This book solidly epitomises the growing conceptual, methodological and analytical sophistication of research on care-giving. The rationale for this book is the relative lack of attention paid to the sources of variability in experiences of care-giving, particularly in terms of social connections within the families that provide care and the factors in the community and the wider social milieu that affect the care process and its outcomes. The volume is framed in terms of a contextual perspective on care-giving, focused primarily on socio-cultural, familial and socio-political contexts. Just over one-half of the contributors are from the USA, with the remainder from Europe and Israel; they represent a range of social science orientations.
The four chapters in the section on socio-cultural contexts are the strongest in that they use data sets that enable analysis of the behaviours and perspectives of more than one family member and are thereby advancing understanding of within-family differences. Uhlenberg and Cheuk use data from the (US) second Longitudinal Study on Aging to explore how the supply of informal care-givers for the disabled older population may change as the population ages over coming decades. In an exceptionally thorough analysis, the chapter demonstrates how aspects of family structure predict whether a disabled older person receives care from paid sources and how the characteristics of both older and younger cohorts in the future will challenge the current arrangement whereby almost two-thirds of the long-term care received by older disabled people is supplied by kin. Also in this section, Johnson examines the role of relative prices (including estimates of the ‘price of children's time’) in the care decisions individuals make about the choice of long-term care services, highlighting the relationship between adult children's earning capacity and the amount of unpaid help provided. This has interesting implications for frail older adults with well-educated children. Silverstein and colleagues examine the intricate relationship between norms and costs in each sibling's care decisions, providing a very thoughtful analysis of the ways in which filial obligation conditions the tolerance of time costs imposed by geographical distance and other structural barriers. Particular insight into intra-family differences is gained through their analysis of the relative levels of filial obligation amongst ‘anomalous’ siblings at the margins of distance and care. The final chapter in this section by Lowenstein, Katz and Gur-Yaish uses data from Europe and Israel to examine the relationship between levels of state-provided services and support from informal sources.
Three chapters examine familial contexts of care (by spouses, by adult children and by adolescent children in care-giving families). Szinovacz and Davey conceptualise care-giving in terms of network characteristics and examine how such factors as changes in the composition of sibling support networks over time affect the wellbeing of adult children. In a unique contribution, Szinovacz draws insights from a small qualitative study of adolescents assisting in the care of relatives with dementia, arguing that care-giving by young children is ‘non-normative and often involuntary’. The final section of the book examines socio-political contexts, noting the confusing and ad hoc character of programmes that support elders and their families that have evolved in many countries, and demonstrating both progress and erosion in selected policies in the USA and in Europe over time. Sundström and colleagues examine family care for elders in Europe, with a specific focus on Spain and Sweden, and effectively demonstrate how policies emerge out of specific family contexts as much as families respond to the policies that are available. The concluding chapter by Szinovacz and Davey summarises well how the examination of care from the perspective of divergent contexts (personal, familial, societal and cultural) affords a more comprehensive perspective than the predominant exclusive emphasis on care-givers or care-recipients. While I disagree with their characterisation of the care-giving experience awaiting baby boomers later in their lives as a ‘rather gruesome scenario’ (p. 273), they strongly demonstrate how a contextual perspective on care can inform policy, and solidly make the case for more research (and internationally comparative data) on the interactions amongst divergent care systems.
This volume is methodologically rigorous and well illustrates the increasing importance of national (e.g. US Health and Retirement Study) and longitudinal data sets (e.g. Survey of Health, Ageing, and Retirement in Europe), and international comparative analyses, in examining complex issues within and between families, networks, societies and cultures. Multi- and inter-disciplinary perspectives enhance the volume, especially in those chapters that synthesise elements of several disciplines (as Silverstein and colleagues bring together sociology and economics) or conceptual orientations (as Sundström and colleagues examine the interplay between cultural and political contexts). The chapters collectively present a multi-faceted picture of care-giving and care systems within and across socio-cultural, familial and socio-political contexts. This book demonstrates well how the linkages among these contexts and their dynamics over time will shape the care scenario for future generations of elders. The editors' commitment to identifying the implications of the chapters' findings both for further research and for policy recommendations assures that this book will be of interest to researchers, practitioners and policy makers.
