In 2008, Helen Colbert, once the fireball of her family, became weak and incoherent. Parkinson's disease and diabetes had slowly overtaken her. Helen's children brought her to the hospital, where she spent two days before being transferred unexpectedly to a nursing home in the middle of the night. When her son Louis visited her there the following day, Helen, now 86, was traumatized, unfed, and apparently untreated. That's when Louis—an executive at an office on aging in suburban Philadelphia—sprang into action.
"Why hasn't my mother been given her medications?" he demanded of a nurse.
Her bureaucratic response: "We can't give her any medication because we don't know who to bill it to."
Louis placed a call to the medical director to have his mother released. The doctor initially refused, calling it an unsafe discharge.
"My voice was getting louder and louder, and I was starting to holler," Louis remembers. "The doctor kept saying, 'So you're going to take your mother out against medical advice?' And I said, 'Yes, I'm going to take her out against medical advice.'"
Louis, now 58, won that battle; the facility let his mother go home that afternoon. But Helen's usual caregivers—two of Louis's sisters—were not at home to watch her. Nor were any of his other four siblings available. That day, for the first time, Louis was solely in charge of his mother's care. He was terrified.
"I'm a social worker, trained and working in the field for 30-some years, but I was frightened to death," he says. "You don't want to do anything to hurt your loved one, and I remember praying, 'Oh, dear Lord, please help me.'"
Such fear is not unusual, especially for men, says Brent Ridge, M.D., a geriatrician at Mount Sinai Hospital in New York City. Ridge often receives panicky calls from men thrust into the caregiving role. The CEO of a major publishing corporation once told him, "My father just had a stroke, and my mother isn't strong enough to care for him. I have no idea how to help them."
No one feels comfortable in an instant-caregiver role, says Ridge, yet most adults will care for an aging loved one at some point in their 40s, 50s, or 60s. The number of unpaid family caregivers in the United States now tops 65 million, involving more than three in ten households, according to "Caregiving in the U.S. 2009," a report conducted by the National Alliance for Caregiving (NAC) in collaboration with AARP, and funded by the MetLife Foundation. Despite a common stereotype that caregiving is women's work, one third of American caregivers are men, the report reveals.
Many male caregivers keep this role a secret. In two years of research and hundreds of interviews for my new book, Passages in Caregiving: Turning Chaos Into Confidence, I discovered that many men fear workplace stigmas: the perception that a frail parent or ill spouse is more important than company profits. Among men and women who work full-time while acting as unpaid caregivers to adults, it's the men who more frequently try to hide emergency phone calls, doctors' visits, and other workday distractions that come with the role.
And men tend to approach the job of caregiving differently from women, I found. Most men who help care for family members opt for long-distance or executive tasks such as dealing with insurance companies or lining up nurse visits. Women caregivers, by contrast, are more likely to do hands-on tasks. The NAC/AARP study confirms this. Though male and female caregivers employ about the same amount of outside help—35 percent used paid aides during the course of a year—among caregivers of people over 50, men are more often the ones who arrange that help. But men are only half as likely as their sisters or wives to assist with the more personal task of bathing. Men who do shoulder the heart-wrenching work of dressing and toileting a family member are particularly reluctant to talk about it. It isn't seen as manly, many told me.
Male caregivers opened up to me after learning I had cared for my late husband for many years. And frequently, when they did confide in me, their painfully buried emotions—embarrassment, inadequacy, despair—would bubble to the surface.