Journal of Gerontology: SOCIAL SCIENCES
2007, Vol. 62B, No. 6, S381–S387

Copyright 2007 by The Gerontological Society of America

Characteristics of Strong Commitments to
Intergenerational Family Care of Older Adults
Kathleen W. Piercy
Department of Family, Consumer, and Human Development, Utah State University.
Objectives. The purpose of this research was to describe the characteristics of strong commitment to home-based elder
care among intergenerational family caregivers.
Methods. I conducted two qualitative studies using in-depth interviews with primary and secondary intergenerational
caregivers. A total of 45 primary caregivers, 10 spouses, and 11 adult grandchildren discussed development of their
relative’s care, their caregiving experiences, use of paid services, and how caregiving affected their lives. I followed
McCracken’s five-step method for analysis of long interviews.
Results. Strongly committed caregivers composed half of the total sample. All primary caregivers with strong
commitments were women; some strongly committed secondary caregivers were men. Strong commitments had moral,
religious, and affectionate bases. Participants gave compassionate care and reframed adverse situations as manageable
challenges. Family members and paid providers assisted primary caregivers. Participants viewed caregiving as rewarding
and as an opportunity to teach compassion to children.
Discussion. Results suggest that strongly committed intergenerational caregivers need support from both family and
formal care services to sustain their commitments to care. Future research can investigate the role of resilience in caregiver
commitments and develop caregiver commitment measures for use in elaborating models of informal long-term care.

C

URRENTLY, 34 million adults are providing assistance
to adults aged 50 or older (National Alliance for
Caregiving and AARP, 2004). Care given by family, friends,
or neighbors saved the United States an estimated $306 billion
in 2004 (National Family Caregivers Association and Family
Caregiver Alliance, 2006). Most family caregivers are women,
usually wives, daughters, and daughters-in-law (National
Alliance for Caregiving and AARP, 2004). However, women’s
future ability to provide care is threatened by falling birthrates,
increased employment, and the longer life expectancies of their
aging relatives (Montgomery & Williams, 2001).
Spouse caregivers persist longest in providing care at home
(Pot, Deeg, & Knipscheer, 2001). However, many adult children and other intergenerational caregivers persevere in caring
for very impaired relatives at home (Noonan, Tennstedt, &
Rebelsky, 1996). Despite multiple responsibilities, many
intergenerational caregivers exhibit strong commitment to caregiving roles. In this research, I conceptualize strong commitment with Leik, Owens, and Tallman’s (1999) three-component
definition of commitment: focus, emotion, and duration. One is
committed to the care of the elderly care recipient, and the focus
on caring provides the caregiver with self-esteem, meaning, and
purpose, often becoming part of the caregiver’s identity
(Hoffer, 1951). Committed caregivers express deep emotions
about their care practices. Finally, the committed caregiver
accepts the caregiving relationship for an unspecified future.
Studies of caregiver commitment are rare but support the
notion that spouses are more committed to maintaining the
caregiver role than adult children (Pierce, Lydon, & Yang,
2001). Pierce and associates’ findings suggest that greater
identification with caregiving as a primary role may spark
enthusiastic commitment to the role, which, in turn, lessens

appraisals of threat in difficult situations. Relationship closeness also affects commitment to care. Caregiver daughters who
report greater levels of emotional attachment to their mothers
provided more hours of direct care, felt more positively about
caregiving (Pohl, Boyd, Liang, & Given, 1995), and felt less
subjective burden (Cicirelli, 1993).
Because strong commitment to providing home care may
delay or prevent institutionalization of dependent elders, and
because the majority of family caregivers are daughters or other
younger generation family members, an understanding of the
characteristics of highly committed intergenerational caregivers
is needed. Research on predictors of desire to institutionalize
persons with dementia has suggested that primary caregivers in
well-functioning families with satisfactory levels of social
support express low levels of desire to institutionalize (Morycz,
1985; Spitznagel, Tremont, Davis, & Foster, 2006). Furthermore, understanding strong caregiver commitment may help to
explain why some caregivers persist in providing informal care
under very difficult circumstances. To that end, I utilized samples drawn from two studies of younger generation caregivers.
Research questions addressed were the following: What are the
characteristics of strong caregiver commitment among intergenerational caregivers who are providing home care for older
relatives? How do these caregivers deal with adversity in their
care situations? How do they view their caregiving efforts?
Interpersonal commitment theory provided theoretical guidance for this research. This theory, articulated by scholars of
close personal relationships, blends three theoretical perspectives (Leik et al., 1999). Social exchange theorists argue that
repeated satisfactory exchanges between persons over time
increase their dependence on each other, bringing about mutual
commitment. Identity theory postulates that the self consists of

