Caring for a centenarian parent: an exploratory study on role strains and psychological distress

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Excerpt

Caring for a centenarian is becoming a common situation due to the longevity phenomenon 1. Recent findings from all over the world highlight the increasing number of very old individuals who live at home, often close to or with family members. Findings from the Italian Multicentric Study, for instance, showed that 75.8% of the centenarians lived with family, whereas only 22.1% lived in old peoples’ homes 2. Similarly, in the Tokyo Centenarian Study 75.4% of the participants lived with family and only 21.5% were institutionalised 3. Somewhat lower percentages of centenarians living in private homes were found in the Georgia Centenarian Study (45.5%) 4 and in the first Heidelberg Centenarian Study (50%) 5.
Among community‐dwelling centenarians, co‐residence with family members is an important finding for understanding family demographics, social change and family care for the oldest old, that is those aged 80 and older. Nevertheless, despite the increasing awareness of the caregiving relationship established between centenarians and their co‐resident family members, knowledge on this caregiving situation is still limited 6. Two of the first and few studies with an emphasis on this experience come from Taiwan and Japan. Yang 9 explored the living conditions of centenarians and their care and support systems and found that a high percentage of centenarians lived with family members in their own homes, and highlighted the concept of ‘symbiotic care’. According to the author, the term described the tightness of the care relationship in Taiwanese families, which are supposed to care and nurture the centenarian until death, no matter how high the costs. The second pivotal study regards the Tokyo Metropolitan Area and focused on the experience of 75 centenarians and their caregivers 10. This study found lower levels of anxiety and depression in centenarian caregivers than in a control group and also lower accumulated fatigue level, in spite of worse activities of daily living (ADL) abilities of centenarians and despite being older themselves. The study also found a high number of caregivers who rated their health as very good to good (more than half). Taken together, findings from this last study made the authors suggest that these caregivers perceived their work as worthwhile and satisfying, and that the situation of centenarian care might be a possible model of successful care. However, in the study by Freeman et al. 11 where 55% of the centenarian caregivers were children, they found that caregivers of centenarians do not exhibit less burden or depression levels than caregivers of octogenarians and nonagenarians.
Because of the advanced age of centenarians, family carers are likely to be relatively old 6 and have as care‐receivers centenarians who are relatively frail 12. In addition, they may be maintaining the role for several years and throughout an unexpected period of their lives, which can lead to a long strain on personal ageing trajectories 13 and on family resources 14, making the overall experience a particularly stressful one. Nevertheless, the limited knowledge on these late‐life caregiving relationships does not allow to categorically affirm that caring for a centenarian parent involves distinct features when compared to the care provision of older person with a younger age.
Considering that anxiety, depression and caregiving burden are the most common negative outcomes of providing care for a frail older person 15, this study aims to explore the presence of such symptomatology in a sample of centenarians’ offspring who assume the role of main care providers. In addition, allowing for the dearth of available information on this caregiving experience, the study complementarily explores its overall impact in the children's life.
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