Dr. Mónika Lopez, Associate Professor of Economics at Connecticut College, explores family caregiving with a focus on the expanding role of men as caregivers. Dr. Lopez looks at caregivers and care recipients as a partnership and examines how gender and culturally-based differences impact this dynamic—made stronger by a more supportive community. Learn why we need to take care of the caregiver and find out where the future of family caregiving is headed.

 

Dr. Mónika Lopez, Associate Professor of Economics at Connecticut College, explores family caregiving with a focus on the expanding role of men as caregivers. Dr. Lopez looks at caregivers and care recipients as a partnership and examines how gender and culturally-based differences impact this dynamic—made stronger by a more supportive community. Learn why we need to take care of the caregiver and find out where the future of family caregiving is headed.

 

English Transcript (below):
Transcripción Española

Roseanne Azarian:  Welcome to Front Door, a My Place CT podcast. My Place CT.org is a free, web-based resource from the State of Connecticut that helps people live life independently. It brings together information to help people live how and where they choose. Learn more at MyPlaceCT.org. 

Hi, I’m Roseanne Azarian, the host of Front Door, where older adults, people with disabilities, and the professionals who help support them come for information and inspiration.  Subscribe to Front Door on i-Tunes or the Apple podcast app, Stitcher, Google Play, or wherever you get your podcasts. Front Door is a production of the Connecticut Department of Social Services and Mintz & Hoke.

In today’s episode, we look at the role of family caregivers with an emphasis on men as caregivers. Here to tell us all about it is my guest, Dr. Mónika Lopez, Associate Professor of Economics at Connecticut College. Mónika, welcome to Front Door.

Dr. Mónika Lopez:  Thank you. 

Roseanne:  Traditionally, women have filled the role of the unpaid family caregiver. Now we’re seeing more men join the ranks. What’s behind this shift?

Dr. Lopez:  Well, I think that there are three mains trends that are happening, right? The first one has to do with the reality, right? So, there are demographic factors that maybe parents only have boys, for example, right? There are also economic factors in which perhaps men and women are both participating in the labor force, so that doesn’t necessarily mean that he lady will automatically be the caregiver of the recipient. 

There are also geographic, proximity factors, in which maybe even though there might be two ladies and one gentleman as siblings, for example, that the gentleman is the one that lives next to the parents that need this care.

So also, we have the issue of research underestimating the role of men as caregivers for many reasons. There could be some methodological problems. Maybe the researcher automatically eliminates men in their caregiving sample or maybe they’re just asking the wrong questions and so men don’t identify with the research questions as well.

And finally, there’s just a trend in the norms of society, right? What is expected for me to do—how can I contribute to my family and my society? And men are stepping up. They’re just becoming more hands-on parents and relatives in general.

Roseanne:  Do you think though that men have always been participating but just never thought of themselves as a caregiver? More like, I’m the spouse, I’m the brother?

Dr. Lopez:  Absolutely. So that is also a very important thing that you’re bringing up because the word caregiver is somewhat loaded for some people, and men might just identify it with their family relationship more than with that role because what does it mean to care give? And so even though they might be performing and conducting the same tasks as women, women are more familiarized with that word because they are the natural caregivers in society.

But men, they might be feeding their parents and still not considering themselves caregivers—they’re just the father or the son of that person.

Roseanne:  So how do men care give? And did your research find gender and culturally based difference?

Dr. Lopez:  Yes, absolutely. Oh, and I also wanted to point out that if you look at statistics among millennials, there is an identical likelihood of men and women to care, right? So before now it’s about 40 percent of all caregivers are men.

Roseanne:  Really? Wow.

Dr. Lopez:  But now the percentage would be 50 percent. So, there’s no gender difference anymore. And in terms of gender and culturally based difference, I’d like to emphasize that, you know, “Men” is not a monolithic group, right, behaving homogeneously and identically. So just like gender has a component in caregiving, so does relationship, right—it’s not the same for spouse or a grandson to care for someone. And of course, if you add to that cultural backgrounds and generational expectations, then it’s even a more rich and heterogeneous type of, you know, dynamic. 

Having said that, there are certain patterns and, that distinguish men as caregivers from women as caregivers. For example, the research shows that in general, men have a more problem-solving kind of approach, right, they just want to get it done. And sometimes they have an initial desire to emotionally disconnect from the task at hand—they just want to get it done and not really reflect on how that makes them feel, even though they still have been, it’s been shown that they experience severe emotional burden that sometimes they actually hide, right, and they also under-report.