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a hierarchy of identities to which persons attach salience.
Stryker (1991) contended that more salient identities are
characterized by more commitment to the roles and relationships that invoke those identities. Social network theory
contributes the ideas that specific commitments exist in systems
of relationships, and that formation and negation of commitments occur in the context of one’s connections to a network of
others. Leik and colleagues summarized by defining interpersonal commitment as ‘‘a readiness to act consistently in the
interest of maintaining a relationship with one or more others,
and those aspects of personal identity that derive from that
relationship for an indefinite future’’ (pp. 240–241). Lydon
(1999) asserted that interpersonal commitments are best understood with knowledge of their relationship to adversity. He
posited that when faced with adversity, committed individuals
generally appraise threats as challenges.

METHODS
To answer the research questions, I used data from two
qualitative studies in which primary caregivers were adult
children, children-in-law, grandchildren, or nieces. The use of
two samples from different regions of the United States, recruited from different types of sources, (a) allowed exploration
of caregiver commitment among groups with differing religious
and social backgrounds and (b) increased sample size. The first
study examined the diverse ways in which family care at home
was provided from the perspectives of younger generation
caregivers, their spouses, and adult children. The second
study’s primary purpose was to explore provision and financing
of home care for dependent elderly family members. In both
studies, I queried caregivers about how caregiving began,
length of care provision, assistance with caregiving tasks, and
interpersonal consequences of caregiving.

Sample and Recruitment
Inclusion criteria for the first study were a care recipient aged
65 or older in need of assistance with at least one instrumental
activity of daily living or basic activity of daily living, with
assistance provided in a noninstitutional setting at least 3
months prior to the study. In the second study, the care recipient
was aged 65 or older, received primary care at home, and
received paid assistance such as home health care or adult day
services once or more weekly for at least 3 months. To be
considered a strongly committed caregiver, one had to have
been providing hands-on care for at least 6 months. I did not
include in the analysis of strongly committed caregivers those
who functioned solely as care managers, hiring others to
provide hands-on care around the clock, and those who placed
relatives in assisted living facilities because they were not
providing direct care in a home setting.
Both studies sought a purposeful nonrandom sample of
caregivers and families selected because of their ability to
inform the research problem (Creswell, 2007). Both studies
used a sampling strategy of maximum variation, in which
researchers search for common patterns in cases with diverse
contexts (Miles & Huberman, 1994). In the first study, agencies
and ministers serving older adults in South Carolina referred
participants. In the second study, two Area Agencies on Aging
and a senior center in Utah made referrals. Undergraduate

students at my university referred additional participants.
Referrals were screened by telephone to ensure that they met
the study criteria and were willing to participate.
In the first study, I interviewed 15 primary caregivers, 10
spouses, and 11 adult grandchildren. Care recipients averaged
85 years of age, the middle generation averaged 56 years, and
grandchildren averaged 33 years. In the second study, 30 intergenerational caregivers were interviewed twice; their average
age was 52. The group included 20 daughters, 7 daughtersin-law, 1 son, 1 stepdaughter, and 1 person caring for her
husband’s aunt. Care recipients’ average age was 84 years. Care
recipients in the second study received publicly or privately
funded community services. Most care recipients had health
problems such as stroke, Parkinson’s disease, or heart conditions that had led to multiple activity of daily living limitations;
a third had symptomatic or diagnosed dementia. Most coresided
with primary caregivers.

