Eddy M. Elmer
Simon Fraser University, July 2001
My sincerest thanks goes to the two individuals who volunteered
their time and stories for this case study.
Caregiving relationships between individuals vary greatly in both structure and the direction and patterns of support within them. While many research studies provide valuable data on large numbers of common types of caregiving relationships in the general population, an individual case-by-case analysis of specific caregiving relationships—particularly those which may be less common—can provide for valuable appreciation of the unique everyday realities experienced by those who provide and receive care. These relationships are often influenced by factors not always tapped into by larger studies. One such factor is the role of sexual orientation.
This case study will explore the caregiving relationship between an elderly father and his openly homosexual middle-aged son. The reason for the focus on sexual orientation is to appreciate how family members' negative attitudes towards homosexuality may strain relationships with gay family members (e.g., Kurdek & Schmitt, 1987). As we will see in this case study, when a caregiving relationship is thus affected, there are several implications for the type and quality of support that emerges. That the couple in question is male-male is of particular value in this study because research has suggested that homosexuality is more negatively sanctioned in males than in females, particularly by men (e.g., Whitley & Kite, 1995). It would follow that a male-male caregiving relationship would thus be significantly influenced if one of the members of the relationship were gay.
The participants in this case study are David* and his father, Franklin. Franklin is a 67-year-old retired bricklayer currently living by himself in a suburb of a major western Canadian city. Franklin was born in Montenegro, which along with Serbia forms present-day Yugoslavia. His father, a cattle farmer, and his mother, a seamstress, gave birth to 8 children, Franklin being the second. Through hard work and tremendous thrift, his family usually managed to have shelter and food on the table. Franklin grew up at a time of tremendous strife, when Yugoslavia was forming the all-Yugoslav Partisan force to resist Nazi Germany's attack.
During his entire life in Yugoslavia, Franklin knew a very traditional, patriarchal society with highly-differentiated and stereotyped gender roles and clearly-defined expectations as to support within the family. Parents were to sacrifice all they had for their children, and the children were in turn expected to live in fairly close proximity to the family—if not in the family home itself—for most of their lives, in order to help with the family farm and support the ageing parents. The western notion of "independence" from one's family of origin was quite foreign to Franklin. However, when Franklin's wife, Svetlenka, was pregnant with David, he moved to Canada in hopes of building a more prosperous life for his only child (a second son died of respiratory complications shortly after birth). After many years, Franklin's wife died of a massive stroke and Franklin lived as a widow for several years. Franklin currently suffers from Parkinson's disease, a progressive neurological disorder characterised by muscular tremor, slowness of movement, peculiar gait and posture, and tremendous overall weakness.
Franklin's son, David, lives with his father and provides him daily assistance with the tasks he can no longer perform because of the Parkinson's. David is a single, never-married, 45-year-old mortgage broker working for a major Canadian Bank. He is well-educated, having taken two undergraduate degrees—one in commerce, the other in finance. About ten years ago, David "came out" to his parents, admitting to them that he was gay and would probably never marry a woman or have his own biological children. David's mother all but denied her son could be gay, insisting that David was simply disappointed that he had "not yet met the right woman". She maintained this to her deathbed. David's father, on the other hand, fully believed this reality, but relentlessly ostracised his son—although never fully disowning him. For most of the last ten years, David's father has tried to make him feel guilty about his homosexuality in an effort to "convert" him to heterosexuality. He has often resorted to scathing insults (in the guise of "gentle teasing"), calling his son "fairy", "queer", and even "no-good fag". As a result, when Franklin's health turned for the worse, David was very reluctant to take on a care-giving role, but nonetheless, his father's powerful teaching that children take care of their parents somehow convinced him to set aside his hurt. In fact, it miraculously convinced him to move in with Franklin so he could more easily take care of him!
