C.

Elizabeth Barrette
EDUC 5339 Dr. Kristen Allman
April 16, 2016

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Field Observations Summary.
This assignment asks M.Ed. students to conduct field observation research into the
challenges many adults face in striking a balance between caregiving and employment.
Interestingly (before completing my full read of the assignment), my current role as co-caregiver
to an aging parent led to immediate reflections on the tasks and struggles inherent in balancing
the role of elder-caregiver with parenting/mentoring, achieving ones professional pursuits, and
effectively conducting ones personal self-care. Only at the end of the assignment protocol did it
become evident that the requested focus was on the caregiving-employment balance and its
effect on outcomes for children. This conclusion jump was and remains an intriguing one and
encouraged choosing a subject for this field study who is a caregiver operating at both ends of
the aging spectrum. The subject is the authors (this students) sister-in-law: she is a mother to
three grown adults, grandmother/co-caregiver to four grandchildren, full-time health care
consultant (who only recently began working from a home office), supportive spouse to a hardworking business co-owner, and part-time (and fellow) co-caregiver to an aging parent1. This
assignment asks that students delve into the subjects experience in balancing caregiving and
employment, particularly mindful of:

the most difficult elements of striking the balance;

effective strategies for countering those elements; and

the emotions associated with doing so.

1 Our recently widowed mother-in-law

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Students then are encouraged to offer personal perspectives on how an individuals caregivingemployment balance can affect childrens outcomes. In extending this research to both extremes
of the aging spectrum, this student will include reflections on how the caregiving-employment
balance affects outcomes for the eldercare recipient as well.
In researching an academic backdrop for this work, interesting trends appeared
concerning the publication timing of peer-reviewed articles. A non-comprehensive, initial search
for articles concerning the balance of caregiving and employment showed a notable publication
spike occurring throughout the 1990s that tapered somewhat in the early 2000s, then rose again
in the 2000-teens. This inspires deeper exploration to see if the pattern still holds true under
further scrutiny. World-renown developmental psychologist, Dr. Erik H. Erikson (1902-1994),
pioneered important theories on the psychosocial development of human beings and identified
four stages of adulthood. In discussing Eriksons third adulthood stage, Generativity versus
Stagnation, Dr. Kathleen S. Berger provides the following description: Adults need to care for
the next generation, either by raising their own children or by mentoring, teaching, and helping
othersAdults extend the legacy of their culture and generation with ongoing care, creativity,
and sacrifice (Berger, 2014, p. 632
As we moved into the 21st century, researchers underscored the importance of the
caregiver role. Caregivers are a critical national health care resource. Families often are a
primary source of home care and support for older relatives, contributing services that would
cost hundreds of billions of dollars annually if they had to be purchased (Arno et al., 1999;
Hayman et al., 2001; Langa et al, 2001). Berger defines and summarizes the importance of
quality caregiving for any age: Caregiving includes responding to the emotions of people who

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need a confidante, a cheerleader, a counselor, or a close friend (Berger, 2014, p. 651). Ideal
caregiving is conducted with simultaneous goals of respect of the individual and helping them
self-protect their health and well-being. Particularly for individuals in late adulthood, attitudes
toward aging can become a critical factor in the success of caregiving efforts -- for both the
cared-for and the caregiver. Succumbing to the perils of ageism2 can be insidious, seeping into
and eroding the older persons feelings of competence[the results of which] become a selffulfilling prophecy (Berger, 2014, pp. 668-669). Reaching back through time, Eriksons
observations tellingly support these more current conclusions. In 1963, he highlighted the
crucial importance of respect for the cared-for, emphasizing the criticality of honoring a mature
adults need to be needed (Erikson, 1963, p. 266).
With this as foundation, the assignment asks graduate students to interview an active
caregiver as described above. Notes and transcripted quotes for this interview can be found in
the Appendix.
Description of Activities
The primary subject for this field observation is a 63-year-old female, a degreed
registered nurse who transitioned from bedside nursing to serve as a senior field consultant for a
large medical insurance auditing firm. To permit greater flexibility in co-caring for both her (our)
mother-in-law and her four young grandchildren, the subject coordinated a telecommuter
arrangement with her company allowing her to work full-time from a home office. Questions for
the interview were adapted from the 2015 AARP3 National Caregiving Survey of Registered
2 the idea that age determines who you are, (Berger, 2015, p. 667).
3 American Association of Retired Persons

