Why Daughterhood?

I was trying to explain to a male colleague why I was naming my new (at the time) website “Daughterhood.org.” He’s an expert on aging and shares responsibility with his sister for their mother’s care. So, I wanted his advice on creating a resource that helps families care for their parents.

When he heard the name of the website, his first reaction was: “So this isn’t for me?” A couple of other men were confused too.

They thought I was being impractical. Why would I go to the trouble and expense of building an organization to help people manage their parents’ care and then name the website in such an exclusive way – potentially losing half of an audience who would benefit from the information and resources.

The Numbers

It’s a fair question, and it got me thinking about the differences between how men and women approach caring for their parents. The biggest difference starts with the numbers.

It’s an undisputed fact that, in caring for frail, elderly parents, women are doing more unpaid work. Survey data analyzed by my colleagues, Rich Johnson, and Josh Wiener, reveal that daughters account for about seven of every ten adult children who help their frail parents. And five of every six assume primary responsibility for the day-to-day, in-the-trenches, labor-intensive duties that keep a parent dressed, fed, bathed and out of a nursing home bed.

But anecdotally, I know a lot of men do heavy lifting too. They manage finances, haggle with doctors, hospitals and insurance companies. They research and make decisions about where, who and how paid care will be delivered. Some also do hands-on daily care.

And, while there may be fewer men providing and managing their parents’ care, they worry about their parents just as much as women and they’re as deeply affected as women by the burden of responsibility and the experience of witnessing their parents’ loss of independence and dignity.

The Difference I Worry About

The relative contribution between men and women of money, time and stress are important – in particular, the loss of earned income, career advancement and retirement savings that comes with the extra, unpaid work That women do. I also worry about how parental care aggravates a more subtle and insidious gender difference that plays out in other aspects of women’s lives.

This difference – the “not.good.enough.try.harder.please.everyone” – is expressed really well by Lisa Miller in the last paragraph of her article, Stop Blaming Women for Holding Themselves Back at Work. She says,

“Try harder. That’s the message that women hear all around. Try harder to be happy. Try harder to be skinny. Try harder to be a good employee, mother, wife, daughter, friend. Try harder to feed your family nutritious meals and to give your child every possible opportunity. Try harder to find “flow” at work. Try harder to succeed…… when there’s a whole lot of trying without commensurate succeeding, then you have to start to consider that the game is rigged.”

This is an important observation relative to our health and elder care systems because they are truly, truly rigged. As a family member caring for elderly parents, it’s almost impossible to feel good about the job you do. The complexities of the situation require professional skills. Unfortunately, most of the medical professionals assisting in these areas: doctors, hospitals, insurance companies, nursing homes, and assisted and independent living facilities … have an extremely NARROW view of their responsibilities.

What do I mean by “narrow?” I mean that our health care system, by and large, works well with technical problems but is terrible with complex problems. And frail, elderly people have tremendously complex lives. Their needs cross-cut basic tasks of living, medical care and emotional and family issues. The professionals participating in the health and elder care systems just aren’t trained to look across these domains.

If your healthy, vigorous 70-year-old dad needs a heart valve replaced: you’re in luck. There’s a surgeon out there who is a great technician. However, if your confused 82-year-old mother ends up in the hospital because of stomach problems, she’ll get an endoscopy and NOT the nutrition counseling or meal preparation she needs at home to prevent her from eating spoiled food. Also, her physician may not delve into the root cause of the confusion:  Is it her medications? Are there too many? All this will be up to you to find out.

This leaves you performing professional duties without the requisite skills. If a boss gave you a job you weren’t qualified to perform without any support and then told you that your family’s well-being depended on you, we could safely say you are set to fail. At the very least you’d certainly be set up for an ulcer.

A typical man responds: “This situation stinks.” A typical woman responds: “I’m failing.” What’s worse, the woman will perceive herself to have failed her parent.

It’s this toxic blend of self-reproach and a dysfunctional elder care system that warrants a community dedicated to women. It’s called Daughterhood because I want – first and foremost – to convince my girlfriends – women caregivers and managers – that we are up against a mighty wind, AND that our efforts ARE good enough. Working together, we can do something about this, creating a sense of ease and control. If men want to be part of it, all the better – I want men to be part of this conversation.

flickr//geekounet

A Profile of Frail Older Americans and Their Caregivers, The Retirement Project, The Urban Institute, Occasional Paper Number 8, February 2006.