| Caregivers, especially women, have found themselves facing simultaneous
demands from the care-receiver; from spouses who might also be failing
in health; from their own children; and increasingly from employers.
Terms such as "caught generation," "sandwich generation"
and "women in the middle" are used to describe the tug-of-war
conflicts faced by the caregiver who tries to manage the demands
and needs of multiple generations within the family system. This
situation, over time, is usually complicated by the reality that
fulfilling all of these demands is impossible.
Caregivers report lower stress levels when more family members
cooperate. The opposite is equally true. If family members are available
to offer assistance and cannot or will not, caregivers usually report
higher levels of stress, anxiety and tension. The more family members
there are to remind us of what they can do but are not doing, the
more resentment, frustration and regret will follow.
Can caregivers change or alter this negative situation? Yes, but
change requires understanding the full family dynamics and taking
control where control is possible. Start by identifying the family
members involved or available to be involved in the care of the
older adult. Your family will probably include members who, knowingly
or unknowingly, perform specific roles in the family. In most instances,
their roles have a historic component (i.e., they have functioned
in that role for many years).
Begin with the most obvious role, that of the caregiver. In most
circumstances, the caregiver role is neither appointed, anointed,
elected or decreed. It is commonly assumed by the holder based on
a long history of responsible involvement similar in nature to the
job-at-hand. Researchers at the University of Toronto have given
that role the position title of "kinkeeper". When asking
families about this particular position, the researchers posed this
question: "Thinking about your side of the family in the broadest
terms, including your brothers, sisters, aunts, uncles, cousins,
grandparents, and so forth is there currently any one person among
you and your family who, in your opinion, works harder than others
at keeping the family in touch with one another?" According,
to researchers, this family position has some specific, responsible
take-charge tasks. They include telephoning, writing, visiting,organizing
or holding get-togethers, reunions, birthday parties, special events,
linking family members together and providing information to the
rest of the family. Kinkeepers tend to be responsible and responsive
which is consistent with their past performance. Again, the role
of caregiver (kinkeeper) is not normally appointed by the family,
but naturally assumed in light of family responsibility.
Who are the other members of the family system that need to be
understood and properly used? The researchers also indicate that
most families will report having a specialist in representing the
family to the outside world, otherwise known as an ambassador. This
individual assures family representation at such events as funerals
for family, friends, or distant relatives. Just as important to
the family is the comforter. This person serves as an earpiece for
other members to discuss troubles or seek advice and comfort. Essential
to any caregiver is the financial advisor, who provides advice about
financial matters to the other family members. In the case of caring
for an older, frail adult, the financial advisor may also control
the financial decision-making, thereby forcing the attention and
cooperation of the caregiver.
Other roles to be identified include the fence-siter, who, by definition,
is not terribly active or involved. At best, this individual has
no stated opinon about the matter or, at worst, changes his opinion
depending on who last had his ear. Finally, and potentially most
difficult, is the consultant. As in most organizations, the consultant
is someone outside the mainstream of operation, considered influential
or powerful by the members and a force to be dealt with. In a caregiving
context, the consultant rarely provides hands-on care and often
spends little time with either the caregiver or care-receiver. However,
the time spent with either or both never goes unnoticed. For example,
the consultant (brother, sister, aunt, uncle, etc.) may arrive in
town to take the care-receiver out for lunch, buy a few presents,
make a few promises and then as quickly exits the scene. For the
following weeks, the consultant is referred to by the care-receiver
in the most positive light, setting up the caregiver in a comparison
that is unrealistic and usually unfavorable. In a sense, the consultant
is deified and becomes the reference point by which others are measured
- particularly the caregiver. Comments such as, "Why aren't
you like your brother? He's wonderful to me", are not uncommon,
but always stressful.
How can this information be used to help a caregiver? First, one
must identify the characters and their roles in the family system.
Referring to the following diagram, fill in the names of the members
who fit the title. If there are others, fill in their names and
give them a title equal to their role; certainly there may be more
roles than those previously discussed.
To print the diagram below:
Click here then print
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