Lisa Groger and  Pamela S. Mayberry
 
 This research was supported by a Grant from the Administration on Aging
  (Award # 90-AR-2034- 1996-1997)

 INTRODUCTION

    In this paper we examine how African Americans we interviewed struggle to live up to their ideal of filial obligation toward elders in need of care in an era when it is becoming increasingly more challenging to do so. Anthropologists have long explored the tension between the cultural ideal of what should be and the constraints that limit actual behaviors to what can be. Often we recognize this tension as a symptom of rapid social change in the material realm that makes it ever more difficult to achieve the cultural ideal. One way of minimizing this tension would be for individuals to revise or reformulate their ideal to bring it in line with the new material contingencies. Failure to make this readjustment results in cultural lag which has been defined as "the retardation in the rate of change of one part of an interrelated culture complex as against another part...[or]... a delay in translating a change in material culture to the nonmaterial techniques for controlling it" (Winnick 1972:308). In other words, material conditions are changing faster than are the ideas we have about them. If our ideas about how to deal with the material conditions do not acknowledge the divergence and thus fail to change accordingly, the growing discrepancy between the real and the ideal could be seen to result in maladaptation, especially if it creates cognitive dissonance in individuals who fail to adapt their old ideal to the new reality.

    Although Clark & Anderson's (1967) model of adaptation conceptualizes the criteria and tasks required for successful adaptation to aging, its general principles can also be applied to other areas of change that require a reordering of the interaction between the personal and the social system. For the purpose of this paper, the personal system is constituted of individuals' beliefs about filial obligations–what children think they should do for their parents, and filial expectations–what parents expect their children to do for them. The social system comprises the larger context in which filial obligations and expectations are enacted and either reinforced or undercut. The social system for the purpose of this paper includes the demographics of a post- industrial aging society: a greater number of competing demands on caregivers' time due to women's increasing labor force participation, geographic mobility and smaller families–all of which reduce the number of available caregivers for a growing number of elders in need of increasingly longer periods of care. In spite of these societal forces that conspire to diminish the supply of, and increase the demand for, caregivers, many actual and potential caregivers continue to espouse ideals of elder care that are either not attainable or can be attained only at great, and ultimately unsustainable, cost to the caregiver.

    We explored ideas about filial obligations and the extent to which elders are cared for by their families by talking with African Americans about their long-term care preferences and choices. We conducted eight focus group discussions with high school and college students, young and middle-aged adults, and elders. We also collected 62 individual open-ended face-to- face interviews with care recipients and caregivers, in three different care settings about their experiences, aspirations, and feelings about receiving and providing care (Groger et al., 1997). Our findings about perceptions of filial obligations and expectations are primarily derived from the focus groups whose members varied considerably in their ability to reconcile traditional norms of filial piety with the exigencies of their caregiving situation. We draw on individual interviews for examples of variously adaptive behaviors. By contrasting informants who embrace the ideal, but cannot attain it, with others who were able to adapt their ideal to their caregiving situation, we are able to specify the conditions that foster or hamper successful adaptation to the exigencies of eldercare.

    Clark & Anderson's (1967) distinction between adaptation and adjustment is useful for understanding our informants' reported behaviors and conflicting feelings. Adaptation defined as "getting along well enough with society and oneself to preserve intact the personal functions" is always positive, whereas adjustment defined as calling "for behavior which will not arouse sanctions from the environment" (p. 394) may be maladaptive if it results in individuals violating their personal needs simply to conform to externally imposed norms. According to Clark and Anderson,
 ...the criteria for adjustment are external to the personal system... The criteria of adaptation, on the other hand, are the internal and external accommodations individuals must make to the social order in which they live. Thus it is possible to be well–adapted without epitomizing the core-values as long as the individual does not flagrantly defy them in ways so as to bring down sanctions upon himself. In brief, the adapted person has worked out a compromise which satisfies both his society and his own personality" (p. 394).

    Thus a caregiver who jeopardizes her own health because she is determined to fulfill an unreasonably high and abstractly formulated ideal of filial obligation makes maladaptive adjustments to meet that ideal. In contrast, a caregiver who recognizes the need to preserve her own health and her own personal system by scaling down on caregiving tasks and finding someone else to provide care may have compromised the abstract ideal of filial obligation but is acting adaptively.