Data Collection and Analysis
For the most part, participants were interviewed individually,
but a few included their spouses. Interviews occurred in a place
convenient to participants, usually their homes. I conducted all
interviews in the first study. Four trained graduate assistants
and I conducted the interviews in the second study. Both
studies used a semistructured interview protocol with probes for
additional information. We asked all caregivers in both studies
the following questions: What led to your relative’s need for
care? What are your current caregiving arrangements? How has
caregiving affected your relationships with the care recipient
and other family members? and What are your beliefs about
how to best care for older family members? Interviews lasted
from 45 to 120 min and were audiotaped and transcribed
verbatim for analysis.
Because the sample characteristics and the general caregiving questions asked of both groups were very similar, I combined data from both groups for analysis. I used McCracken’s
(1988) multistage process for analysis of long interviews to
analyze data. Initially, I read each interview transcript twice for
content understanding and identification of useful observations.
Next I developed observations into preliminary descriptive and
interpretive categories based on evidence from the transcripts
and the extant literature. Then I thoroughly examined these
preliminary codes to identify connections and develop pattern
codes. Next I used clusters of respondent comments and my
analytic memos to identify basic themes. Finally, I examined
all interviews to delineate predominant themes. At all stages
of the process, research assistants reviewed and discussed the
evolving coding scheme and data interpretations with me. I
used the computer software program QSR NUD*IST Version 6
(QSR International, 2005) for data management and analysis.

RESULTS
Although caregivers in both samples exhibited some degree
of commitment to caregiving, those with strong commitments
composed half of both samples. All primary caregivers with
strong commitments were women; some secondary caregivers
with strong commitments were men. Overall, 48% of primary
caregivers with strong commitments were employed in the paid
labor force. A total of 57% of strongly committed primary

COMMITMENT TO INTERGENERATIONAL ELDER CARE

caregivers were daughters; 30% were daughters-in-law; and
13% were other family members, such as granddaughters.
Those with strong commitments offered compassionate care
and went to considerable lengths to preserve the home care
arrangement, or intended to do so if it was threatened. They
viewed adverse conditions as manageable challenges. One or
more family members and paid providers often assisted them
with elder care.
I present the findings in three sections. First, I describe the
characteristics of strong commitments to care among intergenerational caregivers. Second, I delineate the ways in
which these caregivers dealt with adversity in the caregiving
situation and how they viewed caregiving efforts. Third, I
present themes from caregivers with weaker commitments.

Characteristics of Strong Commitments to Care
Moral and religious bases. —Moral and religious bases for
care are found in the writings of religious philosophers and
theologians. For example, Niebuhr (1963) described the
responsible self as a social, accountable person with trust in
a living God, responding fittingly to the created worth of others.
Among strongly committed intergenerational caregivers, providing assistance was a moral decision, often rooted in religious
convictions. A daughter remarked, ‘‘I just considered it the
moral thing to do. The only reason I had to not do it was
selfishness and that didn’t seem to be reason enough. I didn’t
want to be that kind of person.’’ A granddaughter primary caregiver stated, ‘‘I believe that we’re to honor our parents and our
grandparents, and in caring for them, we’re honoring them.’’
Several daughters-in-law also felt a moral commitment to
care. One remarked:
It’s our duty as human beings to fill special needs for each
other. We try to be very sensitive to what she [mother-in-law]
has indicated were her fears and concerns about aging.
Mainly, we feel like it is the right thing to do.

Closely aligned with a moral or religious basis for care
provision was the belief that family care is best for older family
members. A woman who was a certified nursing assistant and
was caring for her spouse’s aunt described how the aunt came
to live with her family:
They put Eloise [pseudonym] in a nursing home. I tried to
fight it through my husband. I couldn’t really say much. And
when there were some concerns with the family about her
treatment, then I stepped in and offered, ‘‘Have you ever
considered letting me take care of her in my home where she
can be around family?’’ I have five children that she adores,
and I just felt like it would be an ideal situation for both of us.

