Sarah.Qualls, PhD, is a clinical psychology faculty member at the University of Colorado at Colorado Springs. She has twenty years of academic, clinical, and continuing education training experience and is the co-chair of the Adult Development and Aging Division of the American Psychological Association.

Steven H. Zarit, PhD, is Professor and Head of the Department of Human Development and Family Studies at Pennsylvania State University. He is a clinical psychologist whose research and practice have centered for more than a decade on stress in family caregivers of dementia patients.

Aging Families and Caregiving

John Wiley & Sons

Copyright © 2009 Sara H. Qualls and Steven H. Zarit
All right reserved.
ISBN: 978-0-470-00855-3

Chapter One

Who Are the Aging Families?

Rosemary Blieszner

Adults typically grow old within multigenerational families. Ties with relatives are mostly positive experiences that supply companionship, provide numerous forms of support, and lend meaning to life. Of course, close relationships can include conflict and distress, as well. This chapter is introductory to the rest of the volume on interventions aimed at problematic aspects of late-life family ties. It sets the stage for the other discussions by focusing on the diversity of older adults’ family structures and interactions. First is a detailed look at the definition of family for elderly persons, including illustrations of a range of family structures. Next is information about different types of old-age family ties. The final section addresses numerous personal, sociocultural, and historical influences on the nature of family interactions in the later years of life.

DEFINING OLDER ADULTS’ FAMILY

Everyone has an intuitive idea of what the term family means; but when people articulate their views, many different perspectives become apparent. For example, individuals differ on how broad and permeable they consider the boundaries of family to be, with some viewing family as a fairly small and fixed group and others having a more encompassing and even shifting perspective on who is included. Understanding what people mean by family is crucial for psychologists because the definition influences who is important to patients, who is involved with them as they seek help, and who professionals consider when developing treatment and intervention plans.

Traditionally, anthropologists and sociologists used the term family to denote the nuclear family unit, composed of married partners and their children and situated within the larger kinship network (i.e., the group of all other relatives) (Adams, 1968). Another term for nuclear family is family of procreation, used to distinguish the married partners in each new nuclear family from their family of origin, comprising their parents and siblings. One problem with this traditional conception of family and its application in social science research and professional practice is that it marginalizes old people. That is, adult children belong to their parents’ family of procreation, but their parents belong to the adult children’s extended kin system, not to their family. This way of thinking about family leads some researchers and professionals to forget that old people both have relatives and are other peoples’ relatives!

Another problem is that the traditional definition tends to pathologize family structures in African American, Native American, and other minority families that differ in composition from the mainstream patterns (Dilworth-Anderson, Burton, & Johnson, 1993). The chosen families of gay and lesbian persons who cannot legally marry are overlooked in the traditional definition (Savin-Williams & Esterberg, 2000), as are those of single adults (Amato, 2000; DePaulo, 2006). Families belonging to the minority by virtue of their racial ethnic group, class, single status, or sexual orientation often have open and fluid boundaries, with friends and neighbors (fictive kin), distant relatives, and older family members playing roles they might not play in traditional nuclear families (e.g., assuming parenting or caregiving responsibilities).

The U.S. Census Bureau perpetuates a narrow conception of family (“a group of two or more people who reside together and who are related by birth, marriage, or adoption”), which implicitly omits elders who reside in a different household (“all the people who occupy a housing unit as their usual place of residence”) from that of their children, grandchildren, or siblings (U.S. Census Bureau, 2006). Although the Census definitions of family and household serve demographic functions, they are not very useful for capturing the essence of family that is most meaningful to people on a day-to-day basis: the functional and emotional aspects of relationships. Not only do the functional and emotional aspects of family ties often lend more meaning in everyday life than the formal structural dimensions do, they are also the chief reasons for individuals and families to seek assistance from psychologists. Even so, family interactions and the feelings family members hold for one another are connected to the different kinds of family structures, not dissociated from them. Thus, the purpose of this chapter is to provide an overview of important structural features of contemporary families in which older adults participate. Chapter 2 addresses specific family functions in greater detail.

