Listen to Me: Noncaregiving Adult Children's Needs From Healthcare Providers
Repository Posting Date2017-07-25T20:17:42Z
Author DetailsMunira Wells, PhD, RN; Connie Rutan Kartoz
Lead Author Sigma AffliationLambda Iota
Other Title(s)Promoting Health Globally
Level of EvidenceN/A
Purpose: Based on findings from a phenomenological study, the purpose of this abstract is to present the ways in which nurses can assist non caregiving adults to navigate a life-stage that involves independent but aging parents. Extended lifespans, globalization and transnational migration will significantly reshape twenty-first century societies (Horn & Schweppe, 2015; The United Nations, 2015). In the United States, more than half the population may live up to 80 years of age, with much of that time in a relative state of good health (Arias, 2015). Adult children can expect to spend time as equal adults in this non-caregiving relationship with their aging parents. For adults with healthy and moderate to highly functioning, independent parents, this time is not defined by the stress associated with caregiver burden, but it does have its own characteristics that impact upon the emotional and physical health of these aging families. It is important for healthcare systems and specifically nurses to recognize this new aspect of the family life course. As healthy aging is a relatively new phenomenon, little is known about the lived experience of adult children with aging parents. There is however, data to suggest that the quality of the pre-caregiving intergenerational relationship and planning for caregiving can improve clinical outcomes for the aging family during caregiving (Quinn, Clare & Woods, 2012; Fowler & Afifi, 2011).
Methods: A descriptive phenomenological approach was used to analyze interview data obtained from study participants (N=16). After IRB approval, purposive and snow ball sampling yielded sixteen participants who met inclusion criteria (English speaking, non-caregiving adult children with at least one living parent over the age of 65). Upon data saturation, the sample consisted mainly of females (75%), aged 30 to 60s, and living in the east coast of the US. Three of the participants had parents that lived transnationally in Asia (1) and Europe (2). Two in-depth, semi-structured interviews, ranging from 45 to 90 minutes were conducted and transcripts were analyzed independently by the two investigators. Joint review confirmed emerging themes.
Results: Data analysis revealed that despite self-identifying as individuals who were not caregivers, adults did, in fact, provide care to aging parents. While asserting that parents were independent, participants described activities that ranged from minor chores (taking parent shopping) to larger, more time consuming activities (accompanying parent to medical appointments and managing finances). Participants also engaged in a constant, often unconscious, evaluation of changes in parents’ functionality and health, resulting in feelings of worry and concern related to potential loss of parental good health and independence. In addition, participants identified shortcomings in a healthcare system that often provides care in silos and communication between parents, healthcare providers and adult children is fragmented or absent. Lack of communication was a particular issue for participants whose parents lived internationally. Adult children want healthcare providers to avoid making assumptions about their aging parents, and to actively acknowledge individual and cultural differences. The creation of a new role of care navigator was raised by several participants. Lastly, the need for health care providers to identify and assist in self-care activities of adults with aging parents emerged.
Conclusion: These findings confirm previous studies that show adult children spend time assessing their parents for possible needs (Fingerman, Sechrist & Birditt, 2013) and also support the idea that definitions of caregiving are variable (Van Durme, Macq, Janmart & Gobert, 2012). The desire for more effective communication suggests that adult children welcome input as they anticipate a potentially stressful demand for care and support of parents. This also raises significant questions of how nurses will communicate with adult children living internationally. As globalization and expanded lifespans are likely to continue, nurses who understand the needs of aging families from a global perspective will be most likely to provide effective anticipatory guidance for this life stage. Confirmation of findings with more globally diverse researchers and participants may provide insights into interventions to reduce strain and improve clinical outcomes in aging families across the globe.