Published on: July 2, 2017
by Jason Karlawish for Forbes:
“Aren’t there any sons?”
“Sure aren’t. If it’s not daughters, it’s daughters-in-law.”
This question and answer exchange is recounted in Making An Exit, Elinor Fuchs’ compelling narrative of her and her mother Lil Kessler’s decade of living with dementia. I write “her and her mother’s dementia” because among Fuchs’ insights is how she bears her mother’s disease as much as, if not even more than, her mother. This shared experience is why any changes to how we care for America’s older adults ramify into the lives of their families and why some ideas that have been swirling around Washington, D.C. for the last six months are simply batty.
“This is my job, no escape,” Fuchs says of caregiving. “For the next nine years, in monthly visits from wherever I am to Washington, and for the early hours of every day on the telephone or in correspondence, I inhabit my mother’s life.”
Fuchs’ story also debunks misconceptions. Caregiving doesn’t “stop” after the person moves into “a facility.” In the assisted living facility and, later, the nursing home where her mother lived, Fuchs’ had to make decisions, keep up on paperwork, manage finances, schedule doctor visits, and provide hands-on care when illness flared, and so extra care was needed.
Her question — “Aren’t there any sons?” — was to one of the female staff at Chevy Chase House, the assisted living facility where Lil lived. She was asking about the family members who assist in the care of residents. The answer (daughters and daughters-in-law) reveals the peculiar demography of aging in America. It’s a problem of and for women.
Studies show large gender disparities in who provides care for community-dwelling, disabled older adults (“disabled” describes a person who needs help to perform such basic activities as dressing and washing up, and instrumental activities that allow the person to live and thrive as an adult, such as preparing a meal and managing finances). In fact, 80% of adult child caregivers are women. For older adults with cognitive impairment, daughters are more likely to be the caregiver than spouses, sons, or other relatives.
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