We need to define family in such a way as to recognize old members as active participants. What is an alternative to the traditional definition of family as limited to the nuclear unit? Developing a definition that encompasses the experiences of older adults requires attending not only to the relatives with whom they interact regularly regardless of household status, but also to those who have psychological importance, even though they may be estranged or no longer living, and to fictive or chosen kin. With these considerations in mind, Victoria Bedford and I created the following definition of family: “A family is a set of relationships determined by biology, adoption, marriage, and … social designation, and existing even in the absence of contact or affective involvement, and in come cases, even after the death of certain members” (Bedford & Blieszner, 2000, p. 160). Our intention was to capture the experiences of many types of families and many personal perspectives, including both latent and potential family or family-like relationships. The implication of this definition is that it becomes crucial to ask individuals whom they consider to be part of their family, rather than assuming who belongs (which assumption would likely be based on the traditional nuclear family definition).

The necessity and importance of taking a broad perspective on family is illustrated by research that colleagues and I completed with older adults living independently in the community. We were curious about older adults’ perspectives on contemporary family issues. We also wanted to learn about similarities or differences over generations in patterns of family life reflecting a continuum from traditional to nontraditional orientations. We coded as traditional or conventional the ideal nuclear family structure with its sequence of family events encompassing one heterosexual marriage, followed by birth of children, and enduring until the death of one spouse. Although this family type is often idealized by lay people, politicians, and professionals, it represents only 6% of the U.S. population (Jackson, Brown, Antonucci, & Daatland, 2005). In contrast, we coded any other pattern of family life as nontraditional or postmodern. Examples include families experiencing divorce, remarriage, gay or lesbian relationships, pregnancy before or outside of marriage, nonmarital cohabitation, singlehood, and the like (Allen, Blieszner, Roberto, Farnsworth, & Wilcox, 1999). We conducted detailed, in-depth interviews with 45 older women and men. We applied a comprehensive open-coding data-analysis process to transcripts of the interviews and used extensive verification procedures to identify themes related to family patterns.

We were not surprised to find that whereas 60% of the older adults had lived according to a conventional family model themselves, only 22% of their offspring had done so. Specifically, 15 female and 6 male elderly respondents reported the traditional pattern in their own lives but structural diversity in the families of their adult children. However, the other 24 cases reflected less typical patterns of family life. For 10 females and 4 males, both they and their adult children had nontraditional family structures, depicting the greatest complexity and variety of families in the sample. These families included as many chosen kin ties as legal and biological family ties, they portrayed egalitarian relationships, and they reflected adaptation to events and situations such as divorce, mental illness, incarceration, and death. For example, one man began rearing two young sisters-in-law right after he got married because his new wife’s (and her sisters’) mother died at that time. He considered those girls his daughters. Other elders and their offspring reared stepchildren or stepgrandchildren who were not biological kin, reared grandchildren after they thought their active parenting days were finished, or had friends playing more significant roles in their lives than their biological relatives. Atypically, another five females and one male reported that both they and their offspring had followed the conventional model of family life. Finally, most unusual of all were the four females who had experienced some type of structural diversity in their own lives but had children whose lives were conventional in that none had divorced and all were rearing their own children with their original spouses.

Contrary to ageist stereotypes, we found that the older adult participants mostly were accepting of nontraditional family patterns in their offspring’s lives. Those who expressed intolerance of a certain lifestyle (e.g., biracial marriage, gay or lesbian partnership) actually had not experienced it within their own families. Moreover, some of the participants had themselves been living nontraditional lifestyles, demonstrating family structure heterogeneity in the older adult population. Thus, our findings show that older adults are not necessarily conservative or “set in their ways” and do not necessarily oppose social change. Based on their experiences, many clearly did not believe the traditional nuclear family is the only successful type of family life.

Discovering a wide range of family patterns across the generations in a sample drawn from small cities, towns, and rural areas in southwest Virginia suggests the likelihood of uncovering much diversity in the families of older adults from other locations, if researchers were only to ask the right questions. In fact, once a discussion starts about family (broadly defined), family history, and life events, elders often reveal very interesting situations and experiences that may not be apparent at first glance.

The information in this section provides a rationale for using a broad and inclusive definition of family. Research findings from a study of older adults revealed their acceptance of diverse family structures. The following section highlights typical family ties comprising older adults’ family structures.

TYPES OF FAMILY TIES IN LATE LIFE

Depending on longevity of the oldest family members and spacing of successive generations, it is possible for contemporary families to contain four or even five generations for the first time in history. Thus, some older adults will still have surviving parents as the oldest generation in the family. Looking within their own generation, they are likely to have a spouse or romantic partner as well as siblings in their family. Succeeding generations probably include children, grandchildren, and possibly great-grandchildren.