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Voters Age 40 and Older (Bonner, 2015). A transcript of the interview and notes are provided in
the Appendix.
Interpretation and Analysis
Though conducted informally, analysis of the in-field interviews coupled with key quotes
from the abovementioned video yield telling insights into the challenging, even strenuous nature
of balancing caregiving and professional responsibilities. The subject observed that her most
challenging factors are time and energy, i.e., there never seems to be enough of either. The stress
associated with keeping all bases covered stays at a high level. In discussing her most prevalent
emotions, the subject (with a deep sigh) reported
I had [a feeling of inadequacy] for years while taking care of my
own mother (before grandchildren)I kept coming back to,
Whats wrong with me? Im one of the most organized people I
know! And Im a nurse! This should be all in a days work for
me. Yet, its more than that. The endless, endless details required
in adequate record-keeping and monitoring of either home care or
nursing home care is so daunting. And thats what I do for a living,
really. Thats what I auditthe constant, 24/7, no-real-vacation
vigilance is exhausting. Especially in our present situation, the
fatigue (is that an emotion?) is a significant factor. Theres also
some guilt somewhere in me that wonders about the toll this is
taking on our marriages. You and I have strong marriagesstill, I
think the one-to-one time with our spouses frequently is
compromised or sacrificed. Thats applicable for caregiving
offered to both the kids and Mom.
The subjects reflections mirror Dr. Catherine Barbers summary in our class video, i.e.,
Accumulated stress takes a physical toll as well as an emotional one (Barber, 2015). It is
echoed in an insightful study by Drs. Richard Schulz and Paula R. Sherwood who observe
Caregiving has all the features of a chronic stress experience: It
creates physical and psychological strain over extended periods of

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time, is accompanied by high levels of unpredictability and

uncontrollability, has the capacity to create secondary stress in
multiple life domains such as work and family relationships, and
frequently requires high levels of vigilance Emerging evidence
suggests that other factors, such as the level of patient suffering,
may contribute just as much to a health decline in the caregiver
(Schulz & Sherwood, 2008, pp. 105, 111).
The Health decline in the caregiver particularly resonates in the subjects reflections. When
asked about her own self-care regimen, specifically exercise, her reply of, Exercise? Really?,
spoke eloquently and sadly to her belief that time for herself did not, could not exist.

Self-Reflection, Conclusions and Recommendations

The subjects observations are illuminating and, unfortunately, describe what I believe to
be all but a universal, i.e., most middle age adults, at some point, will have parental
responsibility for their parents or parent-like mentors; often this will be simultaneous to
grandparental responsibilities. There are signs of hope. Home health care options have been
blossoming in number and type over the past two decades, particularly. Senior independent-toassisted living facilities are also burgeoning in style and number nationwide. While these will
not entirely remove the responsibilities of hands-on caregiving by a family (or like-family)
member, the daily circumstances can be ameliorated. The subject is able to see the changes and
think they are largely an improvement, though we have miles to go. She observed, at both
personal and professional levels, that the number of companies allowing flex-time and
telecommuting options for those adding caregiving to their personal routine is steadily
increasing. She noted her own request and receipt of a telecommuting option so that she could
care for her grandchildren while her daughter and son-in-law were at work. This led to ending
our interview on a positive note. She noted, The benefit, especially with the kids, is that I feel

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were deepening our lifetime bonds, which is exactly what I want most. Continue to discover
and develop ways to deepen those bonds is a worthy goal indeed.

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Appendix
Caregiving~Employment Balance Field Observations ~ Notes
(Non-normative/qualitative; adapted using the University of Californias writing guide for field reports 4;
survey adapted from Aisha Bonners 2015 AARP5 National Caregiving Survey of Registered Voters
Age 40 and Older)

Introduction to the Interviewees: My task for this assignment is to focus on the key challenges
many adults face in striking a balance between caregiving and professional employment. This
interview will address your caregiving duties as a working adult and your experience juxtaposing
these responsibilities with your professional ones. I will include questions about the most
challenging parts of striking this balance, effective strategies, associated emotions, etc. The
information gathered for this study will be used to draw preliminary conclusions concerning how
educators might leverage these insights for creating more positive experiences for all concerned.
Your insights related to this topic will be particularly welcomed and useful. Your input will be
held in confidence and used for this assignment only. Moreover, you may decline answering any
questions as desired.
Subjects: E. M. B. (age: 63 years) ~ female
Date of field study: April 14, 2016
Observations:

Physical setting. An upper middle-class single-family home in rural Wisconsin.

