How do older people work out care for themselves, and what can we learn by speaking with multiple family members?

Catherine Powell is a Research Fellow at the School of Dementia Studies. Catherine is currently working on the National Institute for Health Research funded ‘Better Health in Residents in Care Homes (BHiRCH)’ project on improving health care for residents in care homes.

Catherine Powell’s research interests are in care, ageing, family, intergenerational relationships, dementia and care homes.

Catherine tells us about some of the key findings from her doctoral research, available in the published paper, Powell, C. (2016). Care for older people in multigenerational families: a life course analysis across four generations. Families, Relationships and Societies.

Care for Older People in Multigenerational Families

As the population ages, an increasing number older people will need quality care. I wanted to understand how older people arranged care for themselves. This meant learning about what the care arrangements looked like in detail, and how these care arrangements had come about.

I interviewed five families, asking them about their life history. I decided to carry out my research with four generation families, which are those with a great grandparent, grandparent, parent and children. Research has focused on care between one carer and a care recipient, such as a parent and child. There has been little research into four generation families, with a few notable exceptions (Brannen et al. 2004). There may be other family members and close friends involved. Looking across several generations of family members could help us better understand this.

I also learnt about professional support, such as changes in institutional care, available to older people across the twentieth and early twenty first century. Had experiences and opinions of professional support across the generations influenced care arrangements?

Finding: Older people arrange care in negotiation with several family members

The research uncovered many significant findings, one of which was that care for older people can be the result of a negotiation across several family members.

It was not necessarily the case that all family members were carrying out practical caring tasks, such as personal care, for the great grandparents (although there were instances of multiple carers and people caring for more than one family member at once), but that older people and their family members considered what was happening in each other’s lives. They negotiated a balance of privacy, autonomy and support, when deciding how care should be worked out. This meant that older people and their family members shared care between themselves as well as different professional support.

These negotiations indicated four different types of care arrangements for the great grandparents, living at home, living at home with some professional support, sheltered housing and a care home.

To give two examples of negotiations…

Younger generations, grandparents and parents, did not want the oldest generation to move into a care home. However, the great grandparents sometimes felt that living in a care home would be better as it would help their children. Diane Buckingham preferred her mother Rita Buckingham, whom she had a close relationship with, to live with her if she needed more support. Rita felt otherwise…

“Rita Buckingham: I don’t want them to think they have to take me into their homes…If I ever get that I can’t look after myself I don’t want to do that…Diane (Rita’s daughter) just said ‘well we’ll see’. I said ‘no we won’t, because I’ve done my will and I’ve put in my will I do not want to go and live with Diane’. She said ‘you wouldn’t dare!’ ‘Yeah I would!’…They’d have to put me in a home. (Great grandparent, age 76)” (Powell 2016: 13)

In the Thwaite family, financial constraints and care needs across several generations over time had meant that the four generations had to live closer together. When the great grandparent generation Gladys needed support, her daughter Tracey and granddaughter Katy were able to help. The great grandparent, Gladys also had professional support as she lived in sheltered accommodation, despite disliking professional sources of support.

Why do we need to know care arrangements for older people depends on these multiple relationships and professional support?

Care arrangements were not made independently. Living autonomously for older people (and younger people) meant depending on different mixes of family and professional support.

The results showed the importance of having good quality professional support that is flexible to the lives of older people and their families. By improving this support, older people and their families can balance privacy, autonomy and support, in ways that suit each individual family.

 

References

Brannen, J., Moss, P., and Mooney, A. (2004). Working and Caring over the Twentieth Century, Change and Continuity in Four Generation Families. Hampshire: Palgrave Macmillan

Powell, C. (2016). Care for older people in multigenerational families: a life course analysis across four generations. Families, Relationships and Societies.