PERCEPTIONS OF FILIAL OBLIGATIONS ACROSS GENERATIONS

    The literature on filial obligations is largely based on quantitative research which examines the relationship between norms, affect, interaction, and helping behaviors.  For example, Bengtson & Roberts's (1991) model of inter-generational solidarity in aging families treats norms of filial piety as the independent variable which is shown to influence a parent's and a child's affection for each other as well as the interaction between them.  Furthermore, the model treats a parent's declining health as a constraint on interaction and exchange, suggesting that a parent's declining health would have basically the same effect on interaction and exchange as, for example, a child's full-time job: both are seen as causing a decrease in the amount and frequency of interaction between parent and child.

    Bengtson and Roberts (1991, p. 868) lament the fact that they "do not have adequate indicators of exchange given and received; thus the important part of the model involving exchange relationships could not be tested."  Nor does their model take into consideration another aspect of a parent's declining health, namely a parent's need for care.  We know from our study that decline in a parent's health was a catalyst for stepped-up interaction and exchange, and that caregiving/care receiving looms large in filial exchanges.  We also found that norms of filial expectation (what elders expect from their children) and perceptions of filial obligations (what children think they should do for their parents) varied by the interrelated aspects of age, impairment, need for care, and concrete caregiving experience.  That is, the older the parents, the more likely they were to be impaired and thus to need help.  But they were also least likely to consider that it was their children's "filial obligation" to meet these needs.  Rather, they claimed that if their children took care of them it was because they loved them.

    This distinction between love and duty as a motivating force for providing care seems trivial but is profound. By disavowing any responsibility or duty on the part of their children, and by invoking affection as the only legitimate motivation for caregiving, elders might equate the cessation of caregiving with a cessation of affection. Similarly, those children who consider their caregiving as an expression of love for their parents are likely to insist on providing care even if this requires maladaptive adjustments on their part. If, on the other hand, obligation is recognized as a legitimate motivating force, "there may be more than one legitimate way to fulfill it. Arranging for care may be as appropriate as providing it oneself," whereas unreasonable insistence on family care engenders guilt when formal care has to be sought (Strawbridge & Wallhagen, 1992, p. 88). Our data suggest that caregivers who insisted on providing hands-on care as a measure of their love for the care recipient struggled longer to relinquish care and found it difficult to come to terms with their decision.

AFRICAN AMERICAN FAMILIES AND INFORMAL SUPPORT

    The large body of literature on racial comparisons in informal support and filial piety suggests that there are clear-cut differences in the ways in which African American and white families care for their elders. The notion of filial obligation as expressed through informal support permeates most discussions about African American elders' provision of and need for informal support in general and long-term care in particular, yet the extensive literature on this subject has yielded mostly inconclusive and sometimes contradictory findings. This is partly attributable to the fact that different researchers use differing definitions of support. Informal support has been discussed in terms of such diverse variables as expectations of filial obligation, experience of caregiver burden, size of informal helping network, sources of help, frequency of interaction, amount of help, flow/direction of help, kinds of help, and degree of satisfaction reported by elders. Such differences in definitions alone account for the fact that African Americans' norms of filial obligations and expectations were reported in one study to be stronger (Frisby-Farmer, 1991), and in another weaker (Hanson, Sauer, & Seelbach, 1983) (used five Likert-type normative statements about living arrangements, caregiving, financial help, and visiting patterns) than those reported by whites.
 The literature on informal support is equally inconclusive. African Americans have been shown to have larger support networks and to rely more heavily on informal support than do whites (Barer & Johnson, 1990); to contribute significantly more hours to caregiving (White- Means & Thornton, 1990); to be more likely to provide assistance to children and to parents (Morgan, 1983); to be more likely than whites to draw on multiple sources of support (Gibson, 1986), including individuals who are not immediate kin (Burton, Kasper, Shore, Cagney, LaVeist, Cubbin, & German, 1995); to receive rather than to give help as a function of socio-economic status (Mitchell & Register, 1984); and to receive significantly more informal care after hospitalization than whites but to be less satisfied with their care (Chadiha, Proctor, Morrow- Howell, Darkwa, & Doore, 1995).

