Academic journal article Journal of Comparative Family Studies

Introduction to the Special Issue

Academic journal article Journal of Comparative Family Studies

Introduction to the Special Issue

Article excerpt

In most cultures, families have traditionally been responsible for caring for their older members. While in the past, extended care occurred infrequently due to low longevity, current trends indicate that the need for prolonged periods of family caregiving is growing and will continue to grow. A sharp decline in mortality rates over the past century and a continued decline in mortality at the end of the life span, combined with the aging of the relatively large "baby boom" cohort, will result in the overall aging of the population as the number of older persons in the population as well as in the proportion of older adults in the total population continue to grow. Although the majority of older adults can live independently or with minimal assistance, a substantial number of older adults have disabilities and therefore require care. Because chronic disabling diseases become more prevalent at older ages, and because the rates of severe disability increase with age, the need for family care and other forms of long-term care is growing (Zarit & Reid, 1994).

In the United States, the population of older adults is expected to double in the coming thirty years. The fastest growing component of the population are those age 85 and over. This age group has the highest rates of disability and need for assistance with personal care, with almost 20 percent of women age 85 and over. Estimates by the Congressional Budget Office (CBO) indicate that about 19 percent of older adults experience some degree of chronic physical impairment (2004). Projections anticipate that approximately 65 percent of people over age 65 will need long term care at some point during their remaining lives, and 30-40 percent will spend one or more days in a nursing facility. Microsimulation models estimating the potential future need of LTC suggest that over the rest of their lives, individuals who were 65 years old in 2005 will need an average of three years of long term care, with women needing an average of 3.7 years and men an average of 2.2 years. However, variation around these estimates is substantial (Kemper, Komisar, & Aecxih, 2005). Despite the uncertainty regarding the accuracy of these estimates, it is clear that increasing numbers of individuals are likely to face long term care needs for prolonged periods of time in the future due to increased life expectancy, population growth, and chronic disease burden. Additionally, the lack of integration between primary, preventive, and acute health care services results in a fragmented system that does little to provide supportive home and community services to people at the highest risk for entering nursing homes (Grabowski et al., 2010).

The widely-held belief that contemporary families do not provide care for their aging members and the "myth of alienation" (Shanas, 1979), according to which older adults are alienated from their families, have been disproved by years of research (Brody «fe Brody, 1989; Cicirelli, 1988, Troll, 1986). In fact, families always have been and continue to be the main provider of long-term health and social support to their aging members (Brody & Brody, 1989). Furthermore, families are viewed by policymakers as social units that are ready, willing, and able to meet the growing needs of the elderly population, and to provide help to aging family members at times of need (Parrott & Bengtson, 1999). Most of family caregiving is performed by spouses, and mainly wives (Stone, Cafferta, Lee & Sangl, 1987). When a spouse is absent or unable to provide care, adult children, typically adult daughters, are the next "line of defense" (Zarit & Reid, 1994, p. 240). Future trends indicate that family caregiving will become an increasingly demanding responsibility for adult children (Cicirelli, 1990). It is estimated that at least 25percent of adult daughters may be expected to take on parental care at varying intensity at some point in their lives (Sorenson & Zarit, 1996). …

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