Our FaceTime backgrounds were our home offices.

Use of language. Language was friendly, casual, familial yet professional. E and I were
completely at ease, even eager to share notes and impressions.

Behavior cycles. Were we not close sisters-in-law, I feel the behaviors would have varied
more widely. Because we are, Es and my behaviors were largely open, empathetic and
unchallenging.

The order in which events unfold. After a brief discussion of her children and
grandchildren, E and I followed the course of questions proscribed by the modified
AARP survey.

4 University of California. (2016, March 12). Writing a field report. Retrieved from
http://libguides.usc.edu/writingguide/fieldreport
5 American Association of Retired Persons

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Physical characteristics of subjects. We were both casually dressed.

Expressive body movements. Expressive body movements supported the language used
in conversation.

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Interview Notes:
For the record, would you please describe the typical caregiving responsibilities you have
absorbed? I take care of the four grandchildren at our home three days a week as an alternative
to day care. I pick up the eldest from her kindergarten every afternoon so that her mother (her
daughter/my niece) and father do not have to leave their offices. In the midst of all this, we now
have Moms unpredictable health concerns governing our spare moments. Prior to her February
illnesses, we had a semi-routine in placegrocery-shopping, checking the home health care
records, insuring she reaches her medical appointments, encouraging her already eager self to
take advantage of the field trips and activities available at San Camillos, the independent senior
living facility.
Have you experienced any of the following in your role as caregiver to your grandchildren? If
so, with what frequency?
Feel emotionally stressed and/or drained
Frequency, if applicable: Virtually always
Find it difficult to take a break
Frequency, if applicable: Often
Feel stressed in try to balance job and family
Frequency, if applicable: Frequently
Find it difficult to exercise regularly
Frequency, if applicable: Exercise? Really?
Find it difficult to take care of household responsibilities
Frequency, if applicable: From time to time; not often
Feel financially strained
Frequency, if applicable: On occasion
Have you experienced any of the following in your role as co-caregiver to our mother-in-law? If
so, with what frequency
Feel emotionally stressed and/or drained
Frequency, if applicable: Virtually always
Find it difficult to take a break
Frequency, if applicable: As above
Feel stressed in try to balance job and family
Frequency, if applicable: Frequently
Find it difficult to exercise regularly
Frequency, if applicable: As above
Find it difficult to take care of household responsibilities

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Frequency, if applicable: As above

Feel financially strained
Frequency, if applicable: Mom has her own trust fund so we dont have to worry
as much about being able to meet the costs of her care; we all follow it closely, as
you know, but so far, so good. We know were blessed being in this position; so
many are not able to make these ends meet. Really grateful to Mom and Dad for
managing this so well all those years ago.

What services or resources would be most helpful to you as a family caregiver?

Information about caregiver resources
Respite care
Assistance with chores
Assistance with transportation to medical appointments
Assistance with transportation, general
Assistance with meals We do regular shopping for Moms apartment at the senior
living facility (San Camillo) to cover her breakfast and snack needs. As you know, hot
lunches and dinners are already provided in the San Camillo dining room.
Assistance with managing medications We have this set up with the home health care
nurses at both Moms rehab and her independent living facility, San Camillos
Connecting with other caregivers
Time off from work for caregiving tasks This is a constant balance issue
Assistance with transportation to childrens activities
Assistance with balancing needs of older and younger children
Assistance with meals
Assistance with managing clothing changes, naps, standard child care tasks
Having more energy to play with the children
Time off from work for caregiving tasks
What do you consider the most challenging parts of striking the balance between your caregiving
and professional roles? TIME and energy. I know exactly what I need to do for work; its
having the time to do it well. I find that Im often working late into the evening after the kids
have gone home.
Have you discovered or developed effective strategies to deal with the challenges youve
identified? Thats a laugh. I feel I just do things day by daytaking each ripple as they come.
Thats pretty much how I feel about handling Moms issues. With the kids, were a little more
structureda little more advance-planned. Still, there are unexpected hiccups more often than