Older adults with living parents assume regular responsibility for helping them to the extent they can, given their own functional health, geographic location, and financial circumstances. If they live close enough, they are likely to check on their older parents daily, prepare meals, provide shopping and transportation assistance, and complete household chores for them (Blieszner, Roberto, & Singh, 2002).

Although the majority of older men in the United States are married (72%), the proportion is smaller for older women (42%), who are more likely to be widowed (43% of older women vs. 14% of older men). Thus, over half (55%) of older adults live with a spouse, but nearly a third (30%) live alone due to widowhood, separation, or divorce (U.S. Census Bureau, 2007). Spouses and partners provide emotional support, companionship, and direct care to one another, and they help foster better physical and psychological health in each other (Connidis, 2001).

Sibling ties are a unique dimension of late-life family structure because siblings share potentially the longest-enduring close relationship of all (see Bedford, 1995). Studies using the National Survey of Families and Households show that adults tend to have at least monthly contact with their siblings for 60 or more years of adulthood and usually consider siblings as potential sources of support even if they do not actually help each other very often, particularly in advanced old age. Sister-sister relationships are strongest, and having living parents increases contact, affection, and exchanges of support among siblings (White, 2001; White & Reidmann, 1992).

Eighty percent of persons aged 65 years or more are parents (Connidis, 2001). Relationships with their adult children usually involve reciprocal exchanges of social and emotional support, shared leisure activities and companionship, and assistance with household chores throughout the adult years. Parents are more likely to provide financial assistance to their children than the reverse, however. As parents’ functional health diminishes, they may receive more instrumental support and assistance from their children and grandchildren than previously. Next to spouses, adult children are most likely to provide elders with intense daily monitoring, meals, and numerous other forms of assistance.

Among the four-fifths of older adults who are parents, 94% have grandchildren and 50% have great-grandchildren (Giarrusso, Silverstein, & Bengtson, 1996). Grandmothers and grandfathers value their relationships with their grandchildren a great deal, although great-grandchildren seem less salient to them (Roberto, Allen, & Blieszner, 1999, 2001). Grandparents usually derive emotional satisfaction and a sense of generational continuity from interacting with grandchildren.

As indicated earlier, changes in mortality and fertility rates have led to families having fewer members in younger generations available to help with caregiving than in the past. Because such families may need assistance with caring for aged members, home health aides, who often spend quite a lot of intimate time with their clients and develop close relationships with them, represent a new category of fictive kin for old people (Piercy, 2000). Similarly, extended kin who would not ordinarily be primary care providers for old people with their own children may indeed be tapped to fill such a role for childless elders. In such cases, an older adult may elevate a more distant relative to a closer role in her or his family structure (e.g., “My niece is like a daughter to me. She would help me if I needed anything.”). Finally, given current rates of divorce and remarriage, stepfamilies are increasingly common in the lives of older adults, leading to new questions within families about the obligations of steprelatives to help one another within and across the generations (Ganong & Coleman, 1998a, b).

The most common same-generation family relationships for older adults, then, are romantic and sibling ties; the usual multigenerational relationships are with children and grandchildren and, rarely, parents. Relatively little research has examined bonds of old people with their aunts and uncles, cousins, or nieces and nephews, although those relationships are important to at least some elders (Allen, Blieszner, & Roberto, 2008). Family ties depend not only on the composition of the family, but also on a host of personal, sociocultural, and historical influences, as discussed in the next section.

INFLUENCES ON OLDER ADULTS’ FAMILY COMPOSITION AND EXPERIENCES

Personal characteristics of the individual members influence family experiences. So do cultural variations in the definition of family and family interaction patterns, historical and social changes, legal and policy matters, and the kinds of roles different family members play as they interact with one another.

Effects of Personal Characteristics

Being a woman or man, coming from a certain racial ethnic background, belonging to a particular socioeconomic class, preferring one or another sexual orientation, and enjoying good health or coping with illness or disability are key attributes that intersect with current age-group membership to define one’s self-identity and place in society. These personal characteristics are socially delineated and have certain expectations and privileges attached to each. They create different opportunities and constraints for participating in society, and their effects are reciprocally influential and intertwined. Moreover, the meaning and influence of personal characteristics such as these change over time and differ across cultures (Allen, Fine, & Demo, 2000; Calasanti & Slevin, 2001). These influences on self-identity help shape family composition and experiences.

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