Embracing the caregiver identity. —All strongly committed
caregivers had internalized the caregiver identity. There were
different sources of this internalization process. Some had internalized moral or religious precepts taught to them as children. A daughter who had removed her stroke-impaired mother
from a nursing home to care for her at home exemplified these
caregivers:
Some people are more giving toward others, more ‘‘other’’
oriented, and some are more ‘‘self’’ oriented. And I think I
was born ‘‘other’’ oriented. I have to say that my father really

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influenced that. Since my parents were missionaries, he taught
us that we should always be doing for other people. That was
his focus.

With her spouse, she had fostered many children over the years,
adopting five of them.
Several caregivers pointed to their prior caregiving experiences. One daughter said, ‘‘It has always been kind of a gift
for me. It just seems to come naturally. I guess it is just being
a mom, it is just a natural instinct.’’
Experiences in caring professions also shaped strong
caregiver identities. A nurse with a widowed mother-in-law
living at home with dementia was primary family caregiver,
keeping close watch on paid providers, consulting with her
brother and sisters-in-law, and providing hands-on care as
needed. She gave several reasons for her strong care provision:
I love this lady and this family, and I’ve oftentimes said I
would just step back. I say to my husband, ‘‘I’ll just play
a low profile,’’ but I guess it’s not my nature. I like to be
involved. I said, ‘‘Jim [spouse] I love your mother, and
somebody needs to do this, she needs the care.’’

Affection for the care recipient. —Affection for the care
recipient was prevalent among strongly committed caregivers.
One caregiver described her feelings for her grandparents as
follows: ‘‘I love them . . . I don’t know what I’d do with myself
if something happened to them, how I’d fill my days. I’d
probably miss the phone calls at 9 o’clock at night.’’
A daughter providing daily care to her dementia-diagnosed
mother described a nightly ritual of putting her to bed: ‘‘I’ll kiss
her and I’ll say, ‘You sleep good now,’ and sometimes we’ll
have a prayer together and I tell her, ‘I love you.’ She’ll say,
‘I love you oh so much.’’’
Ability to provide compassionate care. —Most strongly
committed caregivers expressed compassion for their loved
ones. They were open and receptive to their plight, treated them
with respect, and had the ability to be present in their situations
(Underwood, 2002). Sometimes compassion was the catalyst
for offering assistance, as in the case of a daughter-in-law,
who described her decision to care for her mother-in-law as
follows:
I can remember exactly when it came to me. I was sitting by
her bedside, and I could tell that she was really sick. It scared
me for her and I remember just putting my arms around her,
and it just came to me that I’m really willing to take care of
her and see her finish the rest of her life. I just didn’t want her
to be alone anymore.

Providing compassionate care meant being sensitive to the
older adult’s feelings about assistance. Caregivers preserved
their relatives’ dignity by putting themselves in the elder’s
place and ‘‘cutting down on their embarrassment and
confusion.’’ A 54-year-old daughter-in-law caregiver said:
I find it very important that you let them maintain their
dignity, and even though now she’s so forgetful and
repeats herself, you think, this isn’t the mother-in-law I
used to know, and you don’t want to do anything to hurt her
feelings. You just have to think now if that were me—
maybe it will be someday. You just have to be kind, try to be
patient.

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A daughter who helped her mother with personal care
observed:
I have a lot of empathy thinking how would I feel if someone
had to do these things for me, things that are private. That
can’t be easy for anybody because she knows . . . she’s the
same person that she was, her body has gotten older, but that
spirit is just the same.

Lastly, a 24-year-old grandson who shared the care of his
coresident grandmother with his parents expressed compassion
that stemmed from caring for his grandmother. He said:
Be patient, listen to what older people have to say ‘cause
they’re wiser than you are. They’ve had more experiences
than you’ve had. Be sensitive to them because you don’t
really know what it’s like. They may be old, but they still like
to have a good time. Just treat them like you would treat
anybody else, and how you would want to be treated.

