Hochschild and Machung (1989) coined the term “second shift” to describe the double burden that women experience by being responsible for both paid labor and the large majority of unpaid domestic labor. This unpaid domestic labor, by definition, includes childcare and housework (Hochschild, 2012). Even within heterosexual couples who have a more equitable allocation of domestic work, women consistently have responsibility for household tasks while men typically can choose when they contribute (Hochschild, 2012). Despite the far-reaching influence of the second shift on feminist ideology, little attention has been given to informal caregiving for older adults as another part of the domestic labor that women do. The growing number of women providing care for older adult family members represents a “third shift,” as described by Dorres-Worther (1994).
More than 25 years after Dorres-Worthers (1994) called attention to caregiving as a “third shift,” many second shift tasks have become more equally distributed across genders; however, caregiving remains a task predominantly maintained by women (Institute on Aging, 2016). The population of older adults in the United States is growing. By 2030, 20% of the U.S. population will be over 65 years old (Center of Disease Control and Prevention, 2013). Women caregivers to older adults (age 65+) are providing more care, may experience more emotional labor through caregiver burden and are confronted with more financial implications of caregiving in comparison to men (Institute on Aging, 2015; MetLife Mature Market Institute, 2011; Revenson et al., 2015). Disproportionate caregiving duties (i.e., the “third shift”) have a negative impact on women both financially and emotionally and will continue to do so into the future. Therefore, psychologists should devote greater resources and attention within our advocacy efforts to support women caregivers on the systems level and individual level.
Historically, in many cultures, caregiving for older or ill family members was a part of the private sphere where women held sole responsibility. For this reason, women may hold being a caregiver as an important part of their identities . Women may have higher expectations for themselves as caregivers and may be less likely to ask for help, as doing so would represent a threat to their caregiver identity (Abraido-Lanza & Revenson, 2006; Miller & Cafasso, 1992). In addition, women tend to use the pronoun “I” when speaking about caregiving duties, and men tend to use the pronoun “we” (Gerstel & Gallagher, 2001). This finding demonstrates that, when men are involved in caregiving, it is more likely to be in a complementary role to his partner, rather than substituting for women caregivers (Revenson et al., 2016). A caregiver identity may also be a source of resilience for women. Lin, Fee, and Wu (2012) found that long hours of caregiving were more stressful for men than for women.
The percentage of caregivers who identify as a woman is upwards of 75%, and cumulatively, women spend approximately 50% more time providing care to older adults than men (Institute on Aging, 2016). Women caregivers are more likely to make alternate work arrangements like taking a less demanding job (16%) or giving up work altogether (12%); the percentages for men caregivers are 6% and 3% respectively (The National Alliance for Caregiving and AARP, 2009). The New York Times recently reported that more than 60% of caregivers to older adults are also employed and "economists say the virtual absence of support for eldercare is a prime suspect in explaining why the share of women taking part in the labor force stalled in the late 1990s after rising relentlessly for 50 years" (p. 1; Porter, 2019).
Caregivers who identify as women reported more emotional distress, depressive symptoms, stress and caregiver burden in comparison to caregivers who identify as men (Pinquart & Sorensen, 2006; Revenson et al., 2016). Canetto (2001) connected the adverse emotional outcomes to task overload when she stated “caregiving impinges on women's already limited resources, leading to emotional, physical and economic strain. Social contact and self-care may be reduced, due to task overload” (p. 189). Cultural norms and caregiver role perception may influence caregiver outcomes and coping styles. For example, Latinx and Caribbean women caregivers who believed caregiving was a “family duty” reported more burden and depression than male caregivers (Friedemann & Buckwalter, 2014). In the same study, women who felt freer to define their caregiver role within their already established personal life (rather than as an obligation) were less vulnerable to emotional and physical health problems (Friedemann & Buckwalter, 2014).
In conclusion, greater resources and attention within psychology advocacy efforts should be directed toward supporting women caregivers on the systems level and individual level. One possible way to increase advocacy on the systems level is to write or email a letter to your elected representatives (on federal, state or local levels). Track relevant policies and legislation through the following resources: National Alliance for Caregiving, National Respite Coalition, Consortium for Citizens with Disabilities, American Psychological Association Advocacy for Caregivers and the Alzheimer's Association.
Advocacy could also take the form of supporting caregivers in your own life through providing respite opportunities, social and emotional support or affirming agencies in your community that are already doing this. Furthermore, information presented in this review should inform those in clinical practice with women caregivers to recognize potential indicators for caregiver distress and task overload and a reminder to promote self-care and coping strategies. Resources on the individual level may include: Community Resource Finder from Alzheimer's Association & AARP, Memory Café and Family Caregiver Alliance State-by-State Help for Family Caregivers, among others.
It is important to show support to women caregivers, clients or community organizations in your own life by first asking what they need. Every individual caregiver, family system or community organization has both unique needs and unique points of resilience. No matter how you choose to engage, doing so will increase the visibility of women caregivers in the United States who are working an unpaid “third shift.”
About the Author
Anastasia E. Canell, MEd, is in her third year of Lehigh University's counseling psychology doctoral program. Her research interests focus on the experiences of young, informal caregivers to older adult care-recipients and the effects of ageist attitudes within caregiver populations.
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