    But African Americans have also been found to have weaker intergenerational ties as expressed through exchanges (Silverstein, Lawton, & Bengtson, 1994) and to demonstrate less solidarity than other races (Lawton, Silverstein, & Bengtson, 1994); to report significantly less help from others with health care; to show greater dependence on formal services; and to have smaller support networks than whites (Musa, Silverman, Ford, Jennings, & McAlister, 1996). Other researchers have found race to be either less important than previously reported (Mindel, Wright, & Starrett, 1986) or insignificant as a predictor of informal support structures (Miner, 1995; Smerglia, Deimling, and Barresi 1988). Burton et al. (1995), who examined racial differences in informal care, found that level of impairment and not race was "the strongest predictor of size of caregiving network" (p. 750). Racial differences in social support have also been shown to be affected by gender and life stage (Silverstein & Waite, 1993), socioeconomic status (Mitchell & Register, 1984), differences in the composition rather than the size of caregiver network (Burton et al., 1995), and the meaning of exchanges (Groger & Kunkel, 1995).

    Concerning the question of caregiver burden, a topic often discussed in the context of informal support, Fredman, Daly, & Lazur (1995) found that although African American caregivers provided more help to relatives with greater functional and cognitive impairment than did whites, they reported less stress than did whites. Fredman et al. (1995) found that fewer variables contributed to caregiver stress experienced by African Americans than whites, suggesting that African Americans may have a somewhat higher tolerance for stressors. Similarly, Mui (1992) found that African American caregiving daughters reported less role strain than did their white counterparts. In contrast, Young & Kahana (1995) found more similarities than differences in their race comparison of caregiver burden, suggesting "that some previously established models of cultural and racial differences in caregiving may need to be reconsidered" (p. 225).

    Studies that examined only African American elders found considerable intragroup variation in the kind and extent of informal support, depending on a complex interplay of demographic and familial variables (Chatters, Taylor, & Jackson, 1986; Groger, 1992; McAdoo, 1978; Perry & Johnson, 1994; Taylor, 1985, 1986; Taylor & Chatters, 1986). These intragoup differences suggest that the categorical superiority of African American families' filial piety and informal eldercare may have been greatly exaggerated. It may have resulted in an "informal support euphoria" (Sokolovsky, 1985) that is ultimately detrimental to African Americans because it may have stereotyped their behaviors and distracted from their needs. Dilworth-Anderson (1992, p. 31) points out that the African American system of "extended familsm" is being challenged by demographic changes and suggests "that family caregivers of aged blacks will not be able to maintain their traditional system of mutual aid and support."  Similarly, Perry and Johnson (1994) found that more formal services may be required to meet the long-term care needs of African American elders whose family members are increasingly struggling with competing demands. Our data show that no matter what African American caregivers may think they should do for their elders, they are not always be able to achieve it.

METHODS

    Our research was guided by the assumption that we would indeed find intra-group differences in levels of both filial obligation and filial expectation among African Americans. We also assumed that African American families are subject to the same demographic forces that strain other groups' ability to provide eldercare. To explore intragroup differences in caregiving practices and ideas about them, we conducted eight focus groups with different age-homogeneous participants to explore these grand-tour questions: Do different age groups of African Americans have different ideas about filial obligations/expectations in general, and caregiving in particular? If so, how do they differ? How do material constraints shape individuals' ideas about filial obligations/expectation in general, and caregiving in particular? How do such material constraints prevent individuals from fully meeting their ideal of filial obligations? How and to what extent does the actual level of effort expended in caring for elders represent a compromise between the ideal and the feasible? When formal services must be used, what is the ideal, and how well do current services meet that ideal? How do elders reconcile their expectations of filial obligations with the reality of their care situation?

    We operationalized these grand-tour questions by asking our focus group participants the following specific questions, with age-appropriate variations: 1) What are the needs of older persons in your family? 2) What do YOU do for elders in your family? 3) Why do you do that? 4) What do you think people SHOULD do for their elders? 5) How do your family members feel about that? 6) What might keep family members from doing all they think they should do? 7) What other sources of help might older people use? 8) Any services YOUR family has used? 9) How do you think families feel about relying on help from outsiders? 10) How do you think older people feel about outside help?

