The most common portrayal of care provision is a relationship where the older and/or sick person is taken care of by younger, healthy family members or paid workers. This flies in the face of the reality that (1) in many homes the less sick person is caring for the more sick person; (2) many people do not have a family system to fall back on; and (3) paid caregivers are increasingly unaffordable and scarce.

While in many ways caregiving is caregiving I have seen one factor that really alters the landscape in a fundamental way—caregiving on the vertical (intergenerational: family, volunteers, paid helpers) in contrast with caregiving on the lateral (intra-generational: family, friends, volunteers, paid helpers).

Given the demographics and economics of aging, many of us will be giving and receiving care with our peers who will be mostly volunteers. For example,

  • Seniors who are single and/or childless or who live at a great distance (geographic, emotional) from family.
  • Adult children caught in the squeeze generation might only have enough resources for the younger people in the family.
  • Seniors might not have the resources to hire paid help (agencies, grey market).

While this can sound pretty dire, I see enormous potential for creating a type of relationship that can be vital and rich in meaning—alliances (a union or association formed for mutual benefit), i.e. a win-win. (Google Dictionary) As many caregivers and care-receivers can attest, this is often not the norm in care situations.

Four factors are essential to finding allies and creating alliances:

  1. Clear communication about what one needs and what one is able to contribute;
  2. Able to negotiate an agreement; keep the agreement; re-negotiate the agreement when necessary;
  3. A willingness to learn how to do this if it has not been a necessary skill up till now; and,
  4. Respect for the other person(s) and the process.

Sounds kind of simple and straightforward so what might be some problems?

Well, for one, often in family systems there is not a lot of negotiating. Patterns of relating might be set in stone. There can be a culture of my way or the highway. People who have lived alone for a long time might not have had to negotiate in recent memory.

A person might not know how to step outside of his/her current habitual existence to ask crucial questions: What do I need? What do I want? What’s the difference? What’s essential for me? What can I do without?

Behavior that might be tolerated within the family system (rudeness, bullying, unwillingness to compromise, etc.) will need to make way for respect, flexibility and courtesy.

So where does alchemy come in?

Originally a medieval science that is the forerunner of chemistry, alchemy can also be described as a seemingly magical process of transformation, creation, or combination. (Google Dictionary)

Think quilting bee or a theatre production. I think of my sister-in-law whom I hardly knew before I moved to Milwaukee. Shared goals, clearly articulated needs on both our parts, and her willingness to collaborate generated a seemingly magical process of…creation…of a friendship.