Caregiving: A Family Responsibility

By Kevin Brown | Bio

Recently I was reading a blog post by Paul Span and the associated stream of comments in the New York Times concerning the use of contracts between a family member providing care, a family member receiving care, and other family members. I must say that initially I found the idea of a contract somewhat disturbing. I realize that the idea bothers me because I hold the view that a family caregiver should be approaching caregiving out of a sense of responsibility, love and compassion. Imagine if our parents could have entered into a contract for parenting in which their time invested was logged and at some future point we (the children) would have to pay our parents for their time and out-of-pocket expenses. Silly, you might suggest, because our parents chose to have us and therefore should not be entitled to be reimbursed. Well, what about those adults who choose parenthood and then expect to have their daycare costs subsidized by the tax payer? This can be a very slippery slope indeed.
Having identified my bias and my view of how things should be, I do acknowledge that aging parents and family members providing care is ‘just what’s so’ and I choose to accept that. In this space, I can see the value of some formal understanding (which could indeed be a contract) between those receiving care, those providing care and services, and any remaining family members who may not be in a position to provide care and services.
Caregiving can be a daunting responsibility. Whether it is the surrendering of one’s time, money, energy or emotion, there is much that a family caregiver contributes to an aging parent. In short spurts, this can we a willing and fully knowledgeable contribution. However, in many cases, the provision of care can extend over a number of years to the point that caregiving can place a significant physical and emotional drain not only on the caregiver, but also on the caregiver’s spouse and family members.
Just contemplating a formal agreement invites everyone to fully consider all that is and may be involved as the provision of care extends over time. The question of whether time should be compensated, or whether expenses incurred by the caregiver should be reimbursed, the consideration of food and lodging, transportation expenses to cover, doctors appointments, etc. could all be considered. In fact, it can get even more complicated if the caregiver also has ‘Power of Attorney’ or is an executor of the estate. Then consideration should be given to a semi-annual financial report prepared and provided to all family members.
All too often, the approach to providing care by family members remains informal. This often leads to strained relationships when the responsibility for care is not equally shared. All too often, things get left unsaid during the life of the aging parent, so as to not create tension for the one being cared for. Sadly, this often changes once the family member passes on. Then, when it comes to the estate, all the issues of the past can surface creating hurt feelings and strained relationships.
At the Eldering Institute, one of the principles of Eldering is SERVICE. In the service of others, Elders care deeply and are connected to other people. Elders create more space and possibility for others. We contribute the best of who we are in a way that empowers others and we are valued for our contributions.

In the service of others, all members of a family can be responsible for the manner in which care is provided and recognized within the family unit. Agreeing up front what care is to be provided, by whom, what expenses will be compensated, and whether a reporting of finances is appropriate can empower those providing care and ensure that their contributions are valued long after the services are no longer required.

Should you and your extended family be entering a period in which family caregiving will be present, I recommend the Eldering principles for your consideration.

© 2009 Kevin Brown. All rights reserved.