Article

Transitions to Caregiving, Gender, and Psychological Well‐Being: A Prospective U.S. National Study

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Abstract

Guided by a life course perspective, this study examined the effects of transitioning into caregiving activity for a child, spouse, parent, other relative, or nonkin associate on nine dimensions of psychological well-being. Data came from adults ages 19–95, who were noncaregiver primary respondents in the National Survey of Families and Households in 1987–88 and who were followed up longitudinally in 1992–93 (N= 8,286). Results from multivariate regression models confirmed that the transition to caregiving for primary kin (i.e., a child, spouse, or biological parent) was associated with an increase in depressive symptoms. However in selected instances, caregiving was associated with beneficial effects (e.g., women who began to provide nonresidential care to a biological parent reported more purpose in life than noncaregiving women). Evidence regarding gender differences was inconsistent, varying across caregiving role relationship types.

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... Married caregivers are associated with the lowest level of SWB compared to being divorced or widowed or separated because married people have a high level of responsibilities than unmarried, such as child-rearing )Natsala Longphasuk, Supreeda Monkong, and Yupapin Sirapo-ngam, 2018; Panyathorn, 2014(. Especially, the higher level of stress among married women than unmarried women are explained in terms of traditional trends, demands of society and more roles and responsibilities assigned to them as a mother, wife, and homemaker, as compared to unmarried women ) Marks, Lambert, and Choi, 2004;Gray and Thepsuwan, 2014(. Therefore, it can be said that the caregivers who are married will have lower SWB than those who have another status )Gray and Thepsuwan, 2014(. ...
... According to the OECD )2005(, these stereotypes are present today in reality, with women across the world spending up to ten times more time on unpaid care work than men. If a member of a family becomes ill or has a disability, the commonly adopted attitude is that the main caregiver should be a female member of the family ) Marks, Lambert, and Choi, 2004). The role of the caregiver, predominately assumed by women, contributes to inequalities between the genders, with women having fewer opportunities to attain their basic level of human rights in comparison to their male counterparts. ...
... The caregiver's life is an oscillation between hope and grief. The close relationship between the family caregiver and the care recipient may require being on call 24 hours a day, and comprises shared emotions, experiences, and memories that place the caregiver at higher risk for psychological and physical exhaustion ) Marks et al., 2004(. ...
Conference Paper
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This paper is in line with the theme of survey literatures of the Thai elderly in the economic dimension. Its knowledge border is also reaching into negative and positive on the Thai economy. The former illustrates the causes of the negative impacts of the Thai elderly on economy. It reveals that low fertility, long life, expectancy, low consumption as well as high public spending on health care lead aggregate output growth decline in the long run. Meanwhile, the latter attempts to explain the hypotheses of why the elderly can contribute to the economy. The main key is the investment in human capital. Further, the Thai elderly leads the positively affect in the economic dimension via an increase in the effective labor, knowledge transfers as well as change in saving patterns.
... Previous studies have assessed on caregiving (Sequiera, 2013;Dettinger & Clarkberg, 2002;Marks, Lambert & Choi, 2002;Haley, Roth, Howard, & Stafford, 2010), but few studies have focused on the relationship between resiliency and coping strategies of caregivers who perform dual roles such as that of a family caregiver and public servant at the same time. Hence, the conduct of this study is imperative. ...
... Furthermore, informal caregivers were mostly old or senior women (75 percent), and only 25 percent were young (Kipp et al., 2007;Donnellan, 2017;Alvarez et al., 2017;Haley et al., 2010;Marks et al., 2002). This can be attributed to the positivity bias of older caregivers (Donnellan, 2017), positive coping (Haley et al., 2010), and caregiver's gain (Marks et al., 2002). ...
... Furthermore, informal caregivers were mostly old or senior women (75 percent), and only 25 percent were young (Kipp et al., 2007;Donnellan, 2017;Alvarez et al., 2017;Haley et al., 2010;Marks et al., 2002). This can be attributed to the positivity bias of older caregivers (Donnellan, 2017), positive coping (Haley et al., 2010), and caregiver's gain (Marks et al., 2002). ...
... Transitions in caregiving status are also thought to have a differential effect on a caregiver's depressive symptoms [14,15]. Typically, starting or continuously providing family caregiving is regarded to be associated with an increase in the caregiver's depressive symptoms [16][17][18][19]. In terms of ceasing caregiving, there are mixed findings on the incidence of depressive symptoms. ...
... In this study, we examined the relationship between caregiving-statu and the magnitude of depressive symptoms among middle-aged or older K Consistent with previous studies, our results indicated that starting (only in continuing caregiving for family members with ADL limitations were ass higher depressive-symptom scores [16][17][18][19]. Participants who had ceased c previous year did not show a difference in depressive symptoms compare noncaregivers. ...
... In this study, we examined the relationship between caregiving-status transitions and the magnitude of depressive symptoms among middle-aged or older Korean adults. Consistent with previous studies, our results indicated that starting (only in women) and continuing caregiving for family members with ADL limitations were associated with higher depressive-symptom scores [16][17][18][19]. Participants who had ceased caregiving the previous year did not show a difference in depressive symptoms compared to those of noncaregivers. ...
