Informal Family & Serial Caregiving


caregivingInformal or family caregiving for an elderly loved one when they are ill or disabled is expected in virtually all cultures of the world and is generally accepted as the "norm" in most developing countries. In the US, family continues to provide most of the care and supportive services to older family members. The family contribution to health care represents between 70 to 80 % of all such care in the form of informal caregiving. Family members provide both short-term assistance (e.g. following surgery) and long-term assistance (e.g. for permanent or extended loss function such as loss of sight, mobility or cognitive impairment). Family members provide direct services (grocery shopping, transportation to doctors), the purchase of services (housecleaning, nursing services) and the management of services (coordinating and overseeing medical/rehabilitative or custodial care) as well as financial, emotional and social support.

Who becomes the primary caregiver for a frail older person? Usually it is the spouse, followed by an adult child, or other such relative such as a sibling, niece or nephew or grandchild. In terms of gender, the primary caregiver is most often female. While it has been observed the world over that women assume the bulk of responsibility in caring for elderly family members, 40% of the current caregivers in the US are men (husbands and sons). Studies have shown that wives, adult daughters-in-law and daughters provide most of the personal care and help with the household tasks; transportation and shopping for the elderly while men are more likely to purchase services or provide the management of services. Women sometimes leave the work force or work part time in order to care for frail relatives (generally spouses or parents) just at a time when they may want to work for retirement benefits in their own old age. Other women have responsibilities for frail relatives while adjusting to their own retirement, widowhood and reduced incomes. Many school age children may have parents or grandparents who provide care to an older relative and may themselves be involved in the caregiving activities such as grocery shopping or providing custodial care after school hours in lieu of extracurricular activities.

Due to increased longevity, many caregivers are now finding themselves in the position of becoming "serial caregivers" - providing support to a parent, then a spouse and in many cases to a functionally impaired adult child, or to grandchildren. An older adult caregiver may spend decades in caregiving activities.

For many people, the overwhelming anxiety of eldercare issues may appear suddenly after an accident or unexpected illness. Having access to the right information and knowledge of available services and governmental resources can reduce the stress on the entire family at a time when quick decisions, with little or no preparation are necessary.

By Rita M Files

Ms. Files is a nationally recognized "subject matter expert" on the knowledge and skills needed for working with the elderly. She has over 28 years in the healthcare industry, with 16 years focused primarily on eldercare. Her background includes program development for many leading providers in the senior living industry. In addition to her nursing experience, Ms. Files holds both state and national certifications in Assisted Living Administration and is a Certified Senior Advisor® through The Society of Certified Senior Advisors, a Member of the Case Management Society of America, and the American Society on Aging.

Rita is co-founder of Aging with Grace, LLC which offers a new and innovative approach to eldercare stress in the workplace. The Aging with Grace" program addresses an issue that is expected to reach major proportions in the next 10 to 15 years. To learn more about the positive impact of this program for both employers and employees, visit

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