Many of the elderly individuals prefer to remain living at their own home in the community, but are forced to transfer to a nursing home because community-based supports are not sufficient to meet their personal needs [1] [2]. Family caregiver is a term used to refer to unpaid individuals such as family members, who provide care [3]. Family caregiver can be primary (i.e., the person who spends the most time helping) or secondary caregiver, full time or part time, and can live with the person being cared for or live separately [3]. Most family caregivers prefer to care for their elderly parents with chronic disease and/or age-related disorders at caregivers' home. In Europe, the public demand for informal elderly care is high and will increase because of the increase in aging population. Although caregiving is intended to contribute to the care recipient's health, its effects on the health of older European family caregivers are not yet clear [4]. Despite traditional culture within Turkish families, in some cases, hospitalization of the elderly in nursing home is inevitable, and this negatively affects the elderly individual and his/her siblings. Furthermore, elderly parents with no income cannot get paid for their basic living expenses except health payment if they live at caregiver's home in Turkey.

As well as providing physical and emotional support the elderly persons prefer to remain living alone at their own home, their close family members have to deal with daily problems and strive to maintain family life, work and other responsibilities. The effects of presence of elderly person live alone will, of course, vary from family to family. On the negative side, the burdens of care giving can lead to resentment, burnout, and friction among siblings, especially when the primary caregiver faces that others do not help enough. Unmarried, primary caregiver usually take on significant caring responsibilities, particularly if the elderly person was previously faced unwelcomed behaviors by married ones who have not intend to provide physical and emotional support their parents. Sometimes primary caregiver sibling will find himself / herself unable to engage in the same activities they did prior to the elderly parent care as a result of lack of time, lack of enthusiasm or feelings of guilt that the elderly mother/father can no longer join in - and can thus begin to feel socially isolated. Studies have shown that elderly caring family member all alone can experience equivalent or sometimes even higher levels of psychological distress than the elderly individual, with anxiety and depression being two of the most commonly reported problems [4] [5]. Other emotional disorders such as feelings of fear and uncertainty, hopelessness, resentment and mood changes also occur [4] [5].

As evidence grows regarding the potential social impact of aging on families, more attention should be paid to find ways to promote the health and well-being of elderly person and their family caregivers. No government institution or community-based support organization now offers any psychological or practical support specifically for family caregivers in developing countries such as Turkey. Governments and gerontologist need to begin to study the usefulness of psychological or emotional support, in improving outcomes for both family caregivers and their elderly loved ones.

Keywords: Elderly parents, Family caregiver, Primary caregiver, Psychological distress, Secondary caregiver

1. A Balancing Act: State Long-Term Care Reform. Kassner Er, Reinhard S, Fox-Grage W, American Association of Retired Persons Public Policy Institute. 2014. [Available at: http://www.aarp.org/health/doctors-hospitals/info-07-2008/A_Balancing_Act__State_Long-Term_Care_Reform.html]    
2. Spoelstra SL, Given CW. Development of an index to predict risk of nursing home placement for home and community-based waiver participants. Edorium J Aging Res 2015;1:1–11.    
3. McConnell S, Riggs JA. A public policy agenda: Supporting family caregiving. In: Cantor MA ed. Family Caregiving: Agenda for the Future. San Francisco: American Society on Aging; 1994.    
4. Hiel L, Beenackers MA, Renders CM, Robroek SJ, Burdorf A, Croezen S. Providing personal informal care to older European adults: should we care about the caregivers' health? Prev Med 2015 Jan;70:64–8.   [CrossRef]   [Pubmed]    
5. Pinquart M, Sörensen S. Differences between caregivers and noncaregivers in psychological health and physical health: a meta-analysis. Psychol Aging 2003 Jun;18(2):250–67.   [CrossRef]   [Pubmed]