The Stress of Caring for a Parent: Effects of the Elder's Impairment on an Employed, Adult Child

Abstract

MARJORIE E. STARRELS Colorado State University BERIT INGERSOLL-DAYTON University of Michigan* DAVID W. DOWLER University of Michigan** MARGARET B. NEAL Portland State University*** This study examines direct and indirect effects of an elder's impairment on the caregiving stress of employed sons and daughters. Using path analysis and decomposition of variance, it examines data provided by 1,585 employees who care for a parent or parent-in-law aged 60 or older. The direct effect of impairment on stress is stronger for cognitive-behavioral problems than it is for limitations in activities of daily living. Also, there are indirect effects of impairment on caregiver stress via the amount of caregiving. Significant effects also were found for time off from work to help the elder and for the elder's assistance to caregivers. Key Words: caregiver stress, elder care, employed caregivers, elder impairment, parent-child relations, work. Adult children's provision of care to their aging parents is becoming an increasingly important issue as we approach the 21st century. Demographic shifts and cultural norms (e.g., the aging of the population, fewer children per family and childbearing at later ages, greater geographical dispersion of families, and more participation in and commitment to the labor force among middle-aged women) have resulted in compelling dilemmas involving the care of parents. Gorey, Rice, and Brice (1992) reviewed 17 studies that addressed the prevalence of elder-care responsibilities among employees. On average, from one fifth to one quarter of employed family members reported providing care to an older dependent. After implementing statistical controls to adjust for response rates and variability in operational definitions of elder care, Gorey and colleagues estimated that from 7% to 12% of employees have elder-care responsibilities. In addition, Stone, Cafferta, and Sangl (1987) found that, based on data from the Informal Caregivers' Survey, 31% of all caregivers were employed (44% of daughters and 55% of sons). For employed adults, conflicts among jobs, parent care, and other family responsibilities can be stressful. In view of these challenges, it is important to analyze more closely the factors that inhibit or exacerbate the stress often experienced by employed adult children due to their caregiving role. Although there is a sizeable literature addressing the nature and extent of stress outcomes for caregivers of elders (see Walker, Pratt, & Eddy, 1995), there has been limited, albeit growing, attention to the subpopulation of employed family members who provide care to an older person. This group is significant because of its increasing size, as well as the unique role conflicts and constraints that may be experienced by its members. Indeed, employment is generally considered to increase caregivers' vulnerability to caregiver burden, physical fatigue, depression, and other indicators of physical and emotional stress (Brody, 1990; Neal, Chapman, IngersollDayton, & Emlen, 1993; Steuve & O'Donnell, 1989). Building on previous research, this study focuses on the relationship between an elder's impairment and caregiver stress. Previous studies are inconsistent with regard to the effect of the elder's level of impairment on caregiver stress (Dura, Haywood-Niles, & Kiecolt-Glaser, 1990; Miller,1990a, 1990b; Pearson, Verma, & Nellert, 1988). Furthermore, most studies do not consider the indirect effects, as well as direct effects, of the elder's impairment. Therefore, our study contributes to the literature by examining the direct and indirect effects of elder impairment on the stress outcomes of employed daughters and sons who are providing care to their parents and parents-in-law. Previous studies have distinguished between two kinds of impairment: physical impairment and cognitive-behavioral problems. Physical impairment typically involves difficulty in accomplishing activities of daily living or instrumental activities of daily living-difficulties that result from limitations in ambulatory capacity and other basic physical functioning. …