Daughters-in-Law as Primary Caregivers
Nearly a third of strongly committed primary caregivers were
daughters-in-law who shared similar characteristics to blood
kin caregivers. Data suggested two factors by which their
commitment was sustained: strong spousal support, and
caregiver ability to overcome reluctance to direct in-law care.

couldn’t force someone to do what they don’t want to do. You
almost have to separate yourself from it, and say, ‘‘I’m sorry,
this is the way it is, and this is what you have to do.’’

How Strongly Committed Caregivers Handle
Adversity and View Caregiving
Strongly committed intergenerational caregivers found
ways to sustain their commitment to care. They did so by
accepting their situations and making adjustments, by obtaining
family member assistance with care tasks, and by using formal
care services. When necessary, they altered their own lifestyles
to meet their relatives’ needs. They viewed their caring efforts
as personal and family growth experiences, even when
stressful.
Accepting the situation and making adjustments. —
Caregivers felt stresses associated with caregiving and talked
frankly about the lifestyle changes their commitments entailed.
A daughter-in-law remarked:
You have to realize that you go with the flow of life as it’s
there at the time. Don’t plan the future too terribly much or
moan over what happened yesterday because for this person
[care recipient], it’s just right now. Some days you are not
going anywhere. You are staying home all day. If you have
that acceptance, it’s very calming to them [elders].

Spousal support. —Spousal support was important to these
daughters-in-law, all of whom were in long-term marriages. A
caregiver remarked of her spouse:

One daughter described her adjustment to caring for her mother
with dementia as follows:

Once in a while he’ll say, ‘‘Billie, I just don’t know what we’d
all do if you weren’t here to do this for mother, and I feel bad
you have to be the one to take care of her,’’ but I think it’s
brought us closer because he’s never seemed to resent what
I’ve done. He seems to be appreciative of it.

You fight and scream and kick all the way; you don’t want it.
‘‘I want my mother back!’’ But after awhile you learn to cope
with your situation, and you learn to laugh to keep from
crying—and she says some very funny things. Sometimes we
get tickled at her.

Sons also expressed appreciation for their wives’ commitment to care for their mothers. Most of them relied on their
wives to provide the majority of daily care. Of his wife’s care
for his mother with dementia, a son who traveled extensively on
business said:

In the second sample, caregivers were asked how they would
respond if the state-funded services currently provided by state
and local agencies were no longer available to them. Those with
strong commitments to home-based care offered a variety of
solutions. For example, one daughter with a mother in adult
day care said:

I certainly have a deep appreciation of what she is
contributing to all of this. It doesn’t surprise me at all, she’s
always been that way, but certainly she’s really come through,
and I know that it’s not easy all the time. I think she’s telling
the truth when she says it’s not that burdensome, but still, it’s
not her mother.

Overcoming difficulties in caring for in-laws. —Several
daughters-in-law felt uncomfortable telling their mother- or
fathers-in-law what to do. However, they overcame their
reluctance, as noted by one caregiver who felt closer to her
mother-in-law as a result of caring for her. ‘‘I also have had to
take a stand and tell her no on things when I think it is a danger
for her. I don’t think any daughter-in-law would like to be in
that position.’’
Another daughter-in-law caring for both her mother- and
father-in-law noted that her role as caregiver had changed their
relationships because of her insistence on her relatives’ good
hygiene. She remarked:
Our relationship is more businesslike than it used to be. If I
looked at things from a real loving viewpoint, then I almost

I guess my brother and I would pay for it and [have her] try to
go fewer days. I know that my brother and I would do
whatever we needed to do so that she would be taken care of.
I would see if there were other agencies. There are always
things out there that you don’t know about that you can get
help from.

