Who will help you when you are old? Your family? Anyone else?
Professor Linda Chatters and Associate Professor Letha Chadiha have studied these questions to identify and support elderly African Americans and their unpaid caregivers.
They say that caregiving can come from a number of places—nuclear and extended family members, the church, and “fictive kin”—family friends who are so close, they feel like family.
Chatters’ research with husband and fellow School of Social Work Professor Robert Joseph Taylor is voluminous. During nearly twenty years on U-M faculty, including five at the School of Social Work, she has authored over sixty articles, twenty-five book chapters, and three books. In them, she talks about a broad range of issues involving African American family life, including the fact that there is a wide range of relationships that nurture the elderly.
Chadiha’s research has found that rural and urban elderly have different service needs and that family nurturing can help Black women caregivers feel less depressed. A former faculty member in the George Warren Brown School of Social Work at Washington University, she has been on the U-M School of Social Work faculty for six years. While on sabbatical in the winter of 2009, she will be writing a book about rural and urban African American female caregivers of older African Americans.
Chatters’ and Chadiha’s research is particularly topical because the population is aging. By 2030, nearly one in five Americans will be over age sixty-five.
However, the nation is not prepared to meet the social and health needs of elderly people, according to an April report by the Institute of Medicine.1 Therefore, informal means of caregiving by family and others will become increasingly important. The value of informal care that women currently provide ranges in value from $148 to $188 billion, according to the Family Caregiver Alliance.
Recently, Ongoing spoke with Chatters and Chadiha to learn more about their lives and their research.
Ongoing: What motivated you to go into your research areas?
Chatters: What motivated me in particular was an interest in setting the record straight. When we [Chatters and husband Robert Joseph Taylor] were being trained, we were aware of a lot of research on African Americans in the area of family and family support as well as in the area of religious involvement. But it was typically based on small and nonrepresentative samples, often from economically and socially disadvantaged groups. These portrayals were not particularly helpful in terms of understanding the diversity within the African American population.
Ongoing: What was your family upbringing?
Chatters: My family growing up in Los Angeles included a mother and a father, two sisters, and at various points in time, my father’s cousin came to live with us, my maternal grandmother lived with us, and a maternal uncle. The term used in academics would be “extended kin.” I was able to take advantage of national data sets looking at African Americans to get a broader assessment of how often and under what circumstances these types of arrangements existed within the African American population.
Ongoing: Did you use census data?
Chatters: I did my dissertation research on the National Survey of Black Americans. And more recently, data is available from the National Survey of American Life, which includes African Americans, Caribbean Blacks, and White Americans.
Ongoing: How do you find your research has helped you in your own life?
Chadiha: That is a difficult question for me to answer because my father died when I was ten years old and my mother died almost thirty years ago. However, I do think that my research with African American family caregivers has helped me help caregivers and elderly persons, but mainly caregivers, to validate their experiences.
Chatters: It’s helped for me to see that within my family, within the neighborhood in Los Angeles that I grew up in, there were a lot of different household compositions and family compositions and not to assume that the nuclear family is the only desirable form. My father was disabled. He had polio as an adult. My mother worked at the post office. I was in a twoparent family in which the woman worked and the husband did not work. I saw that that kind of family works as well.
Ongoing: Professor Chadiha, how did you get into your research area?
Chadiha: My career has been inspired and stimulated by practice issues in gerontology and other people in the field, namely a colleague at Washington University, Dr. Nancy Morrow-Howell. She got me involved with the St. Louis Alzheimer’s Association and its outreach efforts to the inner-city Black community, which led to my first gerontology research study, and it was during this study that I realized there was inadequate information out there about African American caregivers. I got interested in the area of connecting caregivers to services.
In another study, an intervention project with African American female caregivers of frail elders without Alzheimer’s disease, I used the narrative approach to help women in a focus group tell stories about their caregiving experiences. As a consequence of the women telling stories, they were able to see that they were not alone in their caregiving challenges. We used their stories to help them to problem-solve.
Chatters: Just hearing Letha talk about her work reminded me of kind of how I approach looking at large national data sets. It takes my reading someone else’s research to get ideas about where the relationships are in the data that I’m looking at. I’ll say, “Gee, I wonder who’s the primary caregiver? I wonder if there are secondary caregivers?” We did some early analysis of the support that older people report getting from their church networks.
Ongoing: What kind of support do people get from their church network?
Chatters: People just tend to say, “My church members do everything for me. They’re like family.” When we initially started looking at older people in church networks, we were finding that reports of receiving assistance tended to drop off as the person got older, and we wanted to know what was the nature of that. And we found that having an adult child seemed to make a difference. The adult child seemed to operate as a broker of services to the elderly person.
And let me just say, Letha, that I didn’t realize that our parental profiles were similar. My father died when I was thirteen. My mother died when I was in my thirties. We had a lot of older relatives live with us so that became, to me, normative.
Ongoing: Professor Chadiha, did you have relatives living with you as well? Or did you live with relatives?
Chadiha: I lived with relatives in what I would call a compound—next door was my half sibling with her mother, and another door down was a half brother, and my father’s sister lived with them.
I can relate to what Linda has said, about a piece of it—fictive kin. I don’t have any living biological parents. However, I have godparents. My godmother still lives in Alabama, in the country, where I grew up. I have been able to understand her situation through the lens of my experiences in my research.
For example, old people want to remain independent as long as they can and they will do everything that they possibly can to stay independent, and this woman epitomizes that person. She is eighty-eight years old; she lives alone in the country. If she calls 911, it will take a very long time for someone to get to her. She tells me that she’s wearing diapers but she prefers to stay in her house and wear her diapers than be in her daughter’s house and be told by her daughter what it is that she should do. I just find this amazing!
And to think of her situation in a larger context, she is relying very heavily on an extended church network. One of the deacons of her church looks after her, comes to her house every morning to ensure that she’s up and about and takes her to the local town, which is approximately fifteen to twenty miles away, to shop.
Before her husband died, everyone thought that she had Alzheimer’s disease. The woman was obviously stressed. She couldn’t remember anything. She’s now very lucid. She continues to drive to her retired schoolteachers’ meeting.
Ongoing: How do you see your research as helping the social work community?
Chatters: For the area of supportive relationships, whether it’s family or church, don’t suppose that support is available and that it’s sufficient. We need to think about whether a particular organization, whether it be a church or a friendship group or whatever, has the capacity and the willingness to provide assistance. We just need to ask the questions.
Chadiha: I would say that we should be asking the questions of the people we are addressing. In my case, it would be caregivers. Get the person’s perspective by asking direct questions, and I get it from my having them tell stories in a focus group.
Ongoing: How can our society care for the caregiver?
Chadiha: You care for the caregiver by providing services to the caregiver. Most of our services are set up to help the elderly person, such as daycare and respite care. And of course, that indirectly benefits the caregiver. I’d like to give a membership to the local gym so the caregiver can go there and work out. We were talking about this at a recent conference in Washington, D.C.
I think the one statistic that says we should care for the caregiver is knowing that many caregivers die before the older person. And they die from all that stress and strain and not taking care of themselves. There are going to be many more sixty-year-old people taking care of eighty-year-old people than we’ve ever had, unprecedented numbers.
Ongoing: Anything else you want to add?
Chadiha: No. I’m just wondering what’s going to happen to me!
—Debbie Eisenberg Merion, MSW ’78, is a writer and writing coach in Ann Arbor.
FOOTNOTE
1 Paula Allen-Meares serves on the committee that issued the Institute of Medicine report.