    We hired four African Americans to lead the focus group discussions. Although we would have preferred to use the same leader for all eight focus groups to assure uniformity of procedure, we had to enlist the services of four because we could not find one person who was free for the amount of time required to do all eight focus groups. We believe we were able to minimize the potential for lack of uniformity of procedure by providing focus group training. Although we opted for the optimal number of eight participants per group (Krueger, 1994) and over-recruited accordingly, our recruiting efforts yielded variable results. We were able to obtain a total of 47 participants, of whom 31 were women.  Table 1 summarizes the composition of our focus groups.
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            Group                                                     Number of Participants
                                                                           Female             Male

University students                                                   2             3
High school students                                                7             1
Young adults                                                           1             3
Middle-aged adults                                                  2             1
Elders attending rural senior center                           6             1
Elders attending urban senior center                         5             3
Nursing home residents (elders)                               4             0
Adult day care center clients (elders)                        4             4

     Total                                                                  31            16
     Grand total                         47
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     Older groups tended to temper their ideals of filial obligations with their observed or
experienced realities of the demands of caregiving.  In contrast, the youngest groups who were
the farthest removed from actually having to give care, were the most vehement in their insistence
on strict norms of filial obligations. All age groups expressed a strong commitment to filial
obligations, although this expression varied in fervor, passion, and recognition of constraints.
Similarly, participants in all age groups considered nursing home placement as undesirable and to
be avoided at all cost but varied in their ability to consider it appropriate or acceptable as a "last
resort." For the youngest focus group members, nursing home placement emerged as the hallmark
of rescinding one's filial obligation; for middle-aged participants it was an undesirable but
sometimes inevitable outcome; for elders it was preferable to kincare beyond of what one could
reasonably expect of one's children.

      This variation was clearly related to cohort differences and the speakers' own experiences
as caregivers or care recipients.  Students were most demanding in their expression of filial
obligation.  They insisted that "out of respect," elders should be taken care of by family members,
regardless of the quality of the relationship and the emotional and financial cost.  Although they
acknowledged that their ideal might not always be achievable, they could not fully grasp the
power of constraints and limitations on family members' ability to provide care.  At the same time,
many of them had observed their parents in sustained, arduous caregiving activities, which seemed
to have inspired rather than dispirited them.  They were confident that watching their parents or
grandparents give care taught them how to be future care givers.  The youngest among them
declared that they would be willing to give up their careers to care for their parents.  In their
opinion, putting a person into a nursing home was the worst thing one could do to an elder. In
fact, it was even worse than limiting one's visits to those days when the elders received their
Social Security check. This age group has not yet encountered, and much less come to grips with,
any of the many material constraints that may compromise the ideal of filial obligation.

     Young adults too rejected the idea of the nursing home and described their families'
extraordinary efforts to avoid it.  But their discussions also pointed to the fact that family
dynamics play an important role in what happens. Listen to C, a young adult male, who described
how his family dealt with his grandmother:
     The reason why we had to place my grandma in a facility was after four years of talking to
     her and convincing her that that was the best thing because we had tried to have [nursing]
     care in the home, but she always found one reason or another why they weren't sufficient.
     So we had to eventually put her into a nursing home.  Ideally I would love for her to be at
     my home so that there would be someone closer who could deal with her on a daily basis.

    Listen also to K, another young adult male, who is incredulous at the idea that his mother might
want to go to a nursing home "when the time comes:"
     My mother's mother who passed away a couple of years ago wanted to go to a nursing
     home.  I was two layers removed from that, of course, but I didn't understand that.  And I
     talked about it with my mother.  She said that, at that point in time, that is something that
     SHE might want to do.  I'm like, Whoa! I don't understand why they would WANT to
     go.  So that's another whole issue.  My grandmother wanted to go. She said it'd be easier
     for her.  I mean, our family was close enough to the home, but she felt more comfortable
     going in, than us pushing her.

