The Caregiver Evolution: The Five Stages of Becoming a Caregiver

I’ve studied caregiving of elderly parents as part of my research for People Path, LLC. One of the things I’ve found is that in most families becoming a caregiver for an aging parent (one in the “sedentary retiree” stage–see http://peoplepath.wordpress.com/2009/05/09/age-more-than-a-number/) is not a planned part of life–it’s something that seems to just “happen” over time. Families rarely talk about it, and in many instances that caregiving role is almost solely shouldered by one child, even in families with many siblings. Recent research by Rhonda Montgomery and Karl Kosloski (from the University of Wisconsin and University of Nebraska, respectively) sheds more light on this, and identifies potential stages of becoming a caregiver for an elderly parent (or a spouse who is aging more quickly), and how children and spouses of sedentary retirees see themselves differently because of their evolving caregiver role.

They found five phases of the “caregiver evolution:”

Phase 1 (Beginning): The caregiver starts taking on small responsibilities for the increasingly sedentary retiree, such as balancing a checkbook or accompanying them on a grocery trip.

Phase 2 (Realization): This is when the caregiver starts to realize that they are, indeed, providing caregiving duties.

Phase 3 (Tipping Point): At this stage, the caregiver is giving assistance that is well beyond what is considered “normal” from a family member and can cause levels of discomfort, such as assistance getting dressed in the morning, or even bathing. This is the stage when a sedentary retiree might be moved to a nursing home, or when a family obtains professional caregiving assistance. The discomfort a caregiver feels providing intimate tasks for a retiree may become too much to take from an emotional standpoint.

Phase 4 (Role Reversal): At this phase, the caregiving duties dominate the relationship between the caregiver and the retiree. In other words, the caregiver’s role as, say, child or spouse is drastically outshined by their role as caregiver. This can be very stressful and disconcerting for both the caregiver and the retiree.

Phase 5 (Full Circle): This is the last stage of caregiving, and occurs when the retiree needs greater assistance than the caregiver can provide on their own. Here, the familial caregiver can shift their focus once again on their person, family tie with the retiree instead of focusing their role on strictly caregiving duties.

Many caregivers do not reach the Full Circle phase, instead staying in the Role Reversal phase for the remainder of the caregiving relationship. In these cases, the financial means to move into Full Circle is simply not available. In other cases, a caregiver moves from Phase 2 directly to Phase 5, depending upon the resources of the family. In short, these stages are meant as a progressional guide to help caregivers see their caregiving roles (and options) more clearly, and not as a flow-chart style of how things will progress. In the end, each situation and family is different, and how we choose or are forced to navigate through these phases is determined by individual choice, familial resources, and personal desires.

Communicating with your very old parents

The thing about boomers and early stage retirees (pre-retirees, active retirees, and inactive retirees) is that they frequently have to care for their elderly parents (sedentary retirees). This can lead to a mixed bag of conflicting emotions that are hard to handle and questions that are hard to answer. “I need to focus on my own retirement…how can I handle my mother’s too?” “My parents live 800 miles away! How can I possibly care for them long distance?” Or, “My parents will lose their house if I don’t pay for the yearly taxes, but I can barely afford my own…what the heck do I do?” The good news is that many of these issues can be addressed by communicating with your parents, and there are some things to keep in mind to make this easier.

Remember that your in a role-reversal with your parents when they become very old–you become the caregiver and your parent becomes the dependent. Also remember that your parent really, really hates this idea even as they understand the necessity of it. The trick for you is to evolve into this care-taking role by doing what you can to ensure your parents’ sense of autonomy and independence. Here are some ways to enhance that communication that can help you make the transition from child to caregiver:

1) Make a tape recording for your parents expressing how much you love them. Include in this message the idea that you love them so much that you will do your best to keep them independent but you will also do what is needed to take care of them. It is a difficult message for you to send and your parents to hear–allowing them to react privately will allow them to retain their dignity. After the message has settled in, you can start discussing the issue one-on-one with them.

2) Change how you listen to your parents. They are in a habit of telling you what they would tell their child…”everything is fine.” It’s now your job to really get at the truth of what is going on, which means asking more questions and listening to not only the words of what your parent is saying, but also the underlying messages.

3) Try to find out what your parents’ fears are. Understanding the things they are afraid of (being dependent, falling, losing control, being the victim of a financial scam) will provide you with clues regarding what is going on around them, and give you idea on how to mitigate for their fears. But make sure your parent has a say in what is being done–giving them a feeling of independence is key for their happiness!

