Ever since Jeffrey Alger and his wife, Tammy, renovated a room in their home to accommodate his grandmother six years ago, his mornings and evenings have revolved around caregiving.
At 7 a.m. Mr. Alger wakes his grandmother, Mary Stewart, bathes and dresses her, and prepares her breakfast. By 8 on weekdays, a van picks her up for an adult day program. When Mrs. Stewart returns at 5 p.m., Mrs. Alger cares for her until her husband gets home from work. Then he takes over, as he also does on weekends.
"It affects pretty much every aspect of our lives," says Alger, of Chattanooga, Tenn., explaining that his grandmother has been diagnosed with dementia. The Algers have three children, whom Mrs. Alger home-schools.
Say the word "caregiver" and most people think of a woman ministering to a spouse or relative. But men now account for nearly one-third of primary caregivers to older adults, studies show.
As these men - husbands, sons, and even grandsons like Alger - roll up their sleeves, they are quietly pioneering new roles and defying stereotypes. They are also discovering that all caregivers need more support at home and work.
A recent MetLife survey finds that women remain more involved in personal-care tasks such as bathing and dressing. Men are more likely to handle grocery shopping, transportation, and finances. The study, by the National Alliance for Caregiving and the Center for Productive Aging at Towson University, also reports that more men than women provide long-distance care.
Edward Thompson, a gerontologist and coeditor of the book "Men as Caregivers," explains that men approach caregiving differently from the way women do. "They come into it late, come with a lot less prior experience, and come with a lot different motivation," he says. Many men adopt a managerial style.
"Men are fully engaged, but they approach it as a task, rather than an all-consuming job," Mr. Thompson says.
Men are also more likely to take a different approach in caring for parents, he adds. "Sons come in with the desire to keep their parents as independent as possible, while their sisters seek to provide whatever services they think their parents need. Sometimes sisters do things too early from their brothers' point of view."
For Paul Linet of Boxboro, Mass., caregiving began five years ago when his wife, Susan, a pediatrician, was diagnosed with multiple sclerosis. He also has primary responsibility for the couple's two teenage daughters.
"I'm a utility infielder wearing a number of hats," he says. "Caregiving is first and foremost." Still, it comes with challenges. "You need a whole different set of skills than you do going off to work. There's a definite frustration associated with that. You have to know how to raise your hand and say 'I need help' and not feel diminished by asking."
Yet many men are reluctant to ask for help. "Men don't consult enough," Thompson says. "They don't go to support groups. They go to conferences and information sessions and workshops - things that are cognitive. They're not necessarily interested in emphasizing that they need emotional support."
Beside emotional support, men need services that provide information and hands-on instruction, he adds.
Linet's learning curve included fumbling through the beginning stages of cooking. "I could make eggs and oatmeal," he recalls of his early days of caregiving. Now he and his daughters share the cooking. "They have certainly pitched in. We've been blessed that they're good kids."
Caregivers can also face challenges at work. Men are less likely than women to discuss the subject with co-workers, the MetLife study finds. In addition, more men than women must forgo work-related travel because of these responsibilities.
After Paul Gladstone's wife, Joanne, was diagnosed with multiple sclerosis eight years ago, he lost three jobs in two years because of her illness. His schedule was often unreliable when he needed to stay home unexpectedly to help his wife.
When the couple's two children were in elementary school, he did consulting from home for four years to give them stability in the midst of their mother's illness. He returned to work when they entered middle school. Now an aide comes in the morning, enabling him to get to work on time.
Even so, says Mr. Gladstone, of Southfield, Mich., a compensation specialist at Cooper-Standard Automotive, "I had to cancel an 8 o'clock meeting tomorrow because I'm not sure my wife's caregiver will be there." He praises his employer for being understanding and "very accommodating."
Not all caregiving involves medical or physical care. After Peter Russo's father died five years ago, he moved his mother to a house a mile away from his in Mt. Kisko, N.Y. She does her own cooking and laundry, and he takes care of other needs.
"I've basically become her legs," says Mr. Russo, a producer for Fox News in New York. "I was there Sunday night late, cleaning her oven. I do her banking and go to the ATM for her. I pay her bills, write her checks. She gives me a shopping list every Wednesday morning, and every Wednesday night I'll come back with eight bags of food." On Saturdays he takes her to the hairdresser, and they do errands.
"My wife has been very patient," he says. The two plan business trips so they will not be away at the same time.
Even when men are not primary caregivers, some assist a family member who is. Jim Glover of Owensboro, Ky., helps with his father-in-law, who lives with them and has been diagnosed with Alzheimer's.
Because his wife has full responsibility for her father during the day, she needs a break when Mr. Glover returns from work. He helps with his father-in-law's personal care - shaving, bathing - and with what he calls "a continuous watching." The couple take turns attending church and going away for a weekend with their children.
Glover, who works for the federal government, was initially skeptical of the Family and Medical Leave Act, which gives employees time off to care for infants or ill family members. Now, he says, "I see the great importance of having some time to give the other caregiver. You need help. Otherwise you turn your home into a jail cell if you're not careful."
Other help comes from the National Family Caregiver Support Program. It connects families with local services through the Eldercare Locator (800 677-1116; www.elder care.gov).
It also offers counseling - what Lisa Boyens of the Green River Area Agency on Aging in Owensboro, Ky., calls "an ear to listen, a shoulder to cry on, and someone to scream at who won't scream back."
What else do caregivers need? Linet calls the lack of well-trained and well-compensated personal-care assistants "a very significant problem." He says, "You're dealing with such a personal chemistry issue when someone who is not a member of the family is expected to come into the house and become a surrogate family member."
He also sees a need for more respite care.
Alger, who works for Optimal Health Institute, knows firsthand the importance of time off. One weekend a month, his grandmother attends a respite program so the family can spend time together. The Algers work hard to be sure their caregiving does not shortchange the children. If they want to get away on other occasions, they hire a home aide for $100 a day.
"We rely on our faith in God to get us through," he says. "We still have times when we have to step away from it and get a break. It's my grandmother and I love her, but after six years you're, like, 'Help!'"
A sense of humor helps, too. "We have to laugh at some of the things that happen, or it would drive us crazy," Alger says.
In addition to the help Linet gives his wife, he currently views caregiving from another perspective. His father in Florida needs assistance. "My mother is the front line, but I'm certainly trying to be supportive of her efforts."
Drawing on his own experiences in the past five years, Linet is cofounding a business to help caregivers.
Despite the challenges, he and others say they find quiet rewards in their roles. Although men are more likely than women to earn praise from others for caregiving, Russo echoes others when he says, "I'm not doing it for any award. I'm doing it because I love my mom."
He adds, "I look at it this way. My parents were always there for me when I was a little kid. This is the least I can do now."