Article
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This study identifies the effects of transitions in caregiving status on depressive symptoms among middle-aged or older adults who care for family members with limitations in activities of daily living (ADL). Data were collected from the 2006–2018 Korean Longitudinal Study of Aging. A total of 7817 subjects were included. On the basis of their caregiving status transition, participants were categorized into four groups: started caregiving, continued caregiving, stopped caregiving, and noncaregivers. Depressive symptoms were measured using the 10 item Center for Epidemiologic Studies Depression Scale. Analysis using a generalized estimating equation model and subgroup analyses were conducted. Compared to noncaregivers, women who started caregiving showed more depressive symptoms in the following year (β 0.761, p < 0.0001). Regardless of sex, older adults who continued caregiving had more depressive symptoms than noncaregivers did (β 0.616, p < 0.0277 in men, and β 1.091, p < 0.0001 in women). After relinquishing caregiving responsibilities to other caregivers, participants’ depressive symptoms in the following year showed no statistically significant difference from that of noncaregivers. Thus, starting or continuing caregiving was associated with increased depressive symptoms, and those symptoms could be normalized by stopping caregiving. Intervention strategies to reduce family caregivers’ depressive symptoms are needed.
... In an interview conducted by Paweł Pieniążek from "Krytyka Polityczna", Krzysztof Hegemajer noted that an increase in the retirement age was not necessary, but it was important that the retirement age for women and men was equalised and that funds for future pensions were saved in the state budget. 32 2015 was a time of leadership change on the Polish political scene. The parliamentary election held on 25 October 2015 ended with PiS winning with 37.58% support and PO in second place with a score of 24.05%. ...
... The so-called mixed pension system, currently in force, is usually supported by respondents who run their own businesses. 32 According to the results of the survey, in 2007 almost half of the respondents (47%) were dissatisfied with the pension system operation. 28% of respondents indicated their satisfaction, and 25% were not able to clearly express their opinion. ...
... PLN). 32 The distribution of pension size is also significantly different for men and for women. Almost 60% of women receive pensions in the range of between 1,000 and 2,000 PLN, while over 60% of men receive benefits ranging from 2,200 PLN to 32 4,000 PLN. ...
... Caregivers have a smaller amount of selfacceptance and feel less effective and less in control of their lives than non-caregivers (Marks, Lambert, & Choi, 2002;Pinquart, & Sörensen, 2003). More than one-fifth (22%) of caregivers are fatigued at the time when they go to bed at night, and most of the caregivers feel they cannot handle all their caregiving responsibilities (Center on Aging Society, 2005). ...
... Several studies have shown that caregivers use prescription and psychotropic drugs. Family caregivers are at higher risk for greater levels of hostility (Marks, Lambert, & Choi, 2002). Spousal caregivers who are at hazard of clinical depression and are caring for their companion with critical cognitive disability and/or physical care needs are more likely to engage in toxic activities toward their loved ones (Beach, et. ...
Article
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This study was based on family environment and general health among pain disorder and conversion disorders' caregivers. Males and females have been taken to assess the family environment and general health. The subjects were 15 caregivers with pain disorder and 15 caregivers with conversion disorder from Ludhiana. To measure family environment the Family Environment Scale (F.E.S.) by Sanjay Vohra (1998) and a general health questionnaire was used for measuring the current mental health status of the respondent subjects. Results revealed that pain disorder caregivers have a better family environment in relation to conversion disorder caregivers. The present study's conclusion shows that, as it related to caregiving, females had a major impact on self-esteem and a more negative impact on their daily activity routine, poor health, family support, and poor family environment, than males.
... On the other hand, informal elder caregivers are able to create and maintain companionship for their eldercare recipients as they age, strengthening intimacy, love, and familial bonding resources. Research supports the notion that while informal elder caregiving is associated with emotional distress, it may also be associated with increases in self-esteem, meaning of life, engagement, and pride (Kramer, 1997;Marks, 1998;Marks & Lambert, 1998;Marks, Lambert, & Choi, 2002). Qualitative interviews support that informal elder caregivers experience feelings of appreciation and affinity, and growth and satisfaction with their roles while simultaneously experiencing high levels of stress (Eckwall & Hallberg, 2007;Grant & Nolan, 1993;Toljamo, Perala, & Laukkala, 2012). ...
... The burden of elder-caregiving on women is significant. Research suggests that women report more stress from eldercare responsibilities than men (Kramer & Kipnis, 1995;Neal, Chapman, Ingersoll-Dayton, & Emlen, 1993); and that women experience more hostility and less happiness and autonomy than men when transitioning into elder caregiving roles (Marks et al., 2002). In a longitudinal cohort study, Pavalko and Henderson (2006) found that onset of care work for ill or disabled parents or spouses significantly contributed to female caregivers' feelings of distress. ...