In terms of cultural differences, I don’t know many but I have carefully studied the Hispanics as caregivers, both men and women, and also a non-monolithic group, right, so we must remember that the term Hispanic was created by the Census. But there are 21 countries in Latin America. There’s Spain, which is in another continent. They have different historical and generational migration ties to the United States.

However, having said that, there are some things that Hispanic caregivers have in common, which is a sense of a collective culture. You know, I think the literature calls it “Familism”, right—the idea that your family is more important than you as an individual, right? So, they tend to assist—empirically speaking—they tend to assist longer periods of time, more hours, more frequently, and I believe that one in three Hispanic households is caring for someone right now. 

And so that’s good but it’s also problematic in that sometimes policies assume that Hispanic caregivers are all set, they don’t need any help because they’re so close. And emerging research has shown that we might be over-simplifying and over-generalizing this famil-istic power, and in fact Hispanic caregivers have a lot of, they have fewer support than non-Hispanic caregivers do. They’re a lot more isolated. They don’t ask for help. They don’t even know where to ask for help. So, this is actually quite problematic. Yeah.

Roseanne:  Well, it would seem though that they would need more help just in the the fact that they’re, as a group, doing more of the caregiving.

Dr. Lopez:  Precisely.

Roseanne:  Tell me a little bit about how you’re defining caregiving for the unpaid family caregiver.

Dr. Lopez:  Absolutely. So, I define caregiving as providing time and financial assistance. So, some examples, right? You can be a caregiver if you help with the recipient’s household chores, you provide companionship, you provide transportation, you shop for them. And then the more delicate ones—you provide personal care activities such a bathing, feeding, dressing, you’re also their medical advocates, right? You’re making sure that they, you’re managing their medications, their personal finances.

And sadly, but truly, a lot of the caregivers right now are increasingly engaging in medical activities that are rather complex like tube feeding and injections, and many times with very little training. So that is dangerous and overwhelming.

Roseanne: No, no question about that.  We know that caregiving has many positive and rewarding aspects.

Dr. Lopez:  Absolutely.

Roseanne:  What are some of them?

Dr. Lopez:  Of course. So, I mean, I think that caregiving provides lots of fulfillment. There’s also an aspect of gratefulness or reciprocity, right? You know, maybe one time you cared for me, now it’s my turn. There are some, some cultures also link caregiving to a religious or spiritual fulfillment, right—it’s what they’re supposed to do—you don’t abandon your family. 

And we also must remember that caregiving is a partnership, right, in which the care recipient is not a vessel without an identity, right? Oh, care recipients have a lot to give as well. And that’s why we’re very interested in both components or members of this partnership to be as strong and as supported as possible.

Roseanne:  Wow. Mónika, we’ll continue our conversation in a second. I just want to remind our audience to subscribe to Front Doors on i-Tunes or the Apple podcast app, Stitcher, Google Play, or wherever you get your podcasts. Tell us if you like what you hear and write a review. We’d really appreciate it. 

Roseanne: Caregiving can be positive and, and rewarding, yet it comes with considerable stress.

Dr. Lopez:  Right, so caregiving can be a very isolating role and a very long one.  Research is showing now that, you know, if you take care of a child—you know, hopefully a healthy child—basically it gets easier in the sense that they become more independent and let’s say, you know, that you take care of this child for 18 years and then they go to college, right?

In the case of caring for an elder relative, they’re gonna become more dependent on you and in fact now the research shows that you can be taking care of the same person for up to 25 years, for example, right. So, it’s more years of a debilitating type of situation, right. So, if you are isolated, if you have no support, it can be very taxing on you. If you don’t know what you’re doing—if you don’t have the, the appropriate caregiving skills or training, that will also be a trigger, and it will be manifested in those physical, financial, and emotional ways.

Roseanne:  When you talk about isolation, are you talking about, for example, the family caregiver has so much to do in the home and tending to that loved one that they don’t have time to go out. Are you also talking about when people just don’t know what to do—they don’t know if they should stop by or they’re the person that they remembered is not there. Is that isolation both ways?

Dr. Lopez:  Yes.

Roseanne:  Both sort of, both because I have so much work to do here but also because nobody bothers to look in on me cause they’re, let’s face it, uncomfortable.

Dr. Lopez:  And in fact, the research shows that there’s this, what is known as the desertion rate, where even the network of support that you have starts getting smaller and smaller, and the average of the number of people that abandon you, or let’s say betray you, is three per year.  Right? So that is a bummer and m-, and in addition, like you said, the caregiving can be a 24/7 type of activity depending on what the condition of the recipient is, so that also isolates you from your own friends and from your own activity.

