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Care-giving expectations and challenges among elders and their adult children in Southern Sri Lanka

Published online by Cambridge University Press:  08 January 2013

MELISSA H. WATT*
Affiliation:
Duke Global Health Institute, Duke University, Durham, North Carolina, USA.
BILESHA PERERA
Affiliation:
Department of Community Medicine, University of Ruhuna, Galle, Sri Lanka.
TRULS ØSTBYE
Affiliation:
Duke Global Health Institute, Duke University, Durham, North Carolina, USA. Department of Community and Family Medicine, Duke University, Durham, North Carolina, USA.
SHYAMA RANABAHU
Affiliation:
Department of Geography, University of Ruhuna, Matara, Sri Lanka.
HARSHINI RAJAPAKSE
Affiliation:
Department of Psychiatry, University of Ruhuna, Galle, Sri Lanka.
JOANNA MASELKO
Affiliation:
Duke Global Health Institute, Duke University, Durham, North Carolina, USA. Department of Psychiatry, Duke University, Durham, North Carolina, USA.
*
Address for correspondence: Melissa H. Watt, Duke Global Health Institute, Duke University, Box 90519, Durham, NC 27708, USA. E-mail: melissa.watt@duke.edu

Abstract

The elderly population in Sri Lanka is growing rapidly. Elders are traditionally cared for in the homes of their adult children, but the shifting socio-economic environment in Sri Lanka challenges this arrangement. This paper describes the dynamics of elder–care-giver relationships in Southern Sri Lanka. Data included four focus group discussions and five in-depth interviews with elderly, and ten in-depth interviews with adult children of the elderly. Discussion guide topics included care-giving arrangements, and roles/responsibilities of elders and care-givers. Using a grounded theory approach, a comprehensive analytic memo was developed and discussed to explore emerging themes on the care-giver dynamic. Both elders and care-givers felt that elders should be taken care of in the home by their children. They pointed to a sense of duty and role modelling of parental care-giving that is passed down through generations. Even as elders desired support from their children, they feared losing their independence, and saw financial autonomy as important for maintaining relationship balance. Care-giving challenges included: households where both the adult child and his/her spouse worked outside the home; households where elders had a disproportionate amount of household work; economically stressed households; and lack of direct communication between elders and care-givers regarding conflicts. Results point to strong values around caring for elderly in the home, but identify challenges to this arrangement in the future.

