A Four-Generation Autoethnography of Caregiving for Older Family Members

Introduction

More than two thousand years ago, the Psalmist called to God for help in old age and sought protection from the wicked, unrighteous, and cruel members of society who wish to harm the old and weak. But for most of human history, family caregiving, rather than divine intervention, has been the primary source of support for the elderly (Reinhard, et al., 2008). In the United States in the 20^th century, various institutional support systems from government-run pension funds to private-care facilities emerged to “fill the gaps” in elder care, but families remain an important part of the support structure for older adults (Hess & Markson, 1991; Hummert & Nussbaum, 2001; Reinhard et al., 2008; Zawada, 2016). In recent decades, public policy has shifted away from institutional care to home care for the elderly. This aligns with what most people who need help with basic activities of living want. But it also has contributed to increasing reliance on family and friends for care at home and in the community (Feinberg & Spillman, 2019).

This chapter explores the changing roles of family caregiving for elders in the context of four generations of women, all in one family, who reached age 65 or older. That family is mine and those four generations begin with my maternal great-grandmother who was born Amanda E. Purser in 1880 and lived to age 94. She died in 1974, the year I graduated from high school. Her daughter, my grandmother, was born Earsie Floyd Brown in 1897 and died in 1984 at age 87. Her daughter, my mother, was born Betty Jo Boynton in 1924 and died in 2011 at age 87. I was born in 1956. I am now 67 years old and in good health. But I recently needed caregiving after surgery and am planning for additional caregiving needs in the years ahead.

The lives of these four women span a period of dramatic change in many aspects of life (from 1880 to 2023). The Social Security Administration in the United States suggests that four demographic changes which began in the mid-1880s rendered traditional systems of economic security for elderly and infirmed persons increasingly unworkable: the industrial revolution, the urbanization of America, the disappearance of the “extended family,” and an increase in life expectancy (Social Security Administartion, 2023). However, as Coontz (1992) points out, the “traditional extended family” was never as homogenous as nostalgic stories portray.

During the lives of these four women there were also dramatic changes to communication technology. As detailed below, those changes to communication played a significant role in managing family caregiving. My great grandmother was born four years after Alexander Graham Bell received the first patent for the telephone (Casson, 1911). My grandmother was born two years after Marconi sent his first Morse Code message via wireless radio (Barnouw, 1966). My mother was born in the decade when radio became the first broadcast mass medium (Smulyan, 1994). I was born a decade after television made its debut as a mass medium (Russell, 2002). My mother and I both lived into the digital age (Negroponte, 1995; Randell, 1973). She was an avid user of email. I have spent much of my academic career studying the impacts of digital technology on individuals, organizations, and society (See for example: Downes & McMillan, 2000; McMillan, 1998a, 1998b, 1999a, 1999b, 2002a, 2002b, 2005, 2007, 2010, 2019, 2023; McMillan & Childers, 2017; McMillan & Hwang, 2002; McMillan, et al., 2003; McMillan & Morrison, 2006).