Roseanne:  So what kind of supports are out there to enhance the caregiver experience for both men and women?

Dr. Lopez:  I’m a huge advocate for some sort of financial compensation, even if it’s small—symbolically it’s just conveying the message that caregiving is valued in society by private and public actors.

Roseanne:  But how about the emotional support?

Dr. Lopez:  Right. So that, actually this is a really interesting question because this emotional support is quite gender specific, if I may say. So, in the case of ladies, what we have observed is that, first of all, we women tend to be more vocal—we use more words per day than gentlemen do, and we are less afraid to show vulnerability amongst strangers let’s say, right.  

So, support groups have been proven very effective for women, right, to diminish isolation, increase some sort of solidarity. And those support groups can be in person or online as well, right? For gentlemen, support groups have-, have mixed evidence, right?  Many men—again, don’t want to generalize, right, but are not really comfortable sharing their feelings with strangers—not even with their own relatives.

So, it turns out that the emotional support that they, that might be more effective for them is actually to get some hands-on training, right, because if you feel capable and that you can do something, that will diminish those emotional stress triggers. So, men have been found to, you know, look online on “How do I bathe my mother?” Right, “I’ve never seen her naked but now I have to deal with her being embarrassed by me seeing her, and me being embarrassed by seeing her in that vulnerable position,” right. “How do I inject my mom?” “How do I provide some sort of post-relief chemotherapy,” or whatever it is I have to do? And that actually has proven to reduce their emotional burden. 

Roseanne:  Wow, for sure. On both sides—the person receiving the care and obviously the person providing the care—it’s a delicate situation.

Dr. Lopez:  Yes.

Roseanne:  And I can see why there’s a gender difference there—but for everybody it can be a delicate situation.

Dr. Lopez:  Absolutely, and not only gender differences, but I like to emphasize that role of relationship, right—it’s not the same to take care of your spouse than it is to take care of your grandfather, etcetera.  There are some interesting inherent power dynamics.

Roseanne:  Right.

Dr. Lopez:  If you look at taking care of say your partner or spouse, right, versus someone who is older than you, sometimes research shows that psychologically the former might be harder than the latter in the sense that, you know, when people are older you kind of expect that maybe they will get sicker sooner than you.

But when you taking care of your partner or your equal, right, not only is it, can it be very, very painful for you to see that person debilitating, but you might be losing a sense of your own identity cause you’re losing your partner as well.  So, you have to reconfigure…

Roseanne:  Ah, yeah.

Dr. Lopez:  …your own identity of who you are, right, as an individual and as someone that is maybe is part of a marriage—and that can also be very, very straining for that caregiver.

Roseanne:  Twenty years from now, what do, what do you think that family caregiving will look like?

Dr. Lopez:  I’m hoping that if you have more caregivers being part of the conversation and of the power of policy making, that it won’t be an issue of us versus them, right, where we’re just talking in abstract form about this group of people but it’s not affecting me.  I think that the more something affects many people, the higher the likelihood of h-, of having a more sustainable caregiving system.

Roseanne:  How can we best respond to the shift in where caregiving is going?

Dr. Lopez:  Yes. Well, I believe that first of all, who are we, right? So, we are the public and the private sectors, yeah.  And  I think that we must respond to this shift by convincing everyone that multi-generational issues affect us all, right—that it is actually worth to invest in them with time and money, and that we need to take care of our caregivers to ensure a healthier population for the recipients and the caregivers so that they are not neglected—because in my opinion if it takes a village to raise a child, it actually takes a country to care for our loved ones. 

Roseanne:  Makes perfect sense. Personally, I don’t think I could agree more.

Dr. Lopez:  Thank you.

Roseanne:  Thank you so much.

Dr. Lopez:  You’re most welcome. Thank you for having me.

Roseanne:  Thanks so much for listening to Front Door, a My Place CT podcast.  Please subscribe, rate, or review the show on I-Tunes.  And you can access all the episodes as well as transcripts and the show link at MyPlaceCT.org.  Again, I want to thank Dr. Mónika Lopez, Associate Professor of Economics at Connecticut College, for sharing her time with us.  So please stop by Front Door for our next episode. And remember, our door is always open.  Front Door is a production of the Connecticut Department of Social Services and Mintz & Hoke.  My Place CT is the virtual home of No Wrong Door.