There were two reasons for choosing these participants for this study. First was the requirement that the caregiver be 40 or over and that the care receiver be 65 or older, and that the caregiver be providing at least five hours per week of instrumental support. Second was the uniqueness of the relationship—namely, that of a father and son living alone together in a caregiving relationship, in which the son is an open homosexual by whom his father is ostensibly highly dismayed. Although it is safe to say that such an arrangement is probably fairly uncommon, it is of value for a few good reasons:
The participants were chosen also because I personally know the caregiver, David. As a result, I had a valuable, pre-established trust between myself and at least one of the participants. Since the issue of homosexuality, let alone that of caregiving, is a very private one, my existing relationship with David encouraged a candour that may not have been possible were participants chosen randomly from the general population. The unfortunate downside of this is that David, knowing for quite some time that I am a social sciences student, and himself being a friend, may have felt somewhat compelled to provide "good material" for me and thus overstated whatever strife was present in the relationship with his father. Furthermore, because David was contacted about this research before his father was, Franklin may have felt he was not fairly consulted, and might therefore have appeared too judgmental of his son during the research interviews. Despite these difficulties, however, I believe I was able to have fairly thorough and honest discussions with both David and Franklin.
Data on this father-son relationship was gathered by conducting one 20-minute face-to-face interview with David, and another 20-minute telephone interview with Franklin. Interview questions, as per Appendix "A", were designed to gauge the types of support in this caregiving relationship (e.g., instrumental support, vis-à-vis activities of daily living and instrumental activities of daily living, and affective support); the direction of this support (e.g., is it reciprocal and if so, to what extent?); and each participant's reaction to both giving and receiving this support (e.g., what emotions emerge during caregiving, how is the family dynamic altered as a result of the support, etc.).
Even though going into both of these interviews I already knew that David's sexual orientation was an issue in the caregiving relationship, at no time during the interviews did I ask either David or Franklin specifically about the issue of David's homosexuality. I felt that if this issue played a role in the relationship, it would naturally come up in conversation (which, as will be described in the next section, it did). My broaching the issue directly could have encouraged either participant to overestimate the role of David's homosexuality, or, alternatively, such questions might have offended Franklin and discouraged him from discussing the full magnitude of the issue.
Franklin's Parkinson's disease is at a fairly advanced stage. His most troublesome symptoms are extreme slowness of movement and tremor. He tells me that as a result, his son David often must help him with various activities of daily living, including walking to the bathroom, sitting on the toilet, and entering the shower without falling. Since his fine motor movement has also been impaired, David is also on hand to turn on the taps in the shower and in the sink so that Franklin does not burn himself. David also helps his father change into his clothing, and does most of the laundry and ironing for the both of them (again, for fear his father will burn himself using the iron). Since the two of them live together and share the same taste in food, David finds it most convenient to prepare all the daily meals. His father will help with easier tasks such as stirring contents in bowls and taking food out of the refrigerator. In terms of instrumental activities of daily living, David invariably performs most of the tasks such as grocery shopping, cleaning the house, and mowing the lawn. It becomes clear during both interviews that David provides a tremendous amount of instrumental support to his father. In fact, it would seem that he sometimes provides too much, not providing enough opportunities for his father to engage in certain tasks Franklin says he would not have too much trouble doing (e.g., arranging the kitchen cabinets, taking laundry out of the drier and folding, light mopping and dusting).
When Franklin is asked how useful he finds this support, he is ambivalent. On the one hand, he is happy to have someone living in the house who practically takes care of all the household chores, in addition to helping with very difficult tasks such as going to the bathroom. On the other hand, he says he feels "resentful" that his son does so much: "He can make me feel like I'm a helpless old man." However, when asked how he could improve this situation with his son, the conversation turns away from support itself and toward David:
Look at everything he does for me! It's more than my own wife ever did! Imagine if he took all that energy and met himself a wife. There would be a real [sic] happy woman. She'd never have anything to complain about. But instead, my son wants to call himself 'gay' and live with his father.
