To better understand the challenges and pleasures of caregiving for aging persons, it helps to better understand aging care receivers. As people grow older, they need to remain “bonded” to family members or close friends whenever possible. The need to bond is often greater in older women than older men because men more often substitute recreational and work related activities for interpersonal relationships. Either way, living alone without a support network is both lonely and stressful. For example, people who live alone are more likely to become substance abusers.
Family, friends, neighbors and formal care providers help aging people with illness or disability cope more effectively with these situations. Specific physical activities of daily living (ADLs) for which help may be needed include:
- bathing – sponging, and bathing in a bathtub or shower
- bowel and bladder control – including caring for a catheter or colostomy bag
- dressing – putting on all items of clothing including fasteners, braces, etc.
- eating – feeding oneself: from dishes, a feeding tube or by vein
- movement – ability to get in and out of bed, a chair or wheelchair, with or without supports such as walking canes, walkers, crutches and motorized equipment
- toileting – getting to and using the toilet with good associated personal hygiene
The more activities an individual has difficulty with, the more likely it is that he or she needs continuous help.
Psychosocial Aspects of Receiving and Giving Care
Perhaps the most difficult parts of older persons receiving care is having to part with being independent and self-reliant, both of which are conditions aging persons have lived with all of their adult lives. As they accept their need for help, they may develop a decreased feeling of self-worth. In fact, self-reliance is so important to aging persons that it often makes it more difficult to give them the help they can benefit from. Therefore, instead of the caregiver receiving the appreciation that he or she expects, they may experience anger and a lack of appreciation from the care receiver. This may create a cycle in which the caregiver feels negatively toward the care receiver, which the care receiver can sense, and then the care receiver feels even more negatively toward the caregiver.
Although persons with high self-esteem are less willing to accept help than persons with low self-esteem, it is desirable to support the psychological needs of persons with both high and low self-esteem. Although persons with high self-esteem are often more difficult to care for, it is thought by many that their fight for independence contributes to their longevity. (For more on this subject, see our Aging Health Channel.)