The Availability of Care for Late-Middle-Aged Adults With Chronic ...

Importantly, the children of this cohort, particularly those born since 1966, are aging during a time of great economic uncertainty, straining their ability to secure even their own futures (Karner, 2001). It is unclear how this will affect their ability to assist functionally dependent parents in their time of need (Karner). At the same time, adults in late middle age are entering the years immediately preceding retirement amidst an endangered Medicare system, risking financial failure in the absence of sweeping reform. They are forced more than the current older generation to consider how they will support themselves for potentially 20 or more years past the traditional retirement age of 65.

Who Provides Care

Now that differences between the characteristics of the late-middle-aged adults and their older counterparts, their potential helpers, and their access to federal safety nets have been highlighted, we next turn to what we currently know about community-based care. This information is predominantly based on the study of older persons. An extensive body of research affirms that families provide the bulk of care to frail elders (e.g., Jette et al., 1992; Kemper, 1988; Stone et al., 1987, Wolff & Kasper, 2006). Spouses, if available, are the most likely to provide care, followed by adult daughters (Messeri, Silverstein, & Litwak, 1993; Wolff & Kasper). Other kin (e.g., adult siblings) and nonkin provide much less hands-on assistance to individuals with functional limitations. When formal (i.e., paid) assistance is used by elders, it acts mainly as a supplement to existing informal care, rather than as a substitution for it (Penning, 2002; Tennstedt, Harrow, & Crawford, 1996). These findings support Litwak’s task-specificity model of care (Litwak, 1985).