    The implication here is that K's grandmother chose the right moment for supplanting kin care
with nursing home care, and by doing so, she spared herself and her family the indignity
experienced by C's grandmother and family.  Others in the group commented that they
understood how elders might not want to be a burden on their families.  The consensus of the
group on this issue was more about control and autonomy than it was about nursing homes; it was
not about whether or not one should go there, but how one should go about going there.
     The discourse of middle-aged adults, many of whom are experiencing the strains of
caregiving, was marked by the conflict between what is desirable and what is possible. This group
described both the family's struggle to provide care, and the difficulty of relinquishing care.  This
is the generation in the middle, subject to demands from their own children as well as their elders.
Moving in with the elder or having the elder move in with them was one way of satisfying the
multiple demands.  Such a move emerged as a process rather than an event, which begins with the
elder moving closer or to a smaller apartment before actually joining a child's household.  During
this period, families weigh the costs and benefits of a move, which gives all parties concerned an
opportunity to preadjust to the anticipated change in living arrangement.  Middle-aged adults
talked about the family's moral obligation to take in elders, and stressed that even severely
diminished elders can still contribute in small ways. They also talked about the ensuing struggle to
step up care for elders whose health and functional status are declining.  It is during this period of
accelerated decline that caregivers begin to consider other options—at first in-home services, and
eventually nursing home placement, "the last resort." Statements like "we finally had to give her
to a nursing facility" and "giving the responsibility to someone other than family was very difficult
for us" attest to the struggle middle-aged caregivers go through before relinquishing family care.
But they also testify to informants' ability to bridge the potential cultural lag between what they
used to think was required and what they came to recognize as being possible and appropriate.
The increasingly demanding chores of caregiving led middle-aged caregivers to redefine their ideal
of filial obligation.  And because they knew from experience how demanding sustained caregiving
can be, they insisted that they absolutely did not want their own children to go through the same
ordeal.
 
     Finally, elders were much more measured in their expectations: they tended to ask more
for ephemeral, non-instrumental, affective things like not being ignored; being looked after, visited
or called.  The following quotes from elders attending an urban senior center illustrate the
measured nature of their expectations:  "I would like for them to come and visit me and sit down
and talk with me and tell me how much they love me."  "Once in a while call and see how you are.
That means a lot."  This is how clients at an adult day care center expressed their expectations:  "I
think they should make the older people feel wanted.  Make them feel as if they are needed."
"...show them that you love them, give them a hug, give them a pat and let them know that
they're somebody."  Elders stressed their need for independence and described their efforts to
maintain this independence.  They valued their children's help but at the same time were anxious
not to be a burden.  They explained that their children cared for them because they loved them,
because they, the parents, had done so much for their children.  At the same time, they recognized
that what their children could do for them was limited by competing demands, and they were
anxious not to push beyond that limit, as illustrated by this quote:  "Well, I would say, if they're
able, take care of [elders] as long as they can because the time is coming when you can't."  Many
elders had been caregivers themselves and understood the burden of caregiving.

     The three nursing home residents we were able to recruit for a focus group discussion
expressed the most modest expectations.  They appeared unable to consider the conditional nature
of the question about what people should do for their elders; instead they mentioned the "little
things" people were doing for them. In some way, the question about what families should do for
their elders had become as hypothetical to them as it was for the students. The question may also
have caused them pain or resulted in evasive responses because all three participants were
childless and had minimal support. In that respect they were not at all representative of the
nursing home residents we interviewed individually, most of whom had excellent kin support and
felt cherished by their families. Unlike our focus group nursing home residents, they held filial
expectations that resembled those of the community-dwelling elders in our focus groups. They
wanted attention and love from their families and were satisfied that someone else was doing the
body work. Ethel's statement sums up this sentiment that others also expressed, albeit less
eloquently:
     Most people don't realize that rest homes are for you and your condition. But it's not for
     the love. They don't have that time. The people that work in the rest home, they are there
     to minister to your needs. But your love have to come from your family.

    The majority of nursing home residents we interviewed had gradually and successfully adapted to
life in the nursing home. Because of the division of labor, families were now better able to provide
what their elders needed from them most: love, affection, and assurance that they had not been
abandoned.

RECONCILING LOFTY IDEALS WITH THE LIMITS OF CARE

      Our focus group findings suggest that the youngest groups held the most rigidly defined
norms of filial obligation. This led us to hypothesize that, should they be called upon to provide
sustained care to an elder, they would be the most vulnerable to experience cognitive dissonance
because of their inability to reconcile what they think they should do with what they eventually
discover they cannot do. This hypothesis was borne out by interviews with caregiving
grandchildren and nieces who had indeed embraced their caregiving tasks enthusiastically only to
learn that they could not always do what they felt they needed and wanted to do. They found it
difficult to adapt their ideal to the material constraints of competing demands and conflicting
choices.