Family is supportive. —Another way in which caregivers met
adversity was through the assistance of family, usually spouses
and children. One daughter-in-law caregiver said of her
husband, ‘‘He’s a good support to me and when he’s needed,
he’s there to help.’’ Later she noted that he had become
more supportive over time, a situation echoed by several
caregivers:
Sometimes he resented the time that I needed to spend in the
caregiving. When I would talk to him about my frustrations,
he would want to solve all the problems. I didn’t need things
to change; I just needed to talk about it. I think he understands
that better now. He lets me just talk . . . in that way, our
relationship is stronger.

COMMITMENT TO INTERGENERATIONAL ELDER CARE

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Children also were helpful, sometimes more so than siblings
or in-laws. When asked about her children’s involvement in her
parents’ care, one caregiver daughter said:

A 30-year-old granddaughter who assisted her mother with
the care of her grandmother and aunt talked about what this
care provision meant to her:

They stay with Grandma and Grandpa, or they fix meals. If I
need to go someplace they will be here. And it isn’t like it is
a grudge thing. My children all know how to do Grandma’s
medicine, and they could change her. So it has never been
a question with my kids if they would help. It was just, ‘‘What
do we need to do?’’

It means helping my mom, with some of her duties, and also
just giving some love and affection to my loved ones. I
just . . . I like it. I just love spending time with them, hugging
and kissing them, and saying their prayers with them.

Receiving formal care services. —Most participants, particularly employed caregivers, were currently using formal or paid
care services. Although not always pleased with the quality of
services provided, most viewed them as an integral part of their
care provision. For example, a daughter who worked full time
and used adult day services for her mother with dementia said:
They are wonderful; they provide the bus service [to day
care]. Like I said, we were concerned about her getting up so
early, she was fighting me, and I said, ‘‘Is there any way she
can come later?’’ They were actually sending a car out just for
her later in the morning like around 10:00. They were really
going the extra mile.

Another daughter noted that her father made better progress
after hip surgery when physical therapists came to their home to
work with him: ‘‘He had them the normal length of time that
they were needed. He was doing okay. But when they stopped
coming in, we would slack off because we would get busy with
life, instead of concentrating on that.’’
Caregiving is a growth experience. —Strongly committed
caregivers described personal or relationship growth as benefits
of their care provision. Some cited an increased love for their
relatives, whereas others cited improvement in personal
attributes. A daughter-in-law said, ‘‘So our relationship together
has grown because we are able to spend a lot more quality time
together and she has been able to see our family up close and
personal.’’ A daughter who had cared for her father until his
death and who was now looking after her mother said:
When you take care of someone, I think you learn to love
them more. You learn to care about them, about all kinds of
things more. I am finding that before [I cared for my father]
there were things that would bug me about her [mother]. Now
it is more me caring about those things than letting them
bug me.

Another daughter said:
One of the biggest lessons this has taught me is patience, to be
patient, and also to be able to handle things. A few years ago
when there would be problems with mom, I would get a lot
more nervous and upset, and now it seems like it’s easier for
me to handle it.

Additionally, several caregivers mentioned the opportunities
for growth that caring for grandparents had offered their
children. The participant caring for her husband’s aunt
illustrated this effect:
They are learning a lot of important skills with compassion
and service and love for elderly people. It is a beautiful thing
to see take place. They are learning to be more selfless, and in
today’s world that is really important. It is really needed.

Caregivers With Weaker Commitments to
Intergenerational Care
A major difference between those with strong commitments
to care and other caregivers lies in the notion that caring
provides the caregiver with self-esteem, meaning, and purpose.
Those with weaker commitments to care did not see caregiving
as enhancing self-esteem or providing them with a sense of
purpose. Instead, they expressed ambivalent feelings about
caregiving, often struggling with its stressful aspects. Most
felt only duty or obligation to care for their elderly relatives.
For example, a daughter said, ‘‘I do it because she’s my mother.
I do it because my daddy would want me to, and my daddy
was my heart. Mamma and I never were close.’’ Some relationships with care recipients were difficult or lacked affection.
A daughter-in-law who had ‘‘inherited’’ her father-in-law’s
care said of him, ‘‘It’s just frustrating sometimes, he can be
so childlike and I already have a teenager and I don’t need
two. She’s 14 and he’s at the same level at [age] 84 of
stubbornness.’’
Caregivers also emphasized their lifestyle restrictions. A
daughter who cared for a bedridden mother explained:
My children are jealous of it because I cannot go and do with
them. Everything is done here. We don’t go to the beach like
we used to; everything has to be done on the back patio. They
think that it’s wearing me out, that it’s time to put her in
a nursing home.