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notand we have to roll with that flow, too. And, as you know, of the two of us (E & P), I am
the planner!
What are the most prevalent emotions you experience in association with managing these
responsibilities? The first thing that comes to mind is the feeling I had for years while taking
care of my own mother (before grandchildren)I kept coming back to, Whats wrong with me?
Im one of the most organized people I know! And Im a nurse! This should be all in a days
work for me. Yet, its more than that. The endless, endless details required in adequate recordkeeping and monitoring of either home care or nursing home care is so daunting. And thats
what I do for a living, really. Thats what I audit. As you know, I ultimately brought my own
mother home because the SNF (skilled nursing facility) were subjecting her to multiple
negligence events. I just couldnt leave her there. So the constant, 24/7, no-real-vacation
vigilance is exhausting. Especially in our present situation, the fatigue (is that an emotion?) is a
significant factor. Theres also some guilt somewhere in me that wonders about the toll this is
taking on our marriages. You and I have strong marriagesstill, I think the one-to-one time with
our spouses frequently is compromised or sacrificed. Thats applicable for caregiving offered to
both the kids and Mom. The benefit, especially with the kids, is that I feel were deepening our
lifetime bonds, which is exactly what I want most. P (Es husband) cherishes that, too.

Analysis of Observations:

What is the meaning of what you have observed? E is a very organized, middle-aged
adult. She operates as well as Ive seen anyone in these circumstances; very understated
in terms of the overall impact of her many responsibilities. She has always felt this was
her responsibilityshe served (and served very well) as primary caregiver to her own
mother until her mothers death of natural causes. She feels, as do I, that this has
prepared her all the more for her current balance of responsibilities.

Do you see any connections or patterns in what you observed? Es approaches to her
current responsibilities are completely consistent with what I have observed in her past
caregiving and work duties.

Did the stated or implicit objectives of what you were observing match what was
achieved? Yes.

What were the relative merits of the behaviors you observed? There are so many aspects
of Es character that are strong and endearing.

What were the strengths and weaknesses of the observations you recorded? Strengths: I
know the subject very well and can bring to bear a historical perspective on current

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observations; Weaknesses: I am likely (almost surely) not objective where E is

concerned; I am her sister-in-law. We have maintained a closeness through the years that
(thus far) gives her apparent freedom to tell me what she thinks. I highly trust her and
find she is able to anticipate potential needs in her various roles very well.

Do you see connections between what you observed and the findings of similar studies
identified from your review of the literature? Yes, Es behavior is consistent with the
findings outlined in the AARP survey summaries.

Have you learned anything from what you observed? Very much so. Many or Es
observations and insights were consistent with the resources I studied in preparing this
research topic.
References

Arno, P. S., et al. (1999). The economic value of informal caregiving. Health
Affairs (Millwood), 18(2), 182-188.
Barber, C., Ph.D. (2015, June 23). SOE [School of Education] Human Growth
and Development LM11 minilecture. Lecture presented for EDUC 5339
Human Growth and Development in Studio, Houston. Retrieved from
https://www.youtube.com/watch?v=9L4v7vYHZbw
Barrette, E. M. (2016, April 14). Interview with caregiver to both children and
elderly parent [Personal interview].
Berger, K. S. (2014). Developing person through the lifespan (Ninth ed.). New
York, NY: Worth Publishers.
Bonner, A. (2015). 2015 AARP national caregiving survey of registered voters
age 40 and older. Retrieved from

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http://www.aarp.org/research/topics/care/info-2015/national-surveyfamily-caregivers.html
Caregiver-Work balance summary notes [Field observation]. (2016, April 12).
Erikson, E. H. (1963). Childhood and society (2nd ed.). New York: Norton.
Hayman, J. A., et al. (2001). Estimating the cost of informal caregiving for elderly patients with
cancer. Journal of Clinical Oncology, 19(13), 3219-3225.
Langa, K. M., et al. (2001). National estimates of the quantity and cost of informal caregiving for
the elderly with dementia. Journal of General Internal Medicine, 16(11), 770-778.
Schulz, R., & Sherwood, P. R. (2008). Physical and mental health effects of family caregiving.
Journal of Social Work Education, 44, 105-113.