A classic study by the researchers Lowenthal and Haven, demonstrated the importance of a caring relationship as a buffer against “age linked social losses”. The maintenance of a stable intimate relationship was more closely associated with good mental health and high morale than a high level of activity or elevated role status.
In other words, one appears to be able to manage stresses if relationships are close and sustaining, and if they are not, prestige and keeping busy may not always prevent depression.
An intimate and confiding relationship is a buffer against stress and illness. It is increasingly evident that a caring person may be a significant survival resource. Social bonding increases health status, however physiologic pathways are yet to be determined.
A network of relatives, friends and acquaintances can sustain the old and give life meaning.
Social networks are the vehicles through which social support is distributed. For example, married persons tend to have larger and more diverse networks than persons separated, divorced, widowed, or never married.
A longitudinal study by Field and Minkler showed that social supports beyond the family decrease over time for the very old and for men, but not for women and the old-old. Thus satisfaction with support from children tends to increase over time as the elders relinquish involvement beyond the family. According to researchers, this data is significant because it confirms the constancy of family in the support network of the old.
Families also are a source of emotional support across the generations.
The shifting needs for supply and demand among family members helps to establish a reciprocal and comfortable giving and receiving relationship.
Too often we think of the aged as only recipients. Even into advanced old age they often provide emotional and financial support, child care, and cultural and religious continuity.
As the population continues to shift toward increasing numbers of frail aged with multiple problems, there is a danger that this balance will be difficult to maintain. Older family members, who are also impaired, may find themselves taking care of a very old parent. This is already occurring for many but is expected to increase markedly in the future.
Further, as the age when “children” leave home continues to increase, it is likely we will again have three generational households.
It is important to note that the elderly spouse who is caring for a disabled partner has special needs also. Respite from continuous care is essential. Often the spouse has significant health problems that are neglected in deference to the greater needs of the incapacitated partner. Most often the woman is in the role as caregiver and may be in dire need of caring and concern for herself.
Life satisfaction tends to be limited when illness, low income, multiple demands and the loss of intimacy and companionship converge on a conscientious mate. Counseling, and encouraging all involved family members to discuss their needs and concerns may, in the end, produce satisfactory results for the disabled elderly person.
Sometimes people just need an opportunity to share the difficulties they are experiencing and by having an attentive listener without any emotional commitment may also allow ventilation and release of stored-up feelings.
Our greatest contribution to the care of the aged may be to modify temporarily our use of institutional and agency services toward sustaining the natural tendencies of families to care for that dependent family member in a familiar home setting.
This may not have to be an around the clock venture. Consider care provided by a part-time caregiver during the peak hours when physical needs can be given along with other essential duties such as preparing a meal.
There may be times when a family can split up the day to prepare a meal while others can perform light shopping or just provide comfort care by reading to that elderly person, or watch television together.
I am not suggesting this as an easy solution, considering what ongoing caregiving can cost or if family members might not always be available, but it may delay institutionalization for a more happy elderly person at knowing he is still in familiar home surroundings.