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Neighbors, Friends, and Other Nonkin Caregivers of Community-Living Dependent Elders

^a Department of Anthropology, History and Social Medicine, University of California, San Francisco

Judith C. Barker, Department of Anthropology, History and Social Medicine, University of California, 3333 California Street, Suite 485, San Francisco, CA 94143-0850 E-mail: jcbark{at}itsa.ucsf.edu.

Decision Editor: Fredric D. Wolinsky, PhD

Objectives. To describe naturally occurring care relationships between unpaid, nonprofessional, nonkin (unrelated) caregivers and frail community-living older adults.

Methods. Face-to-face, semistructured interviews were conducted with a convenience sample of 114 caregivers and care recipients recruited from the community through a variety of organizations. Standard techniques for thematic analysis of qualitative data were used along with descriptive and other statistics as appropriate for numerate data.

Results. Nonkin caregiving proved to be heterogeneous in initiation of relationship, form, duration, tasks performed, and association with family caregivers. Partnerships ranged from 0.1 to 57 years in duration, with just over half (58%) starting with the provision of care. Many caregivers (47%) were themselves older adults, aged 65 or older. There was little variation in what motivated or rewarded caregivers, many of whom felt morally obligated to help. More than half the sample used kin terms to characterize their relationship. Four distinct styles of relationship were discerned, varying by degree of emotional intimacy and types of assistance given. All relationships, however, involved socializing and help with at least two instrumental tasks of daily life.

Discussion. This kind of caregiving is important for sustaining community living for about 10% of frail elderly persons. A greater understanding is needed, from both theoretical and practical perspectives, of when and how nonkin relationships are beneficial and why they in many ways successfully mirror the actions and sentiments of family caregivers.