Who will take care of us when we are old and frail?
The answer has remained constant for centuries: Your grown children.
Maybe not in their home, but in their hearts, minds and actions until the day you die. You took care of them as babies, toddlers and teens. It’s payback time.
The baby boomer generation, those born between 1946 and 1964, might be the first generation unable to count on their grown children as caregivers, if they even had children.
It’s a new world, future oldsters. Get ready.
Becky Tiller grew up around all four grandparents near Nampa, Idaho. The grandparents often baby-sat Tiller and her siblings. When these family elders grew dependent, Tiller’s parents returned the favor.
“Three of my four grandparents ended up with dementia, and the family was there to help,” said Tiller, owner of Tiller Care Strategies in Spokane, an adult and geriatric care management firm.
From 1991 to 2001, Gail Goeller of Spokane oversaw the care of five family elders – her parents, her in-laws and an aunt. Goeller’s parents had role-modeled devotion to aging elders. When Goeller was a child, her widowed grandfather lived nearby.
“Every morning, my mom would see his hand come through the gate for breakfast. She knew it was part of the package,” remembered Goeller, author of “Coming of Age with Aging Parents.”
Family elder-care expectations were reinforced by religious teachings. Honor thy mother and father, and if you don’t, suffer some Catholic, Jewish, Protestant, Muslim, Hindu, fill-in-the-blank-religion guilt.
If one grown child was immune to this guilt, another could step in, because boomers’ families of origin were bigger than families now.
In 1960, the average fertility rate for women in the United States was about four children. By the 1970s, when many of the older boomers started having families, the fertility rate dropped well below two children, where it remains, according to National Health Statistics Reports.
Peggy Mangiaracina, 61, was a middle child in a family of nine kids.
Between 1996 and 2009, her parents faced serious health challenges. Mangiaracina’s mother underwent three hip surgeries. Her father had a stroke and eventually, Alzheimer’s set in.
Mangiaracina, a nurse who was vice president/executive director of Sacred Heart Children’s Hospital until her retirement in 2011, took family leave several times to fly back to central Minnesota to provide nursing care for her parents. There’s an old saying that one mother can raise nine children, but it takes nine children to care for one aging mother. In Mangiaracina’s family of origin, everyone pitched in.
“I had only about three letters from my father in my whole lifetime, but my dad wrote me a letter after Mom’s first hip surgery,” Mangiaracina said. “He wrote, ‘I can’t tell you what it meant to know you would drop everything in your life and come home and take care of Mom.’ ”
Mangiaracina and her husband, Mark, have two grown children. Neither lives in Spokane.
Goeller has two children. Both live in Spokane.
Tiller, who never married, has no children.
Baby boomers did not replicate the larger families they grew up in, and about one third of grown children no longer live in close proximity to their aging parents.
Those grown boomer daughters who many expected would step in to care for parents in older age? They are busier than ever.
Since the mid-1980s the number of women in the workforce has grown by 44 percent, according to a 2010 congressional report, and 70 percent of those working women are mothers.
“With the impact of the women’s movement, we could have it all: career, children, volunteering, staying fit, inviting dads to do more child care,” Goeller said. “Our daily tempo sped up, compared to the generation before.”
Despite the changing times, families still provide a good deal of care for aging parents. AARP reports that 42.1 million family members – men and women – now provide care to frail, elderly family members.
Aging baby boomers, however, might be the last generation prone to feeling guilty if they don’t come through for their parents. Young people are not as involved with the religious institutions that reinforced honor-thy-mother-and-father guilt.
A 2012 Pew Forum on Religion and Public Life report found that, among adults younger than 30, one-third were not affiliated with any religion.
Guilt, so far, is alive and well.
“I hear a lot of ‘shoulds’ and ‘this is my responsibility,’ ” Tiller said. “I do a lot of counseling with the adult children about not assuming responsibilities they can’t fulfill. A lot of them are not geared to be caregivers. I tell them they would have a better role overseeing the care, not giving the care.”
Some aging baby boomers won’t have grown children to depend on.
In the decades of peak childbearing years for baby boomers, the percentage of childless couples increased significantly, from 2.4 percent in 1982 to 6.6 percent by 1995, according to the National Center of Health Statistics.
If older boomers can’t depend on grown children, where will they turn?
“They’ll establish nontraditional relationships,” Tiller predicted. “You’ll see the ‘Golden Girls’ motif. People will live communally.”
New immigrants to the United States might be key caregivers.
“Right now we have a huge population of Russian immigrants opening adult family homes,” she said. “There are more people coming from the old world, and they honor their elders. They are not afraid of changing incontinence briefs.”
Technology might provide care, too. So-called “granny cams” already allow children to keep a virtual eye on elderly parents, and a 2012 Journal of Aging Research report concludes that elder-care robots – still in the testing stages – will enable people to remain living at home.
Neither Goeller nor Mangiaracina expect – or even desire – their children to do hands-on care for them, but they are confident their children will walk with them in their old-age journeys.
Both women believe the younger generation will provide elder care in more creative and holistic ways.
“Part of what we gave our children was the idea that even if you didn’t come from a family of nine, you are part of a larger community,” Mangiaracina said. “When my kids went to Gonzaga Prep, they did food drives and other sorts of things. Maybe some of their generation will say, ‘I could go over to that lady’s house. I could do Meals on Wheels.’ They feel an obligation to a wider community.”