Caregiving

Caregiving can be defined as providing assistance and support to family members in need. The type and amount of assistance and support required fluctuates throughout the life span. In the context of aging, care-giving commonly refers to caring for an older adult with a chronic illness or a functional disability. It is estimated that between 45 million and 52 million adults in the United States engage in unpaid family caregiving for older relatives.

During the past century, medical advances greatly reduced the incidence of deaths related to acute causes. As the number of older adults surviving formerly fatal conditions (and thereby living with disabilities) increases, so too does the number of family caregivers. In fact, rather than dying more rapidly from acute causes, the pathway to the end of life now more commonly begins with a chronic disease leading to one or more functional disabilities andeventually to death. This shift has meant that currently older adults live longer and with more functional disabilities than at any time in recorded history. The number of family caregivers is expected to continue to rise in accordance with this shift.

Most researchers define caregiving as providing assistance with activities of daily living (ADLs) and assistance with instrumental activities of daily living (IADLs). ADLs involve personal care such as getting in and out of bed or a chair, dressing, toileting, bathing, and feeding oneself. IADLs are tasks common in everyday life such as paying bills, grocery shopping, and preparing meals. The majority of caregivers assist the care recipient with more than one activity. Although most caregiving research is based on function, there is also disease-based research that focuses on health- and quality of life-related issues specific to the care recipient's disease. Regardless of whether the focus of care is on a functional disability or a disease state, there appears to be great variability in the type of assistance provided by caregivers.

Although the caregiving literature has devoted considerable attention to caregivers for Alzheimer's disease patients, older care recipients also commonly suffer from cancer, diabetes, mental illness, heart disease, and stroke. Many elders are affected by multiple ailments simultaneously, serving to complicate care regimens and magnify the burden on caregivers.