Factors influencing the preparedness of adult daughters for taking care of elderly parents.

Abstract

Adult children are often called upon when elderly parents need help. Preparedness is a state of readiness to assume the challenges and is suspected to decrease the negative effects of caregiving. However, research indicates that few adult children make actual plans for the future needs of their parents. Preparedness for caregiving is thought to be a multi-dimensional phenomenon, but has been infrequently explored, especially with adult children. The purposes of this study were to identify dimensions of preparedness for taking care of elderly parents, and to examine current, historical, and cultural factors that might influence that preparedness in American society. A conceptual framework was developed using a process known as contextualization, in which critical theory was applied to reveal historical, cultural, and social influences on the phenomena of preparedness and caregiving of elderly parents in America. Preparedness was proposed to consist of four dimensions: knowledge; ability; commitment; and affinity for caregiving. Relevant historical influences were workforce participation for women; experience taking care of the elderly; co-residence with the parent; and memories of parents' role-modeling of parent care. Cultural influences examined were the parent's autonomy and sibling egalitarianism. The contributions of the acuity and amount of care needed, and of the quality of the relationship between parent and child were also considered. The components and relationships in the conceptual model were evaluated by combining both quantitative and qualitative data analytic strategies (triangulation). Secondary analysis of survey data from 117 adult daughters new to the care of an elderly parent was compared with case studies of an independent sample of caregivers (<italic>N</italic> = 8). Factor analytic strategies indicated that preparedness consisted of three dimensions of ability, knowledge and commitment. Areas of least preparedness were daughter's emotions; arranging formal services; and managing parents' behavioral problems. The results led to re-examination of caregiver role definition, and thus preparedness, as perceived by the adult child, parent, and the health care system, along a time continuum of anticipatory planning, actual demands and ability, and long-term consequences.