Abstract
Male caregivers’ experience of elderly caregiving: Focusing on the burden and transition to a caregiver role
In-Hee Choi
Hyo-Jean Song
Eun-Sook Jee
Da-Eun Jung
The number of male family caregivers in Korea, especially those providing spousal caregiving in old age, has been steadily increasing. However, since women have long predominated in the family caregiving role, few studies have explored the experience of caregiving by males in terms of the breadth and depth of care work and its meaning. The purpose of this study was to explore the caregiving experience of husbands and sons providing care to a spouse or parent(s) aged 55 and older who showed limitations in activities of daily living (ADL) or instrumental activities of daily living (IADL) for a period of at least six months.
Both quantitative and qualitative methods were utilized for this study. Survey data were collected from a purposive sample of 247 male caregivers who served as the primary care providers for a dependent spouse or parent(s). Descriptive statistics and multivariate models were obtained using SPSS Statistics. In addition, semi-structured in-depth interviews with 17 male caregivers were conducted. For the qualitative analysis, a comprehensive content review of all data, including line-by-line analysis, was conducted. Informed consent was obtained from the participants.
Some of the major findings are as follows: First of all, approximately one-fourth of respondents identified personal bonds as being their motivation for taking care of a dependent spouse or parent(s). The average caregiving period was around 47.7 months, and respondents spent approximately 34.1 hours per week on average on caregiving. Secondly, the majority of respondents in our sample reported that they experienced caregiving to be burdensome to some degree, especially in the areas of assistance with bathing (52.9%), voiding (49.5%), household management (44.6%), and meal preparation (50.6%). A significant number of respondents reported that one of the most difficult aspects of caregiving was balancing a personal life with the caregiving role, and most respondents stated that the initial phase of caregiving was the most difficult as they made the transition to the new role as caregiver and restructured their life. In addition, spousal caregivers generally experienced a higher level of caregiving burden compared to son caregivers since they are more likely to be older, unhealthier, and have fewer resources. However, a majority of male caregivers also found caregiving to be a very rewarding experience in that they felt useful (72.9%) by providing care to a dependent family member or they had grown closer to their dependent spouse or parent(s) as a result of the caring (54.7%). Thirdly, about 65% of respondents reported that they had secondary caregivers available to support them regularly in their caregiving. This finding supports previous research in which male caregivers were found to be more likely to have access to additional informal caregivers than were female caregivers. Fourth, although a significant number of respondents in our sample reported that they were aware of long-term care insurance (LTCI) benefits, the number of respondents who were receiving LTCI benefits was relatively smaller. Likewise, while approximately 80% of respondents reported being satisfied with the overall services available, the in-depth interview participants suggested that service adequacy, especially in-home care service, was insufficient for assisting family caregivers with balancing work life with the caregiving role. They also suggested that overall service quality should be improved to enhance quality of life among both older adults and family caregivers. However, in the regression analysis, use of LTCI benefits was not a predictor of male caregivers’ burdens. Fifth, with regard to life satisfaction, the majority of respondents expressed satisfaction with their health and housing conditions, but 38.3% and 57.7% of respondents reported being unsatisfied with their economic status and leisure, respectively. Lastly, approximately 50% of respondents reported willingness to participate in caregiver support programs, such as education programs, so that they could be able to provide better care to their dependent family members. Although our survey included only male caregivers, some of the findings in this study showed similarities between female and male caregivers, while others showed differences. In other words, male caregivers and female caregivers do share commonalities as a caregiver (e.g., motivation, burden), but they also demonstrate differences with respect to gender-based skills and resources. Such findings suggest that policies to support family caregivers should be designed to address not only the universal needs of all caregivers regardless of gender, but also the gender differences in caregiving.
Policy recommendations are as follows: First of all, there is a need to develop a legal foundation to support family caregivers so that comprehensive and systematic support can be provided to enhance quality of life among family caregivers. Secondly, current work-life balance policies should be expanded so that people are able to fulfill their right to give care and their right to receive it throughout the life course. Thirdly, long-term care service coverage and types of services should be expanded and diversified so that such services can ease family caregivers’ caregiving burden. Fourth, a range of gender-sensitive programs to support family caregivers, such as education/training and counseling programs, as well as information and coordination services, should be developed and implemented to aid male caregivers. Lastly, further studies should be conducted to explore the unique experiences of male caregivers through more generalizable study samples.