4) On the flip side, find out from your parents what makes them happy! Generational differences should not be underestimated–what you think would make your parents happy could very well be very different from what would really make them happy. Try not to instill your own views on them, their happiness is the issue here as they move into the last stage of their life, not yours. 

5) Communication is not just between you and your parents, it’s also between you and other family members (sisters, brothers) who have a stake in the care of your parents. In many ways this can be the most difficult piece of the communication puzzle as care-giving responsibilities frequently seem to fall on one family member. This is not right, for sure, but unfortunately the responsible child must try to keep other family members informed of what is going on. It would be nice if they helped out, and maybe if they hear it enough they will.

There are many ways that communication can be used to make your life as a caregiver easier, and the life of your elderly parent more pleasant. Coming to terms with the parent/child role reversal can be difficult, but the effort you put in to communicating changes with your parents in a way that helps them retain their dignity will pay you back over and over in your own life.

Retirement and the Money Trap Concept?

The concept of “retirement” is so tightly wrapped up with money and financial worries that more than one respondent I’ve talked to has said (and I quote), “I want to die before my money runs out.” Lets read that again…”I want to die before my money runs out.” Yep…and you’re probably thinking to yourself, “Yeah, I get that.”

And is it any wonder that people think this? We daily hear about stories of older folks being sent to nursing homes because they couldn’t pay the taxes on their homes, or medical bankruptcy sending retirees scrambling for options. Or, most recently, financial retirement portfolios simpling “poofing” into thin air. And when one thinks about themselves as being too old to work or be hired, well…yep, it’s scary. And maybe dying before the money runs out isn’t such a bad idea.

But I disagree. I think there are other options; I’ve seen them during my many interviews with retired folks nationwide. Specifically, I want to tell you about Sally, a 92-year-old woman living in the home in which she and her husband raised their family. They built the small house about 60 years ago (you heard me…sixty years ago) and added a room onto it as their family grew. It’s modest, cute, and very clean.

Sally lives in this house by herself–her son lives close by and visits her almost every day. She lives modestly, takes a bus to the senior center every day so she can “help older folks who can’t help themselves,” and even gets a little bit of salary doing so. Yep, at 92 she’s helping seniors who can’t get around as well as she can. She goes to church, gardens, and keeps an immaculate home.

No, things aren’t the best financially for Sally. She eats a modest diet of greens and corn bread because she really can’t afford anything else, yet she credits this diet to her good health and wouldn’t want to eat any other way even if she had the money. She keeps the door closed on one bedroom of her home because the roof has caved in; she owns her home but doesn’t even know what a home equity loan is much less how to apply for one to get her roof fixed. Instead Sally is saving  “a dollar here and a dollar there” to get the roof fixed.

Yet Sally is happy. She has no money, her house is literally caving in around her, and she only eats the simplest of foods. She doesn’t travel and can’t afford new clothes. Yet she is happy with her life–she is content because she spends time helping others, has a routine that keeps her active and engaged in the community, and enjoys  the simple pleasures of being outside pulling weeds or sitting and watching the birds. Sally is not someone who would prefer to die before her money runs out because she doesn’t have any.

What Sally does have is perspective. She knows what life is about, and she knows it’s not about a bank account (I don’t even think Sally has a bank account). She doesn’t worry about economic collapses or falling stocks because her life is so far removed from such worries that such things may as well be happening on another planet. She has insulated herself from the current financial downturn better than someone who made a great deal of money and followed their financial advisors advice regarding the “right” investments.

It’s a tough call for sure. Sally’s life isn’t easy, but the woman is happy. And she’s cute as can be with the most wonderful attitude. I want to be like her when I’m 92…and I’d be happy to live like Sally long after my money runs out.

The Age Gap

Famed anthropologist  Margaret Mead taught us many things, including cultural definitions based upon generations teaching one another. She identified two types: cultures where the young learn from the old (postfigurative cultures)  and ones where each generation learns from their peers (cofigurative cultures). With the advent of advanced technologies from the TV to computers, to tweets to yur peeps, we are in a cofigurative culture.

No longer do the elderly in our society teach the young. In fact, new survey results from Pew (http://pewsocialtrends.org/) show us that the generation gap (defined as the “point of view of younger people and older people”) has expanded in the past 40 years. Specifically, 80% of adults surveyed think the gap is greater now than ever before, compared to 74% back in 1969.

What are the implications of this? Well, when the young learned from older folks who had seen it all before, the course of a culture was plotted based upon that experience. Now, the course of the culture is being plotted by generations of young people who have not learned from experience–mistakes are inevitable. Without a doubt it would be wise for our culture (including cultures within individual businesses) to return to a more postfigurative viewpoint, and let the voices of experience lead the way.

