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Study: Reach Out to Male Caregivers

 

Women currently still outnumber men as the family caregivers, but this is shifting across countries from Europe to North America, including Canada.

The shift means that there are increasing numbers of older men caring for their spouses. However, few studies have looked at this growing, but under-recognized group.

New research, based on written narratives from 19 men caring for a spouse in the
northwest of England, has found that older men experience caregiving differently from older women.

The men studied, aged 56 to 89, spent a period of between 10 months and 30 years caring for their wives.

Most were retirees or had given up working to care for their wives full-time. Men came from diverse backgrounds, including a factory worker, physician, farm worker and managing director of his own business.

The qualitative study also drew on in-depth interviews with a range of service providers to understand how the men used these services.

Christine Milligan and Hazel Morbey from Lancaster University reported their findings in the August, 2016 online issue of the Journal of Aging Studies.

Male approaches to caregiving

Findings suggest that older men approach the practical aspects of caregiving by drawing on their prior working lives.

For example, "Jeffrey," a former factory worker, took a problem-solving approach.

His wife's degenerative disease meant that she was increasingly unable to cope with everyday tasks. Instead of doing them for her, he applied his knowledge and skills to make adaptations to the house, inserting swing doors, raising taps and adapting toilet seats, in order to facilitate her prolonged independence.

He also replaced difficult to manage buttons on his wife's clothing with Velcro in order to make it easier for her to dress herself.

"Joseph," a retired scientist, took a similar approach. On a trip to Iceland, he and his wife discovered that the hot water pools had healing properties that temporarily relieved her pain. When they returned home, Joseph used his scientific knowledge to replicate the effects of the hot pools within their home.

From another angle, the findings suggest men may be more reluctant than women caregivers to reach out for support, often waiting until they face a crisis.

"Ben," for example, had been caring for his wife with dementia for over five years. Ben convinced himself that he was coping "despite the fact that 'bad' days were becoming far more frequent than the good, that my fatigue was increasingly expressing itself in impatience, intolerance and harsh words."

One day, Ben found himself walking repeatedly by the office of a social service organization. Finally, he turned around and walked in.

According to service care professionals, only nine of 101 people referred to one service were older males caring for a spouse.

And, even when the men were offered assistance, most refused, hastening to reassure "We're fine, we're fine."

Service providers say many men do not identify themselves as caregivers but as husbands looking after their wives. As a result, they may perceive asking for help as a failure to provide adequately for their spouses.

Coping strategies

For some participants, coping meant adopting a "can-do" attitude. For instance, "Peter" claimed his training in the armed forces helped him to keep going even when he felt overwhelmed.

Another participant, "Edward," said retaining some of his farm work gave him an outlet:

We are very blessed in having the farm as it gives "Rosemary" a nice place to live and I am usually not that far away should she run into trouble. It also gives me an interest so that I have no need to seek respite.

At least four men in the study found comfort in their religious faith, and the support of church members.

To cope, others turned to activities close to home, such as yoga, dog walking, writing or listening to music.

What is the impact of caregiving on older men?

Findings suggest that the caregiving experience can have a significant impact on older men's sense of self and identity.

For one thing, the men's social world contracted after their wives became ill. Many were no longer able to join their male friends for social activities. For some, this led to feelings of isolation.

The men's narratives were peppered with comments relating to stress, self-doubt, and mental and physical exhaustion. Yet they seldom spoke to others about their caregiving responsibilities.

"Alistair", who turned to counseling for emotional support was uncomfortable sharing his need with friends. "I guess it's a 'man's thing,'" he wrote. "But it's a real obstacle to overcome – for me at least."

Shifting care landscape

Early studies suggest older men experience care-giving differently from older women caregivers.

Yet resources for carers today are largely targeted to women.

Participants say social service agencies emphasize domestic work like cooking, cleaning, shopping and so forth, in assessing needs. Little attention is given to housing adaptations, paper work or the practical jobs that men usually do.

Jeffrey adapted the home to suit his wife's needs, and even took dressmaking classes to learn how to alter clothing, so she could dress more easily. However, his contribution garnered little recognition, even from those close to him.

"You're on a permanent holiday," one family member told him. "You just sit at home and do this, and you don't work do you?"

Reach out

With an aging population and more older men caring for ill spouses, what needs to be done?

Milligan and Morbey say community services must work harder to reach out to male caregivers.

The authors want new research to focus on older men's unique needs, contributions and challenges, as spousal carers.