P.S. I Love You: Long-Distance Caregiving
Beverly B. Koerin, PhD, MSW
Marcia P. Harrigan, PhD, MSW
SUMMARY. Family caregiving plays an important role in our health care delivery system, especially for the frail elderly. Despite a substantial literature on caregiving, there is little research on long-distance care-givers, a population expected to double in the next decade. This paper reports a secondary analysis of data from the 1997 NAC/AARP national survey and focuses on long-distance caregivers. Findings include caregiver and care receiver characteristics, patterns of caregiving, and impacts on caregivers. The data are compared to previous national studies on caregiving and implications for practice and further research are considered.
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KEYWORDS.Caregivers, long-distance, elderly, caregiving, family caregiving, care network
Family caregivers play āan invisible role ⦠in our health care delivery system,ā especially for frail elderly individuals. Over 80% of all home-based care is provided on an informal, unpaid basis by family and friends (National Family Caregivers Association, 2000, p. 2). A 1997 study by the National Alliance for Caregiving (NAC) and the American Association of Retired Persons (AARP) found that over 23% of households in the United States contained at least one individual providing care for a relative or friend aged 50 or older. Many factors have contributed to the growing interest in caregiving. Managed care restrictions on hospital care and home health services have increased demands on family caregivers. Demographic changes (e.g., declining birth date, increased longevity) and womenās increasing workforce participation have decreased the pool of caregivers. Geographic mobility of adult children and retirement-age parents has also affected the pool of local family caregivers. A 1997 study by the National Council on Aging (NCOA) reported approximately 7 million individuals were caregivers for relatives, usually parents, living many miles away; the number of long-distance (LD) caregivers was projected to double in the next 15 years (www.ncoa.org). The purpose of the present research is to explore the characteristics of long-distance caregivers, including caregiver stress and well being and services used by long-distance caregivers.
LITERATURE REVIEW
Scope of Caregiving and Caregiver Profiles
Caregiving has been variously defined in terms of kinship or relationship of caregiver to care receiver, living arrangements, types of care services provided, intensity or duration of the caregiving role, and age and health status of the care receiver (e.g., Barer & Johnson, 1990; Brody, 1985; George & Gwyther, 1986; Mui, 1995; NAC/AARP, 1997; Penrod, Kane, Kane, & Finch, 1995; Stone, Cafferata, & Sangl, 1987; Toseland & Rossiter, 1996). Consequently, estimates on the scope and nature of the caregiving population also vary, based on these definitions as well as the size and sources of the study samples. In 1987, an AARP/Travelers Foundation study estimated 7 million households involved in caregiving activities for an elder. The definition of caregiver was an adult individual who, currently or within the past 12 months, provided assistance to someone over the age of 50 with at least one ADL and at least two or more Instrumental Activities of Daily Living (IADL), such as managing finances, housework, arranging for services to the care recipient (Wagner, 1997a, p. 1). In 1997 the National Alliance for Caregiving (NAC) and the American Association of Retired Persons (AARP) published findings of its national survey, Family Caregiving in the U.S. This study estimated there were 22.4 million caregiving households. Caregiving was defined more generally than in previous studies: āproviding unpaid care to a relative or friend who is aged 50 or older to help them take care of themselvesā (AARP/NAC, 1997, p. 6).
Comparing the 1987 and 1997 studies, Wagner (1997b) noted some similarities and differences in caregiver profiles. The majority of caregivers were women (75% in 1987; 72% in 1997), who were on average 45 years old and providing care for a parent. The 1997 caregivers were more likely to be employed (64%) than 1987 caregivers (55%) and reported spending less time in caregiving activities. Wagner noted there were fewer reported āprimary caregiversā in 1997 (41%) than in 1987 (63%), suggesting that many caregivers provide help to an elder, either with assistance from another sibling or relative or by providing such assistance to a sibling or relative....