AMERICAN FAMILIES36 percent were cared for in their own homes
(usually by the father or another relative); 31
percent were cared for in another home (usually
by a nonrelative in the care provider’s home). A
further 9 percent were cared for by their mothers
while they worked—this was generally in a home
environment as well, as most of these mothers had
home-based paid work. Approximately one-quar-
ter of the children who required care while their
mothers worked were enrolled in an organized
day care facility (U.S. Bureau of the Census 1995).
With the increasing use of childcare provided
by individuals other than the mother, concerns
have been raised regarding the impact of nonmaternal
care on children’s physical, cognitive, and psycho-
logical development. The majority of studies on
this topic have concluded that nonmaternal childcare,
and nonparental childcare more generally, is not
in itself harmful to children. In fact, day care
settings apparently aid the development of child-
ren’s social skills. However, the quality of the
care—whether in a family or nonfamily setting—is
extremely important for children’s development
and well-being. A comprehensive report published
by the National Research Council found that child-
ren whose families were undergoing psychological
stress or economic deprivation were more likely to
receive care in lower quality settings. Hence, these
children are vulnerable not only to poverty and
psychological stress within the home, but they are
also likely to suffer from the effects of poor-quality
care outside the home (Hayes, Palmer, and
Zaslow 1990).
Eldercare. Most older Americans live inde-
pendently in the community and are in relatively
good health. Most also provide economic and
other support to their adult children, such as
providing babysitting or other services. It is only
when the elder’s health or economic status is
severely compromised that the balance of exchange
tips in the direction of receiving a greater amount
of support than elders provide to their children.
The bulk of care provided to older Americans
who are frail or ill is provided by family members,
usually women, who are typically spouses or child-
ren of the elder (Stone, Cafferata, and Sangl 1987;
Wolf, Freedman, and Soldo 1997). If a spouse or
child is not available, other relatives or a friend
may provide care (though assistance from these
latter sources is typically less intensive and for
briefer periods of time). Much research attests to
the extensive and prolonged care provided by
family members to elders within a home environ-
ment (see Dwyer and Coward 1992). In many if not
most cases, it is only after families have exhausted
their physical, economic, and emotional resources
that a decision is made to place an elder in a long-
term care facility. Indeed, only 5 percent of all
Americans age sixty-five and older reside in a
nursing home or other long-term care facility at a
given point in time. The chances of nursing home
placement rise with age: Nearly 25 percent of
those age eighty-five or older live in a nursing
home. However, even among this ‘‘oldest-old’’ age
group, the majority of individuals reside in the
community rather than a nursing home (Morgan
and Kunkel 1998).Recognizing that women typically are the pri-
mary care providers to older family members,
researchers and policymakers have raised con-
cerns that such care will be curtailed in the future
due to trends in women’s employment and an
increasing older population. The prevalence of
elder care among the employed population is
difficult to estimate due to variations in sampling
across studies and how caregiving is defined. How-
ever, an averaged estimate from studies on this
topic is that about one in five employees has some
elder care responsibilities (Gorey, Rice, and
Brice 1992).Research has shown that caregiving can be
emotionally gratifying for individuals who are pro-
viding care to a loved one (Lechner 1992). Howev-
er, intensive, long-term caregiving can produce
serious physical, economic, and emotional strains,
especially when caregiving interferes with the pro-
vider’s work or household responsibilities (Gerstel
and Gallagher 1993). A number of studies have
found that employment status does not alter the
type or amount of care provided to the elderly by
their families, but some family members reduce or
terminate their employment in order to provide
elder care. A national survey found that 9 percent
of employees in the study had quit their jobs and a
further 20 percent had altered their work sched-
ules to accommodate their caregiving responsibili-
ties. Women were more likely than men to rear-
range their work schedules or to reduce or terminate
their employment in order to provide family care
(Stone, Cafferata, and Sangl 1987).