Reciprocity, Elder Satisfaction, and Caregiver Stress and Burden: The Exchange of Aid in the Family Caregiving Relationship

Abstract

In this exploratory research we propose a theoretical model and estimate a system of equations in which an impaired mother's reciprocation of assistance provided by a caregiving daughter simultaneously influences the satisfaction of the elder and the stress and burden of the caregiver. The results indicate that, consistent with some previous research, reciprocity does not directly or indirectly affect the satisfaction of older women. Conversely, reciprocity does significantly reduce the stress and burden experienced by caregiving daughters. Reciprocating a gift or service with something of equal value contributes to the initiation and persistence of social ties among individuals (Levi-Strauss, 1964). Such exchanges frequently occur in the context of family relationships both in the course of normative familial intergenerational assistance and in the context of family caregiving for infirm parents (Walker & Pratt, 1991). The inability to provide immediate compensation (specific reciprocity), a characteristic of many older persons due to limited resources and failing health (Dowd, 1975, 1980), results in dependence on the more resourceful party and, perhaps, low levels of psychological well-being (Stoller, 1985). Alternatively, familial norms may place greater emphasis on generalized reciprocity, in which exchanges balance out over a lifetime (Blieszner & Hamon, 1992; Ingersoll-Dayton & Antonucci, 1988; Walker, Pratt, & Oppy, 1992) and, therefore, psychological well-being may be unaffected by elders' inability to reciprocate. The caregiving support provided by adult children to impaired parents has been interpreted frequently as being motivated by their desire to reciprocate for help provided to them in the past (Doty, 1986; Seelbach, 1984; Walker, Pratt, Shin, & Jones, 1989). However, the demands of caregiving for an infirm parent are often so great that the adult children experience high levels of stress and burden (Stoller & Pugliesi, 1989). These negative outcomes may be attenuated if the elderly recipient of care provides some form of contemporary or concurrent reciprocation in exchange for assistance such as financial support, help with domestic chores, or child care (Dwyer & Miller, 1990). Furthermore, such reciprocation may ease the psychological burden of dependence experienced by the elderly parent, resulting in increased psychological well-being (Stoller, 1985; Walker, et al., 1992; Wentkowski, 1981). The purpose of this exploratory study is to propose a theoretical model and estimate a system of equations in which reciprocity simultaneously influences the well-being of elderly, infirm mothers and the stress and burden of their daughters who are primary caregivers. We hypothesize that mothers' reciprocation for caregiving received from daughters reduces caregivers' stress and burden and, partially as a consequence of this, positively affects elders' psychological well-being. The data set employed in this study provides an opportunity to address these relationships with a matched set of impaired older women and the daughters who are their primary sources of care. THEORY AND PRIOR RESEARCH RECIPROCITY AND ELDER WELL-BEING Exchange theory suggests that it is psychologically uncomfortable to be the dependent party in an exchange relationship (Lee, 1985). Actors who consistently receive more from interaction partners than they provide in return are dependent on the partners for the continuation of benefits, but have no power in the relationship because the partners do not depend on them. Dowd (1975, 1980) argues that the diminishing resources of aging persons frequently mean that their only currency in exchange relations with nonelderly persons is their capacity to comply with the wishes of the others. Thus, according to the principle of distributive justice (Homans, 1961), older participants in intergenerational relationships may experience feelings of guilt as a consequence of their inability to reciprocate. …