatives or female nonrelatives.

Although siblings are seldom primary caregivers (Cicirelli, Coward, & Dwyer, 1992), they are sources of companionship and provide emotional and instrumental support for other siblings when a spouse or adult child is not available (Cicirelli et al., 1992; Peters, Hoyt, Babchuk, Kaiser, & Ijima, 1987). In particular, childless and unmarried elderly tend to rely on siblings rather than on other relatives for assistance (C. L. Johnson & Catalano, 1981). Older women are more likely than older men to receive help and support from siblings, especially sisters (Gold, 1989; O'Bryant, 1988).

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