Type
Articles
Copyright
Copyright © Cambridge University Press 2013 

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References

Bertrand, R. M., Saczynski, J. S., Mezzacappa, C., Hulse, M., Ensrud, K. and Fredman, L. 2012. Caregiving and cognitive function in older women: evidence for the healthy caregiver hypothesis. Journal of Aging and Health, 24, 1, 4866.Google Scholar
Buyck, J. F., Bonnaud, S., Boumendil, A., Andrieu, S., Bonenfant, S., Goldberg, M., Zins, M. and Ankri, J. 2011. Informal caregiving and self-reported mental and physical health: results from the Gazel Cohort Study. American Journal of Public Health, 101, 10, 1971–9.Google Scholar
Caldwell, J. C. 2005. On net intergenerational wealth flows: an update. Population and Development Review, 31, 4, 721–40.Google Scholar
Carver, C. S., Scheier, M. F. and Weintraub, J. K. 1989. Assessing coping strategies: a theoretically based approach. Journal of Personality and Social Psychology, 56, 2, 267–83.Google Scholar
Chan, A. 2005. Aging in Southeast and East Asia: issues and policy directions. Journal of Cross-cultural Gerontology, 20, 4, 269–84.Google Scholar
Charmaz, K. 2006. Constructing Grounded Theory. Sage Publications, Thousand Oaks, California.Google Scholar
Chiou, C. J., Chen, I. P. and Wang, H. H. 2005. The health status of family caregivers in Taiwan: an analysis of gender differences. International Journal of Geriatric Psychiatry, 20, 9, 821–6.Google Scholar
Cicirelli, V. G. 1983. Adult children's attachment and helping behavior to elderly parents: a path model. Journal of Marriage and the Family, 45, 4, 815–25.Google Scholar
Cohen, C. A., Colantonio, A. and Vernich, L. 2002. Positive aspects of caregiving: rounding out the caregiver experience. International Journal of Geriatric Psychiatry, 17, 2, 184–8.Google Scholar
Cooper, C., Katona, C., Orrell, M. and Livingston, G. 2008. Coping strategies, anxiety and depression in caregivers of people with Alzheimer's disease. International Journal of Geriatric Psychiatry, 23, 9, 929–36.Google Scholar
Davis, L. L., Gilliss, C. L., Deshefy-Longhi, T., Chestnutt, D. H. and Molloy, M. 2011. The nature and scope of stressful spousal caregiving relationships. Journal of Family Nursing, 17, 2, 224–40.Google Scholar
De Silva, W. I. 1994. How serious is ageing in Sri Lanka and what can be done about it? Asia-Pacific Population Journal, 9, 1, 1936.Google Scholar
Department of Census and Statistics Sri Lanka 2008 a. Brief Analysis of Population and Housing Characteristics. Department of Census and Statistics Sri Lanka, Colombo, Sri Lanka.Google Scholar
Department of Census and Statistics Sri Lanka 2008 b. Estimated Mid-year Population by Sex and District. Department of Census and Statistics Sri Lanka, Colombo, Sri Lanka.Google Scholar
Frankenberg, E., Lillard, L. and Willis, R. J. 2002. Patterns of intergenerational transfers in southeast Asia. Journal of Marriage and Family, 64, 3, 627–41.Google Scholar
Gallicchio, L., Siddiqi, N., Langenberg, P. and Baumgarten, M. 2002. Gender differences in burden and depression among informal caregivers of demented elders in the community. International Journal of Geriatric Psychiatry, 17, 2, 154–63.Google Scholar
Gaminiratne, N. 2004. Population Ageing, Elderly Welfare, and Extending Retirement Coverage: The Case Study of Sri Lanka. Overseas Development Institute, London.Google Scholar
Ikkink, K. K., van Tilburg, T. and Knipscheer, K. 1999. Perceived instrumental support exchanges in relationships between elderly parents and their adult children: normative and structural explanations. Journal of Marriage and the Family, 61, 4, 831–44.Google Scholar
Kaushal, S. and Teja, M. K. 1999. Perceptions of sons and daughters-in-law regarding parent care. Indian Journal of Gerontology, 13, 3/4, 114–28.Google Scholar
Klaus, D. 2009. Why do adult children support their parents? Journal of Comparative Family Studies, 40, 2, 227–41.Google Scholar
Knodel, J., Chayovan, N. and Siriboon, S. 1992. The familial support system of Thai elderly: an overview. Asia Pacific Population Journal, 7, 3, 105–26.Google Scholar
Laidlaw, K., Wang, D., Coelho, C. and Power, M. 2010. Attitudes to ageing and expectations for filial piety across Chinese and British cultures: a pilot exploratory evaluation. Aging and Mental Health, 14, 3, 283–92.Google Scholar
