Self-Characterizations of Adult Female Informal Caregivers: Gender Identity and the Bearing of Burden
Kramer, Maeona K., Research and Theory for Nursing Practice
Gender identity is a powerful aspect of self that shapes values, attitudes, and conduct. Family caregivers, particularly women, tend to forgo institutionalization of care recipients even when care demands are overwhelming. The reluctance of women to relinquish care raises questions about the relationship between gender identity and the bearing of burden. To illuminate the relationship between gender and burden, 36 adult women caring for highly dependent adults were asked to describe the nature of "self; that is, how they characterized themselves as a person. Results were tabulated and critically examined in relation to stereotypical gender traits, as well as social and political processes that create gender dichotomies. Overall, self-characterizations indicated caregivers had internalized stereotypical female gender traits that support and facilitate the enduring of burden.
Keywords: caregiving; women's health; gender identity; caregiving burden; poststructuralism; critical feminist theory
Alleviating the harmful effects of caregiving is a subject of great importance for health care professionals. Although females comprise the greatest number of family caregivers, they are the least likely group to utilize services designed to alleviate care burden (Dorfman, Berlin, & Holmes, 1998; Montgomery, 2003). The question "why?" arises, generating interest in the relationship between gender and caregiver behavior. Gender is a fundamental and pervasive construction of self-identity that is a product of often unrecognized social practices beginning with birth (Kimmel, 2000). Gender identity is created as individuals encounter and internalize the attitudes, values, and behaviors deemed socially appropriate for their sex. Gender identity profoundly influences, indeed creates, life possibilities-forming and patterning thoughts, feelings, and actions toward self and others (McDowell, 1999). Despite the fundamental significance of gender identity, little is known about how it shapes the experience of caregiving (Hooker, Manoogian-O'Dell, Monahan, Frazier, & Shifren, 2000; Weitz & Estes, 2001).
This article examines the relationship between: (a) language utilized by informal female caregivers when asked to describe the nature of the self, and (b) a literature-derived set of stereotypical female gender identity traits. How language use has potential to facilitate and support the bearing of burden is also discussed. The article opens with a brief overview of caregiving demographics, the cost and value of caregiving labor for caregivers and for society, and caregiving as "women's work." second, the theoretical backdrop for analysis relative to gender identity construction, critical feminist theory, and language as an index of gender identity is overviewed. Third, the data acquisition process and descriptive findings are presented. Fourth, self-characterizations are critically analyzed in relation to female gender identity and the enabling of burden. General recommendations for clinicians and researchers are presented.
OVERVIEW OF CAREGIVING
The U.S. population is aging at an unprecedented rate, portending ever-increasing demands for care. By 2030, the older population in the US will double to number about 70 million (Administration on Aging [AoA], 2002). As the population ages, morbidity for chronic illness and disability increases, escalating demands for care (Cassel, 2001; Santos-Eggimann, 2002). Eldercare is costly, and resources to support it are insufficient (Cohen & Miller, 2000; National Alliance for Caregiving & Partnership for Caring, 2001). Since elder households have incomes lower than the national average it is unlikely that elders themselves will be able to pay professional care costs (AoA, 2002). Of community-dwelling elders,1 57%, or 7.3 million, require significant levels of long-term care (Family Caregiver Alliance, 2003). Most long-term care recipients live at home, with informal caregivers (untrained, unpaid family and friends) providing an estimated 80% of care required (Family Caregiver Alliance, 2003; National Alliance for Caregiving & Partnership for Caring, 2001). …