In a follow-up call, she revealed that she had placed her mother
in a nursing home a week after our interview.
Finally, for many of these caregivers, family relations were
strained, especially with siblings. Of her brother-in-law one
woman said, ‘‘It has very much distanced us from the one that
is least involved, because there are some things he has done that
we felt were undermining. So it has really severed what
relationship was there.’’

DISCUSSION
Guided by interpersonal commitment theory, I have described the components of strong caregiver commitments to
parents, in-laws, grandparents, and other elderly family
members. Results suggested that many intergenerational caregivers had strong commitments to home care provision and
maintained their commitments despite competing responsibilities and difficult care demands.
For these caregivers, commitments to care had moral and
religious bases that extended beyond notions of duty or
obligation. They felt genuine affection for the care recipient.
Many of them described being a caregiver as a highly salient
identity. Identities with high salience produce greater commitments to roles invoking those identities (Stryker, 1991).

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Strongly committed caregivers responded to their moral or
religious convictions by providing compassionate care, adjusting their routines, and accepting their changed lifestyles to
accommodate care provision. In so doing, they exhibited a
‘‘moral imagination’’ (Black, 2004), the ability to reflect on
themselves and others, do what they felt was best for elders,
and view their care provision as a process of growth in competence and compassion. These caregivers often reframed the
stressful aspects of caregiving as opportunities for personal and
relationship growth, frequently involving their children in care
tasks so that they too would learn values of compassion and
sacrifice. Their systems of care tended to reflect collectivist
orientations (Pyke & Bengtson, 1996), in which family assumes
the care of frail elders, eschewing nursing home placement
under most conditions.
However, providing compassionate care and altering lifestyles did not preclude recognition of self-care needs. Strongly
committed caregivers sought both instrumental and emotional
support from family and, in many cases, formal care services.
In so doing, these caregivers may have lessened feelings of
subjective burden and role captivity, both of which can
precipitate institutionalization of elders (Gaugler et al., 2000;
McFall & Miller, 1992). Using services also may have
increased their competence as caregivers. In a study of the
meaning of quality home care services, Piercy and Dunkley
(2004) found that family caregivers viewed good-quality formal
services as enhancing the quality of life for care recipients and
teaching them skills that improved their performance in the
caregiver role.
Findings from this study suggest that researchers can extend
interpersonal commitment theory beyond couple relationships
to explain commitment to intergenerational caregiving relationships, particularly in the area of adversity. Adversity in intergenerational care stems from the care recipient’s condition,
caregiver standing as an in-law, and structural conditions such
as paid employment. As the care recipient’s health deteriorates,
caregivers are challenged to maintain elder safety while maintaining a workable alliance with them. Simultaneously, caregivers must meet responsibilities to self, family members, and
employers. Strongly committed caregivers in this study showed
that marshaling personal, familial, and formal care resources
kept adversity at manageable levels.
Daughter-in-law care provision was sustained by spousal
support and caregiver willingness to overcome discomfort
about directing in-law care. Studies of in-law caregiving are
few (Globerman, 1996; Suitor & Pillemer, 1994). Like the
present study, Globerman found that daughter-in-law caregivers
were persons who took charge and ‘‘did what had to be done’’
(p. 40). However, in contrast to Globerman’s findings, some
daughters-in-law in the present study felt deep, long-lasting
affection for their in-laws.
Providing parent or in-law care can affect marriage, too.
Suitor and Pillemer (1994) found that providing dementia
care altered the marital satisfaction of some daughters and
daughters-in-law over time, with husbands’ increased emotional support and decreased hindrance associated with increased marital satisfaction. Although the present study did not
measure marital satisfaction, findings suggest that a spouse’s
emotional support of his wife’s caregiving helps sustain her
commitment to care and oftentimes fosters closeness to each