Li, R., Cooper, C., Bradley, J., Shulman, A. and Livingston, G. 2012. Coping strategies and psychological morbidity in family carers of people with dementia: a systematic review and meta-analysis. Journal of Affective Disorders, 139, 1, 111.Google Scholar
Liu, Y., Insel, K. C., Reed, P. G. and Crist, J. D. 2012. Family caregiving of older Chinese people with dementia testing a model. Nursing Research, 61, 1, 3950.Google Scholar
Lyons, K. S., Zarit, S. H., Sayer, A. G. and Whitlatch, C. J. 2002. Caregiving as a dyadic process: perspectives from caregiver and receiver. Journals of Gerontology, 57, 3, P195204.Google Scholar
Mehta, K. K. 2005. Stress among family caregivers of older persons in Singapore. Journal of Cross-cultural Gerontology, 20, 4, 319–34.Google Scholar
Mendis, N. and Illesinghe, D. 1989. Health and social aspects of the elderly. A preliminary community survey. Ceylon Medical Journal, 34, 2, 9598.Google Scholar
Miller, B. and Cafasso, L. 1992. Gender differences in caregiving: fact or artifact? Gerontologist, 32, 4, 498507.Google Scholar
Ministry of Justice and Law Reforms in Sri Lanka 2000. Protection of the Rights of the Elders Act. Ministry of Justice and Law Reforms of Sri Lanka, Colombo, Sri Lanka.Google Scholar
Ministry of Law and Justice 2007. The Maintenance and Welfare of Parents and Senior Citizens Act, 2007. The Gazette of India, No. 67.Google Scholar
Mitrani, V. B., Lewis, J. E., Feaster, D. J., Czala, S. J., Eisdorfer, C., Schulz, R. and Szapocznik, J. 2006. The role of family functioning in the stress process of dementia caregivers: a structural family framework. Gerontologist, 46, 1, 97105.Google Scholar
Ory, M. G., Hoffman, R. R. 3rd, Yee, J. L., Tennstedt, S. and Schulz, R. 1999. Prevalence and impact of caregiving: a detailed comparison between dementia and nondementia caregivers. Gerontologist, 39, 2, 177–85.Google Scholar
Østbye, T., Chan, A., Malhotra, R. and Kothalawala, J. 2010. Adult children caring for their elderly parents. Asian Population Studies, 6, 1, 8397.Google Scholar
Piercy, K. W. 2007. Characteristics of strong commitments to intergenerational family care of older adults. Journals of Gerontology, 62, 6, S381–7.Google Scholar
Pinquart, M. and Sorensen, S. 2003. Differences between caregivers and noncaregivers in psychological health and physical health: a meta-analysis. Psychology and Aging, 18, 2, 250–67.Google Scholar
Pitsenberger, D. J. 2006. Juggling work and elder caregiving: work–life balance for aging American workers. AAOHN Journal, 54, 4, 181–5.Google Scholar
Siddhisena, K. A. P. 2005. Soci-economic implications of ageing in Sri Lanka: an overview. In Leeson, G. W. (ed.), Oxford Institute of Ageing Working Papers. Working Paper WP105, Oxford Institute of Ageing, Oxford.Google Scholar
Silverstein, M., Parrott, T. M. and Bengtson, V. L. 1995. Factors that predispose middle-aged sons and daughters to provide social support to older parents. Journal of Marriage and the Family, 57, 2, 465–75.Google Scholar
Smerglia, V. L., Miller, N. B., Sotnak, D. L. and Geiss, C. A. 2007. Social support and adjustment to caring for elder family members: a multi-study analysis. Aging and Mental Health, 11, 2, 205–17.Google Scholar
Uhlenberg, P. 1996. Intergenerational support in Sri Lanka: the elderly and their children. In Hareven, T. K. (ed.), Aging and Generational Relations Over the Life Course: A Historical and Cross-cultural Perspective. W. de Gruyter, Berlin, 462–82.Google Scholar
Wakabayashi, C. and Donato, K. M. 2006. Does caregiving increase poverty among women in later life? Evidence from the Health and Retirement Survey. Journal of Health and Social Behavior, 47, 3, 258–74.Google Scholar
Walz, H. S. and Mitchell, T. E. 2007. Adult children and their parents’ expectations of future elder care needs. Journal of Aging and Health, 19, 3, 482–99.Google Scholar
Yap, M. T., Thang, L. L. and Traphagan, J. W. 2005. Introduction: aging in Asia – perennial concerns on support and caring for the old. Journal of Cross-cultural Gerontology, 20, 4, 257–67.Google Scholar
Yee, J. L. and Schulz, R. 2000. Gender differences in psychiatric morbidity among family caregivers: a review and analysis. Gerontologist, 40, 2, 147–64.Google Scholar
Zhan, H. J. 2005. Aging, health care, and elder care: perpetuation of gender inequalities in China. Health Care for Women International, 26, 8, 693712.Google Scholar