title: Caregiving expectations and challenges among elders and their adult children in Southern Sri Lanka.
abstract: The elderly population in Sri Lanka is growing rapidly. Elders are traditionally cared for in the homes of their adult children, but the shifting socio-economic environment in Sri Lanka challenges this arrangement. This paper describes the dynamics of elder-caregiver relationships in Southern Sri Lanka. Data included 4 focus group discussions and 5 in-depth interviews with elderly, and 10 in-depth interviews with adult children of the elderly. Discussion guide topics included caregiving arrangements, and roles/responsibilities of elders and caregivers. Using a grounded theory approach, a comprehensive analytic memo was developed and discussed to explore emerging themes on the caregiver dynamic. Both elders and caregivers felt that elders should be taken care of in the home by their children. They pointed to a sense of duty and role modeling of parental caregiving that is passed down through generations. Even as elders desired support from their children, they feared losing their independence, and saw financial autonomy as important for maintaining relationship balance. Caregiving challenges included: households where both the adult child and his/her spouse worked outside the home; households where elders had a disproportionate amount of household work; economically stressed households; and lack of direct communication between elders and caregivers regarding conflicts. Results point to strong values around caring for elderly in the home, but identify challenges to this arrangement in the future.
authors.affiliation: Duke University, Duke Global Health Institute, Box 90519, Durham, NC 27708, USA, melissa.watt@duke.edu.
authors.forename: Melissa H
authors.initials: MH
authors.lastname: Watt
authors.affiliation: University of Ruhuna, Department of Community Medicine, P.O. Box 70, Galle 80000, Sri Lanka, pperera@indiana.edu.
authors.forename: Bilesha
authors.initials: B
authors.lastname: Perera
authors.affiliation: Duke University, Department of Community and Family Medicine, Box 104006, Durham, NC 27708, USA, truls.ostbye@duke.edu.
authors.forename: Truls
authors.initials: T
authors.lastname: Ostbye
authors.affiliation: University of Ruhuna, Department of Geography, P.O. Box 70, Matara, 80000, Sri Lanka, shyama.ranabahu@gmail.com.
authors.forename: Shyama
authors.initials: S
authors.lastname: Ranabahu
authors.affiliation: University of Ruhuna, Department of Psychiatry, P.O. Box 70, Galle 80000, Sri Lanka, harshini.rajapakse@gmail.com.
authors.forename: Harshini
authors.initials: H
authors.lastname: Rajapakse
authors.affiliation: Duke University, Department of Psychiatry, Box 90519, Durham, NC 27708, USA, joanna.maselko@duke.edu.
authors.forename: Joanna
authors.initials: J
authors.lastname: Maselko
keywords: Sri Lanka; ageing; caregiving; elderly; qualitative methods