other. Research has shown perceived spousal support to benefit
marriage by maintaining emotional contact and increasing
intimacy in couples (Cutrona, 1996).
The concept of resilience also may be useful in understanding strong caregiver commitment to home care. In longitudinal
study of dementia caregivers, Gaugler, Kane, and Newcomer
(2007) found that resilient caregivers were less likely to
institutionalize their relatives over a 3-year period than less
resilient caregivers. Bergeman and Wallace (1999) cited selfconcept, perceptions of control and self-efficacy, and hardiness
as personal factors that may improve resilience. They argued
that being hardy influences interpretation of situations as
stressful or nonstressful. Hardiness also may prompt people to
cope with stressful events in imaginative ways (Maddi, 2002).
Caregivers in this study exhibited creative ways of dealing with
adversity in order to continue home care provision. Their
families also may have possessed resilient traits. Walsh (1996)
suggested that interaction processes such as organization,
communication, and problem solving over time strengthen
both individual and family hardiness. However, the exact
relationship between resilience and commitment to care needs
longitudinal study. Being resilient may be necessary to making
a strong commitment to provide home care, or it may be that
caregivers and their families increase resilience as they adapt to
changing care circumstances, such as the physical or cognitive
decline of the care recipient.
Findings suggest that strongly committed intergenerational
caregivers resist ceding their caregiver roles unless changing
personal or family circumstances reduce salience of the caregiver identity. However, with reduced family sizes and the increasing participation of middle-class women in the paid labor
force, scholars have questioned whether society is asking too
much of families (Hooyman & Gonyea, 1995; Montgomery &
Williams, 2001), particularly women, to provide long-term care
at home. Current policy assumes the presence of nuclear
families with female members readily available to provide elder
care. Such policy flies in the face of current family trends,
leading to unmet needs in community services for dependent
elders (Desai, Lentzner, & Weeks, 2001). This study’s findings
suggest that formal care services are critically important to
sustaining strong commitments to home care among intergenerational caregivers. Policy makers must address expansion of these services and appropriate compensation for
workers because high turnover rates are a serious problem,
especially among paraprofessionals (Feldman, 1993; Kaye,
Chapman, Newcomer, & Harrington, 2006; Montgomery &
Williams, 2001).

Study Limitations
Several limitations to this work are worth noting. First, most
caregivers in both studies were from middle-class families,
which likely increased their ability to commit substantial
resources to caregiving. However, with nearly half of these
caregivers in the paid labor force, employment did not preclude
strong commitment to home care. Second, the study’s findings
are cross-sectional, so the full length of time that participants
sustained commitment to home care is unknown, as is whether
caregivers achieved their intentions to prevent institutionalization. Additionally, most caregivers were married, were
Caucasian, and possessed strong religious backgrounds. Studies

COMMITMENT TO INTERGENERATIONAL ELDER CARE

with samples more diverse in marital status, religiosity, and
ethnicity are needed to see if characteristics of strong commitments to care are similar for these individuals.

Conclusion
Illumination of the characteristics of strong intergenerational
commitments to care for frail elderly family members has
suggested that individuals, caregiver–care recipient dyads,
family systems, and social service systems often combine to
generate and sustain these commitments. Additional study of
the characteristics of strong commitment to maintaining longterm care at home could prompt research focused on the
measurement of these characteristics for use in models of
informal long-term care, as well as in studies that examine links
between caregiver commitment and caregiver and care recipient
outcomes.
CORRESPONDENCE
Address correspondence to Kathleen W. Piercy, Department of Family,
Consumer, and Human Development, Utah State University, 2905 Old
Main Hill, Logan, UT 84322-2905. E-mail: kathy.piercy@usu.edu
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Received April 2, 2007
Accepted June 27, 2007
Decision Editor: Kenneth F. Ferraro, PhD