That’s what I gotta say about that!

Aging Profile: Alice

Every Tuesday and Thursday morning she’s there with her sweats, workout mat, and hand-held weights. She gets there a little early to chat with the other people in the exercise class, but mostly is there to work out! The music starts–BOOM BOOM BOOM chaka BOOM BOOM BOOM chaka–some song by KC and the Sunshine Band that she remembers from the 70s when she worked as a waitress in a local diner. She stretches as the instructor shows the class, then picks up her weights and starts moving for the next hour with the other people in the class trying to lose weight and get in shape, most of whom average about 40 years old. But not Alice. Alice is 92.

Alice works out every day at the community center, taking part in a variety of exercise classes side-by-side with men and woman who are younger than her by a life time. She drives herself to the center in a somewhat nondescript sedan except for its color…red. And Alice doesn’t like that people know how old she really is. “I’m not92,” she says, “my birth certificate may say I am but I’m wayyyy younger than that!” And she is. She socializes, drives, and takes part in other activities besides working out daily to stay fit. She also helps sedentary retirees (most of whom are younger than her) who need extra assistance.

Alice is definitely an active retiree…even at 92. No doubt she is unusual in the most marvelous way, but active she is. Does her age really matter all that much? Nope. It’s how she lives that matters.

Functional Demographics: A Huge Improvement Over the Other Kind

I’m calling it “functional demographics.” I created this concept because I was sick-n-tired of clients and traditional market researchers harping about age of respondents and fitting them into demographic categories when doing so would remove much of the benefit of doing the qualitative research to begin with (that being learning new things!). Pigeonholing behaviors based upon someone’s “boxed age” doesn’t even make sense when you think about it.

 

What does make sense? Functional demographics! With functional demographics you can still have the nice and tidy categories that market researchers and clients like, yet be sticking people in boxes that make sense and produce better research for your client: what the respondents DO in their lives. What FUNCTIONS do the fill in their lives? Do we really care if a pre-retiree is 50 years old or 65 years old if they are DOING the same things in their lives to prepare for said retirement? Of course not.

 

When I do fieldwork, I avoid “age demarcation” like the plague and teach clients that grouping folks by “life function” (functional demographics!) is more useful to them and will result in better data collection. People Path uses four functional demographic categories when researching baby boomers and retirement: pre-retirees, active retirees, inactive retirees, and sedentary retirees (for a detailed explanation of each category see this blog: http://peoplepath.wordpress.com/2009/05/09/age-more-than-a-number/

 

And if you’re a client interested in cross-cultural research, including research outside of the United States, using functional demographics becomes even more critical: the whole traditional demographic theory that same-age means same-behavior theory falls apart outside the US. Functional demographics can be used quite well among and between cultures, and for other groups like product users, shoppers, general consumers, and more.

 

Make the switch to functional demographics! And leave a comment if you’d like more info on this

Should we Keep the Word “Retirement?”

I’ve given presentations about retirement and aging to lots of folks (corporations, small companies, and at seminars such as the Focalyst Executive Forum at Lincoln Center). One thing people (at least those who like tidy labels) always ask me is “if retirement doesn’t mean what it used to, what do we call it now?” It’s not a bad question, though I am not a fan of labels or stereotypes.

But the truth is, the retirement of today simply isn’t what it used to be, and people still think of the definition of retirement as the time in life when you no longer work, and instead hang out and do whatever you want in your “old age.” But only a chosen few can afford to do this, and even of those who can afford it, many choose not to.

In truth, the word “retirement” doesn’t have to change at all, but our definition of it does. To me, retirement is simply a late-life stage that takes on new meaning and function for the retiree. The full time job one had while raising children and building personal capital is replaced by a life that is “chunkier” in its scheduling. Instead of 60% of your waking day being dictated by one company or person (your boss), that time is now under more control. That 60% is now spread over multiple tasks and chosen duties, from part time jobs and volunteer work  to appointments and socializing. Even going back to school or joining the Peace Corps can be added to the mix.

So instead of making up a new word, just realize that the definition is adapting with the “new retirement!”

A Senior Teaches me “rofl”

I personally am not the most techno-loving person on the face of the planet. I’d rather talk to people, take my kayak out for a run, or hang out in my garden. But I do live in the modern world and have, of course, used the technological trappings of the modern age. I’ve got a PDA, which I call the  “bat phone,” I instant message friends on Skype, I even send the occasional tweet. But it took me awhile to start texting–there was something about the whole language evolving with text messaging that I just didn’t have time to understand.

