Gender Differences In Caregiving Among Family

Gender Differences In Caregiving Among Family

All over the world women are the predominant providers of informal care for family members with chronic medical conditions or disabilities, including the elderly and adults with mental illnesses.

It has been suggested that there are several societal and cultural demands on women to adopt the role of a family-caregiver. Stress-coping theories propose that women are more likely to be exposed to caregiving stressors, and are likely to perceive, report and cope with these stressors differently from men.

Many studies, which have examined gender differences among family-caregivers of people with mental illnesses, have concluded that women spend more time in providing care and carry out personal-care tasks more often than men. These studies have also found that women experience greater mental and physical strain, greater caregiver-burden, and higher levels of psychological distress while providing care.

However, almost an equal number of studies have not found any differences between men and women on these aspects. This has led to the view that though there may be certain differences between male and female caregivers, most of these are small in magnitude and of doubtful clinical significance.

Accordingly, caregiver-gender is thought to explain only a minor proportion of the variance in negative caregiving outcomes. A similar inconsistency characterizes the explanations provided for gender differences in caregiving such as role expectations, differences in stress, coping and social support, and response biases in reporting distress. Apart from the equivocal and inconsistent evidence, there are other problems in the literature on gender differences in caregiving.

Most of the evidence has been derived from studies on caregivers of elderly people who either suffer from dementia or other physical conditions. Similar research on other mental illnesses such as schizophrenia or mood disorders is relatively scarce. With changing demographics and social norms men are increasingly assuming roles as caregivers.

However, the experience of men while providing care has not been explored adequately. The impact of gender on caregiving outcomes may be mediated by several other variables including patient-related factors, socio-demographic variables, and effects of kinship status, culture and ethnicity, but these have seldom been considered in the research on gender differences. Finally, it is apparent that methodological variations in samples, designs and assessments between studies contribute a great deal to the observed gender differences.

This review highlights all these issues and concludes that there is much need for further research in this area if the true nature of gender differences in family-caregiving of mental illnesses is to be discerned.

Women form the bulk of those who provide care for people with mental illnesses. Many studies have found that they are more exposed to caregiving stressors and report greater strain, burden and distress than men.

However, the evidence for such gender differences in caregiving is equivocal and inconsistent leading to the view that caregiver-gender explains only a minor proportion of the variance in negative caregiving outcomes. Moreover, the evidence is not representative and often methodologically flawed. There is, thus, much scope for further research to understand the true nature of gender differences in family-caregiving of mental illnesses.

Worldwide, nearly 70% to 80% of the impaired elderly are cared for at home by their family members. Varying estimates across different countries indicate that 57% to 81% of all caregivers of the elderly are women. In most cases female caregivers are wives or adult daughters of the elderly person.

They are usually middle-aged, with a considerable proportion of them being over 65 years themselves. They are also more likely to be employed outside home than in the past. The elderly recipients of care are either frail or chronically physically ill; the majority, however, have dementia or other forms of mental illnesses. Despite the preponderance of women, increased life expectancy, more women working outside home, and smaller families have all increased the pressures on men to assume roles as caregivers of the elderly.

Studies in the eighties in the United States suggested that though women predominated as caregivers, somewhere between 20% and 33% of the caregivers of the elderly were men. More recently, it has been reported that the proportion of men providing care for the elderly has been steadily increasing, so much so that men may constitute nearly half of the primary caregivers of the elderly.

Despite the increasing emergence of men as caregivers, research has not taken into account this trend and continues to maintain its traditional focus on female caregivers. Although it appears that men approach caregiving differently, the experience of caregiving among men has not been examined as often as it has been among women.
Time spent on caregiving and the duration of caregiving: Gender-differences in the time spent on caregiving have been considered in several reviews and studies on the subject. Some of them have concluded that despite conflicting reports, the bulk of the evidence indicates that women devote greater time to caregiving for the elderly, compared to men.

In a comprehensive narrative-review of 30 research-reports, Yee et al concluded that the majority of studies which had examined gender differences in the time spent on caregiving had found that women spend more time on caregiving than men. Explanations based on the gendered nature of paid work have argued that women are more likely to care for the elderly because they are less likely to be employed outside home.

Women’s work roles are viewed as being centred in the home and may reflect a greater sense of family obligation among them. This increases the likelihood of women spending more time providing care. Time-intensive care among women is also more likely in those societies and cultures, which endorse the traditional value of the woman as the natural caregiver.

However, research findings about gender differences in the time spent on caregiving have not always been consistent. A number of reviews and studies have not found gender to be a significant predictor of the time spent on caregiving.

In particular, two meta-analytic reviews on the subject, one of which included 229 studies, have concluded that though women spent more time on caregiving, differences between men and women in this regard were small and of doubtful practical significance. There is also considerable agreement that gender differences in the time spent on caregiving are confounded by several other variables such as kinship (spouses vs children), and cultural or ethnic influences. Regarding the duration of caregiving, there is far greater consensus that gender does not have an impact on total duration of caregiving.

Types of tasks: The literature on gender differences in the type of caregiving tasks has also yielded conflicting findings. A distinction has been made in this literature between tasks associated with personal care such as bathing, dressing and managing incontinence, and tasks associated with management of everyday living.

Some studies have found that women are more likely than men to provide assistance with tasks related to personal care, while others have not reported similar gender differences reviews on the subject have also concluded that gender differences in the types of tasks have only been reported in some but not all studies, and only for tasks related to personal-care. Female caregivers are more likely than men to carry out these tasks.

Gender differences have not been found in tasks associated with everyday living. These conclusions were endorsed by two meta-analytic reviews, but these further concluded that gender differences in personal-care tasks were small in magnitude. Gender differences in the types of tasks also appear to be influenced by several mediating variables such as the patient’s gender and disability levels, kinship, caregivers’ marital and employment status, family composition, social class, and race or ethnicity.

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