: While myths persist that adult children today are not providing as much care to their elders as did previous generations, in reality, adult children nowadays are providing more care and more difficult care to parents over longer periods of time than they ever have in the past. Yet the demand for long-term care is poised to far surpass the projected available supply of both informal (unpaid) and formal (paid) caregivers. As such, increasing concern and attention is being given to the need to sustain and augment the current supply of both informal and formal caregivers. At the same time, the recent advent of programs and policies that allow family members to be paid for caregiving is quickly blurring the distinction between informal and formal caregiving, creating a new category of caregiver that we know little about. To address these concerns, it is important first to unravel our understanding of what leads caregivers (both informal and formal) to adopt caregiver roles and then, to identify what keeps them committed to providing for the long-term care needs of relatives or strangers. The purpose of the proposed study is to illuminate how paid family and friend caregivers describe and make sense of their motives for caregiving, and to examine how their reasons for caregiving are related to caregiver well-being. Using data collected from family and friend caregivers who were formerly paid to care for MediCal eligible disabled and elderly under California's In-Home Supportive Services, this study will employ a mixed method design using a dominant qualitative strategy informed by the tenets of Symbolic Interactionism (SI), which emphasizes the importance of understanding a situation from the person's point of view, and feminist Standpoint Theory (SPT), which brings explicit attention to the social and political context. Guided by the interdisciplinary literatures of psychology, sociology, anthropology, and economics, a supplementary quantitative component (using telephone survey data from all 383 respondents) will be nested ? within the dominant qualitative method (using in-depth interview data from 47 respondents). A modified ? version of Kramer's conceptual model of caregiver adaptation (1997) provides the theoretical framework for the quantitative analyses, as well as a point of comparison for the emergent theory. Understanding what motivates paid family or friend caregivers is important in efforts to assess both the potential availability of caregivers, as well as the efficacy of policies and programs that allow family members and friends to be paid. Such knowledge could have implications for quality of care as it is used to identify those who are most likely - and perhaps those who are most appropriate - to assume a caregiver role. The identification of specific motives may also offer insight into a caregiver's level of commitment and intention to continue. Within the context of policy and program development, these findings could be used to direct caregiver recruitment and retention efforts. ? ? ? ?