Franklin goes on to say that many of the things David does for him, he could do for himself. When asked why he does not mention this to David, he says David is "safer with me. . . here in the house". Apparently, Franklin has a fear that if his son were to go live by himself, he might "catch AIDS or some other disease." He is insistent on this, despite the fact that David has lived on his own for most of his adult life without incident. When asked about any emotional support he receives from David, Franklin is quick to say, "Not always. To be honest, he breaks my heart sometimes and makes me feel bad. I am reminded that I have a 45-year-old gay son at home who doesn't like woman [sic] and will never have kids. . . me, I am the only child he will have. Sometimes I am so sad because of this that I don't want to do anything for myself. I get tired and depressed."
For his part, David also maintains that he does more than his fair share for his father. When asked why he does not let his father try to do more things on his own, he says he thinks his father will hate him even more because of his sexual orientation:
As much as I am hurt by what my father thinks of me being gay, and as much as I hate the names he calls me and how he says I have hurt him because I have embarrassed him and the family, helping him when he is sick is the only other thing I can do to make him think good of me. Without helping him, I'm just his gay son who let him down.
David mentions that he and his father are constantly arguing about these issues, trying to figure out what is best for both of them. On the one hand, they both want to be more independent, but on the other hand, without David having his own family, the relationship between himself and pretty much the only family he knows in Canada is over (he does not have a good relationship with his aunts, uncles, and cousins, citing he feels strange that he has no siblings and that he would not know how to relate to his relatives). When asked specifically if his father offers him any support, David replies, "Yes, I get lots of support—lots of support to get married and make my father proud."
In general, it would seem to the casual observer that the support in this father-son relationship is fairly unidirectional, with most support coming from the son. However, by exploring the issue of homosexuality in this relationship, it becomes clearer that this relationship is in fact extremely bi-directional and is characterised by a strange, but quite pronounced sense of global reciprocity. Let us discuss this issue in the next section.
A theme that repeatedly emerges from these two interviews is the concept of global reciprocity. Norris and Tindale (1994) see intergenerational relationships as usually characterised by a sense of equity over the life course. Under this framework, individuals in a relationship provide support for one another that as a whole is generally equitable over the entire life course. A strong sense of attachment between the individuals in the relationship fosters such equity over time, so that support need not necessarily be reciprocated immediately or be of the same quality, because there is a general understanding that it will be "repaid" at a later time. In the case of David and Franklin, there is a strong sense both of attachment and of an equitable, unidirectional support that appears reflective of a strong sense of global reciprocity between the two.
The attachment is apparent in that David decided to take care of his
ailing father even though Franklin relentlessly ostracised him for his sexual orientation.
This attachment appears to be a result of the closeness and obligation Franklin
experienced with his own parents, who believed in sacrificing for their children and in
the children sacrificing for the parents when they got older. The equity in support in
this ostensibly unidirectional relationship is demonstrated by the affective support
provided by both father and son but not directly acknowledged in the interviews. In
working hard to provide his father instrumental support, David appears to be making
up for the emotional support he feels he has not provided his father for most of
his life—namely, the emotional support he feels is symbolised by getting married and
having a child. He feels the latter would "make my father happy and show him I really
do love him." For his part, Franklin provides a very strong sense of reciprocal
emotional support to David, which appears to be the case for several reasons:
In essence, it would appear that the constant bickering and strife actually binds these two men together. As they try to negotiate a history of emotional turmoil within the context of a son caring for his physically ailing father, they support one another in a way that was not possible before. The sense of global reciprocity between the two is merely magnified in this household drama—both are taking the opportunity in this household arrangement to redress any perceived imbalances in the history of their relationship. Even though to outside observers it would seem absurd that David feels his father's behaviour is actually supportive, in his mind it is. What is important in equitable relationships is not the absolute equity of support, but the perceived equity of support—no matter how bizarre such perceptions may be.