     Kimberly's story exemplifies the dilemma created by a sense of filial obligation that
tolerates no compromise. When Kimberly was 25 years old, her maternal grandmother Juanita had
"a light stroke" and Kimberly became her default caregiver "because there was nobody else and
because I love my grandmother who raised me and did a lot for me." Her parents were divorced
when she was a child, and she and her sister were raised by Juanita, with some help from her
paternal grandmother Mariann. Her sister offered no help at all. Her father had "tried the best he
could" to support the women, but as an army man, he was mostly gone. Her mother was
completely "out of the picture" and living in Texas where she was barely able to support herself.
Kim did not mention her mother's brother, Juanita's son, but in her interview, Juanita talked about
him as "my son who went bad and is in prison." Kimberly expressed strong resentment against her
mother; she felt she was too young to be expected to take care of her grandmother when she
could barely take care of her own children age 8 and 1. She felt it was very unfair that she should
have to do what really was her mother's job.

     When Juanita was released from the acute care hospital after a period of rehabilitation, she
went to stay with Mariann, Kimberly's "other grandmother" where Kimberly joined them with her
two children. Given Mariann's own age and health problems, there was not much she could do for
Juanita except stay with her when Kim was at work. Mariann's house had many environmental
barriers that made it outright dangerous to take Juanita out. Kimberly struggled for five months to
take care of Juanita. She enlisted the services of a visiting nurse for bathing which she said helped
a lot. Juanita had been a very independent person and did not make a good dependent one. She
was demanding and wanted things when she wanted them, not when it was convenient for Kim or
for Mariann. Kim lived in constant fear that something might happen to Juanita while she was out.
It was clear from her account that the situation was extremely stressful for all involved, and that
Kimberly felt overwhelmed and inadequate at the same.

     At the time of the interview with Kim, Juanita had already been in the nursing home for
almost a year, but Kim felt strongly that she should have continued to care for her, although she
was not sure how long she might have been able to do so. It was Juanita herself who had pushed
for nursing home placement, against Kimberly and Mariann's wishes, and she was blissfully happy
that she prevailed. Kimberly, on the other hand, was consumed by guilt: guilt about having "put
grandma in a home;" guilt about not having been a more effective caregiver; a lot of guilt about
not doing more for her grandmother. She feels guilty all the time. She feels guilty for sometimes
feeling too tired to visit. Her grandmother is on her mind all the time. She feels guilty for not
visiting more often, and guilty when she does, for often she ends up fighting with Juanita who is
quick to criticize Kim for all sorts of things. Kim feels she failed in her filial obligation to the
woman who did so much for her. At the same time she tries to explain and come to grips with
why she could not do more. For Kim, placing her grandmother in a nursing home means that she
did not meet her filial obligation. She tortures herself with alternative scenarios and cannot rid
herself of the conviction that she did the wrong thing by letting Juanita enter a nursing home.

     Compare this story with the story of Iola, a 63-year old retired woman who is surrounded
by family with a history of taking care of each other. She lives in a large house which she was able
to buy because her "children helped out." Her daughter, who runs a children's day-care center,
lives and works downstairs; her "baby son" who is 27 lives with her. Her mother used to live with
her son in New York but eventually moved to Florida to be near her younger sister, Iola's aunt.
When the mother's younger sister reported that "mama was acting strange," Iola got her to come
to live with her. As the mother became more and more demented, it became impossible for Iola,
who was still working, to keep her mother at home. She embarked on a systematic search for a
nursing home, visiting many but not liking any of them for quite some time. She had no particular
dislike of nursing homes as such, but was adamantly opposed to placing her mother in one that
looked at if it would not provide good care. When she found the right one, she was relieved and
did not hesitate to place her mother there. At the time of the interview, her mother had been in
this nursing home for four years. Iola feels good about her mother's care. She knows her mother is
in a good place, and she feels nothing but relief. She described how the care she had struggled to
provide at home became less and less effective, and how she can now look after and lavish
affection on her mother without dissipating her energy on hands-on care. She feels only relief and
no guilt at all. For her, placing her mother in a nursing home is not a sign of defaulting on filial
obligation. On the contrary, by ensuring that her mother's safety and appropriate care, she is
convinced that she did the right thing a good daughter should do: make sure her mother receives
the best possible care.