Then my 72-year-old father sent me an email one day (he uses WebTV) with “rofl” written in it. I looked at that an though, “What the heck does ROFL mean and how come my dad knows this and I don’t?” So emailed him back, “Hey, Dad. What the heck does ROFL mean???” He said, “It means “rolling on the floor laughing.” I can’t remember what I wrote that sent him into digital hysterics. But I did lol to myself that my father, one of the 70+ “seniors” that young techie designers claim don’t use technology, taught me most of what I know about text-speak. Who taught him? His older sister, Rita.

And he’s not the only one. I’ve interviewed manyretirees of different levels (my father is an active retiree) who have embraced all that technology and computers can provide. I’ve interviewed sedentary retirees who use their computers to widen the scope of their world. I’ve interviewed active retirees who use the Internet regularly to seek out volunteer opportunities or part time jobs. I’ve interviewed inactive retirees who use snapfish and shutterfly to keep in touch with their families across the United States.

It’s time designers of all kinds (web designers, phone designers, etc.) to wake up and smell the Old Spice–mature consumers are more than capable of taking on your innovations; the question is will your innovations be up to par with their savviness?

(For a web consultant with the mature market in mind, visit www.stoogez.com)

Retiree Profile: Hazel

Hazel lives in a two bedroom townhome on the outskirts of Philadelphia. She is a widow, and her and her husband’s saving was completely depleted by her husband’s battle with cancer, which he lost. Hazel lives on what little social security she has coming in, but is fortunate that her daughter helped her purchase her modest townhome, which is the only thing she can afford. She was lucky enough to find one that had low fees, though she isn’t sure how long those fees will stay low. Her daughter pays her property taxes for her, even though she, too, is of modest income.

But Hazel takes a great deal of pride in how she economizes, even though she realizes there are many things she can’t do that she’d like to do, such as own a cat. Hazel loves animals and knows that a cat would enhance the quality of her life. However, she also knows that she can barely afford her own food much less the food and other expenses associated with having a pet. Hazel also would like to have her local priest or other church members over for visits, but she can’t afford to purchase the coffee or cookies that she would feel obliged to offer visitors. Other ways Hazel saves money includes purchasing bulk rice, beans, and spinach for a simple but balanced diet, avoiding meat because of the expense, and stuffing her freezer with newspaper to decrease the amount of energy it uses. Instead of buying cleaning products, Hazel also uses vinegar and water exclusively to clean her home, which is immaculate.

But Hazel still has a zest for life! She goes to church regularly and is a devout Catholic. On the days she does not feel well enough to make it to church she watches Mass on her small TV. She keeps a very regular schedule with her morning routine of breakfast and prayer; her afternoon routine of a nap, a late lunch, and a two hour walk; in the late afternoon she earns a few extra dollars by taking a neighbor’s dog for a brief walk, then eats dinner. Her evenings are spent with reading and an early bedtime.

In case you think Hazel is far from an active retiree think of this: her schedule is active with tasks of her choosing. She enjoys her routine and makes sure each day has activity in it. What’s even more amazing is that Hazel–who is in perfect health–is 92 years old. She is far from a sedentary retiree that most people attribute to people her age. She is the model of an inactive retiree because she functionally lives the life and makes the choices who is far younger than she. Her biggest obstacles are lack of money, and that her friends have all died. Other than that, she is healthy, active, and has a busy schedule of her own making.

New Retiree Profile: Jennie

Jennie is 56 years old and decided to retire from her job as an insurance agent. Or, rather, she is a pre-retiree and decided it was time to, well, prepare for her ultimate retirement by quitting her job as an insurance agent. Why on earth did she do that? Because she no longer wanted to be an insurance agent, and she decided that she wanted to work until she almost “dropped dead.” So she went back to school and retrained herself in a career she sees herself doing wayyyy into her so-called retirement: she became an esthetician.

Jennie sat down with her husband and figured out ways to budget their finances so they could live on his modest salary while Jennie went to esthetician school. She enrolled herself into an four-month program and graduated this past January with an esthetician’s license. Starting small, Jennie rented space and started giving facials, waxes, and more to men and women in her community. She is seeing an increase in her income and is starting to realize a pay-back for her planning and hard work.

But it doesn’t stop there. As of today Jennie is visiting a friend in New Mexico, and while she’s at it she’s planting the seeds to move her esthetician practice there in the next year. Jennie and her husband want to “retire” to New Mexico, and Jennie’s new career in her “retirement” is part of that plan. They’ll buy some land and live in a modest trailer in a place of their choosing.

Jennie is an example of a ”new retiree!”