Intimately tied to this is the notion of constructing one's personal identity through a caregiving relationship. In her paper, Women and Caring: Constructing Self Through Others, Hazel MacRae (1995) suggests that women's caregiving can be a meaningful part of their self identity. In the case of David and Franklin, the caregiving relationship can also be considered a meaningful part of both their self identities. David's over-involvement in his father's care helps David redefine himself in his father's eyes, and Franklin's negative reaction to his son's sexual orientation maintains his own self identity as a father not to be "blamed" for having raised a gay son. Of course, nobody can be "blamed" for another's sexual orientation, but again, in Franklin's mind the idea of "blame" seems all too real—so real in fact that he works very hard to absolve himself of it. This entire relationship, with its attempts at constructing and re-affirming the perceptions of self identity, can be well conceptualised from a symbolic interactionist perspective, in which caregiving is invested with symbolic meaning, and this symbolic meaning forms the language of communication between this father and son pair. As Blumer (1969) writes:
[There is a] peculiar and distinctive character of interaction. . .takes place between human beings. The peculiarity consists in the fact that human beings interpret or 'define' each other's actions instead of merely reacting to each other's actions. Their 'response' is not made directly to the actions of one another but instead is based on the meaning which they attach to such actions. Thus, human interaction is mediated by the use of symbols, by interpretation, or by ascertaining the meaning of one another's actions (p. 180).
In this case study, we have briefly explored the caregiving relationship between an elderly, ailing father and his openly homosexual son. Of most interest in this case was the bi-directionality of emotional support that emerged from a relationship that on the surface appeared very unidirectional. Whenever conceptualising a caregiving relationship, it is critical that we consider not only individuals' own accounting of the type and quality of support that is exchanged between them, but that we step back from the relationship and re-evaluate any strife and difficulties and consider the potential utility of seemingly dysfunctional attitudes and behaviours in contributing to an equitable relationship. This appreciation is valuable for a number of reasons. From a psychological and sociological perspective, it helps us appreciate just how people construct their caregiving relationships and how such relationships sometimes mean more than meets the eye. Understanding the numerous factors of such relationships, including perceptions, beliefs and attitudes, and outward behaviours points to the complexity of caregiving and alerts us all to the everyday realities of the individuals we study.
From a clinical perspective, individuals who feel they are not
getting what they want or need from their relationships can be referred for family
therapy. The therapist who is able to appreciate the utility of both functional and
dysfunctional attitudes and behaviours in the relationship will be able to tap into
hidden issues and address underlying problems which are merely being played out in the
current drama of the caregiving relationship (see for example Glick, Clarkin, &
Kessler, 1988). This would be useful not only for resolving the underlying issues, but for
restructuring the caregiving relationship so that it is more useful and efficient for all
involved. It is posited that when caregiving energies are directed not only to caregiving
per se, but also to personal dilemmas, its overall utility is greatly compromised. The
goal of family therapy would be to apply a full understanding of the underlying dynamics
so that the individuals in the relationship address their difficulties and thus become
free to both provide and receive support in a healthy, fulfilling fashion.
*The names of all participants in this study have been changed to
protect their confidentiality.
Blumer, H. (1969). Symbolic interactionism: Perspective and method. Berkeley, CA: University of California Press.
Glick, I.D., Clarkin, J.F., & Kessler, D.R. (1987). Marital and family therapy (3rd ed.). Orlando, Florida: Grune & Stratton.
Kurdek, L.A., & Schmitt, J.P. (1987). Perceived emotional support from family and friends in members of homosexual, married, and heterosexual cohabiting couples. Journal of Homosexuality, 14, 57-68.
MacRae, H.M. (1995). Women and caring: Constructing self through others. Journal of Women & Ageing, 7 ½, 145-167.
Norris, J.E., & Tindale, J.A. (1994). Among generations: The cycle of adult relationships. New York: Freeman.
Whitley, B.E., Jr., & Kite, M.E. (1995). Sex differences in attitudes toward
homosexuality: A comment on Oliver and Hyde (1993). Psychological Bulletin, 117
(1), 146-154.
See attached looseleaf notes.
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