DISCUSSION

      Thus our research suggests that middle-aged and older caregivers are better able to
redefine their ideal of filial expectation and filial obligation than younger groups. The majority of
caregivers whose elders had moved to a nursing home might have preferred, at least initially, to
continue to provide care at home, but "given the situation," middle-aged and older caregivers
eventually came to recognize nursing home placement as an appropriate way of meeting their filial
obligations. They felt vindicated in their choice when they saw their loved ones adapt to
institutional life; they were reassured when they saw their elders satisfied, and they continued to
care about them even though they could no longer care for them. They did not feel they had
abandoned their elders or failed in their filial obligations. Instead, they were able to bring their
filial expectations in line with their situation by recognizing that their elders' need for care had
exceeded the limits of informal care. Now the staff did the body work and the families did the
loving. Rather than berating themselves for falling short of the ideal, they reinterpreted the ideal in
light of their specific situation.
     Given their age and previous experience with caregiving, middle-aged and older caregivers
had learned to assess their situation more realistically than could Kimberly and other younger
caregiving granddaughters and nieces. They had observed and helped relatives in their parental
generation take care of family members in their grandparents' generation, and when they were
called upon to provide care, they were aware of the magnitude of the task. They were also more
likely to have had some experience–usually positive–with nursing homes and were much more
open to the idea of institutionalization. This allowed them to opt for nursing home placement
before they became chronically overwhelmed–a process with is clearly adaptive. They recognized
and acknowledged the limits of informal care, and once they had made the decision to relinquish
it, they were satisfied with it. They were more concerned with having found the right place than
with worrying about whether they should have tried harder to continue to provide care. They
expressed feelings of relief rather than guilt–relief that their elder was in a good place and nearby
where it was easy to visit. And visit they did, often checking at odd hours and acting as "kin
police" (Groger et al., 1997) to make sure that their loved ones had all they needed, and to
reassure them of their families' continued vigilance and commitment.
     In contrast, younger caregivers, who were doing the work by default because the middle
generation was not available, found themselves both overwhelmed and afflicted with cognitive
dissonance. Instead of feeling pride in what they were doing, such overwhelmed caregivers felt
guilty and inadequate because they could not do more. Like Kimberly, they were unable to adjust
their "pure" ideal to the exigencies of their situation. Lack of previous observation of, and gradual
socialization into, caregiving accounts for their self-punishing and rigid adherence to norms of
filial obligations they could not possibly meed. For Kimberly, her grandmother was the first sick
old person in her life, and she found herself untrained and unprepared to deal with taking care of
her. Had her mother done what Kimberly considered her mother's work, Kimberly would
conceivably have helped her and, by doing so, would have learned under less stressful
circumstances what sustained caregiving entailed.
     Young participants in our study expressed unbending idealism which may be commendable
in the abstract but may lead to maladaptive behaviors should they be called upon suddenly and
without preparation to assume the role of primary caregivers. When young caregivers meet this
challenge by trying to live up to an absolute ideal, they adjust to the situation but do so in a
maladaptive way. They find themselves both overwhelmed and afflicted with cognitive
dissonance. Instead of finding solace in what they were doing, such overwhelmed caregivers felt
guilty and inadequate because they could not do it all.
     Our study points to intra-group differences that might not have been captured by a black-
white comparison of filial obligations. Because we focused only on African Americans, we did not
ask, and therefore cannot answer, the question whether our findings are specific to African
Americans. Assuming–as we did at the outset of this project–that African American families are
subject to the same demographic pressures that make the provision of informal long-term care
increasingly more difficult, the pressures they feel should not be categorically different from those
experienced by other groups. However, our findings of generational differences in the ability to
adapt the ideal of filial obligation to a changing reality could be used to explore to what extent
this phenomenon affects other groups. We hypothesize that the greater prevalence of African
American grandparents raising grandchildren (Burton, 1990) results in a the greater likelihood of
grandchildren taking care of grandparents without the help of the middle generation. This is the
very condition we identified as the source of cognitive dissonance as a result of younger
caregivers' inability to adjust their lofty ideal about filial obligations to the harsh reality that
requires a redefinition of the ideal.
     We believe that all families, but particularly those headed by grandparents, could greatly
benefit from educational and supportive services to help explore all possible care options, guide
them in their search for appropriate care, and help with planning for situations where elders' needs
may exceed the limits of informal care. Outreach by and accurate information about nursing
homes as an integral part of long-term care planning could greatly help caregivers and care
receivers alike to successful adapt to their changing circumstances.


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