Article
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The purpose of this article is to provide a contemporary, globally focused, multidisciplinary review of the existing literature on eldercare responsibilities and the implications of these responsibilities for working adults and organizations, taking a multilevel perspective. Two major reviews of the impact of eldercare responsibilities on work for employed informal caregivers have been conducted in the past 25 years. However, an update to the extant literature is warranted given that prior reviews have not taken a holistic perspective in understanding eldercare for employees and organizations. In addition, a number of empirical articles about work and informal elder caregiving have been published across multiple disciplines since these reviews were written. Utilizing and extending the work in prior reviews, we propose a model to serve as an organizing framework for understanding the informal eldercare process. Our model includes antecedents to—and consequences of—informal eldercare responsibilities and identifies components of a feedback loop. We also include a discussion of the resources available at the individual, family/social, organizational, and community levels that are available and useful in managing informal elder caregiving and paid employment. Finally, we identify gaps in the extant literature and provide recommendations for future research. © The Author(s) 2018. Published by Oxford University Press. For permissions please e-mail: [email protected]
... Informal care may thereby provide an additional rewarding role (role enhancement) (Rozario et al. 2004), which might improve carer quality of life (Ang and Jiaqing 2012;Brown and Brown 2014). Specifically, prior research has linked providing extra-residential care for a parent to higher sense of mastery (Hansen et al. 2013) and, in women, with heightened reported purpose in life (Marks et al. 2002). ...
... Yet, there is limited evidence regarding the impact of transitions into and out of informal care upon carer quality of life and wellbeing. Transitions into caregiving have been associated with declines in wellbeing and quality of life (Hirst 2005;Marks et al. 2002;Pinquart and Sörensen 2003;Rafnsson et al. 2017). Transitions out of caregiving have been associated with poorer wellbeing (Dolan et al. 2008;Hirst 2005), perhaps because this corresponds to the life event of a close family member entering an institution or passing away, but other studies found no change in quality of life (Rafnsson et al. 2017;Yiengprugsawan et al. 2016). ...
Article
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Providing unpaid informal care to someone who is ill or disabled is a common experience in later life. While a supportive and potentially rewarding role, informal care can become a time and emotionally demanding activity, which may hinder older adults’ quality of life. In a context of rising demand for informal carers, we investigated how caregiving states and transitions are linked to overall levels and changes in quality of life, and how the relationship varies according to care intensity and burden. We used fixed effects and change analyses to examine six-wave panel data (2008–2018) from the Swedish Longitudinal Occupational Survey of Health (SLOSH, n = 5076; ages 50–74). The CASP-19 scale is used to assess both positive and negative aspects of older adults’ quality of life. Caregiving was related with lower levels of quality of life in a graded manner, with those providing more weekly hours and reporting greater burden experiencing larger declines. Two-year transitions corresponding to starting, ceasing and continuing care provision were associated with lower levels of quality of life, compared to continuously not caregiving. Starting and ceasing caregiving were associated with negative and positive changes in quality of life score, respectively, suggesting that cessation of care leads to improvements despite persistent lower overall levels of quality of life. Measures to reduce care burden or time spent providing informal care are likely to improve the quality of life of older people.
... Previous research examining the longitudinal effects of transitioning into family caregiving in general population studies has found that over time, caregiving was associated with worse well-being and increased depression in a general population sample (Haley et al., 2020;Marks et al., 2002). The care recipient was important, and caring for friends was associated with better well-being outcomes for women, while spousal caring was worse for women (Marks et al., 2002), although gender was found not to differ in a more recent study caring for a spouse was associated with worse mental health (Haley et al., 2020). ...
... Previous research examining the longitudinal effects of transitioning into family caregiving in general population studies has found that over time, caregiving was associated with worse well-being and increased depression in a general population sample (Haley et al., 2020;Marks et al., 2002). The care recipient was important, and caring for friends was associated with better well-being outcomes for women, while spousal caring was worse for women (Marks et al., 2002), although gender was found not to differ in a more recent study caring for a spouse was associated with worse mental health (Haley et al., 2020). ...
Article
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Background : The COVID-19 pandemic in 2020 resulted in the older population being asked to remain at home and avoid other people outside their household. This could have implications for both receipt and provision of informal caring. Objective : To determine if informal care provision by older carers changed during the first wave of the COVID-19 pandemic from pre-pandemic care and if this was associated with a change in mental health and well-being of carers. Design and setting : Longitudinal nationally representative study of community dwelling adults from the Irish Longitudinal Study on Ageing (TILDA) (Waves 3-COVID-Wave 6). Methods : We studied a cohort of 3670 adults aged ≥60 in Ireland during the COVID-19 pandemic (July-November 2020) and compared with previous data collections from the same cohort between 2014-2018. Independent variables were caregiving status and caregiving intensity, outcome measures included depressive symptoms (CES-D8), Perceived Stress (PSS4) and Quality of life (CASP12). Mixed models adjusting for socio-demographics and physical health were estimated. Results : Caregiving increased from 8.2% (2014) to 15.4% (2020). Depression, and stress scores increased while quality of life decreased for all participants. Carers reported poorer mental health, and higher caring hours were associated with increased depression and stress and decreased quality of life scores on average, and increased depression was higher for women. Conclusions : Informal caregiving increased during the pandemic and family caregivers reported increased adverse mental health and well-being and this continued throughout the early months of the pandemic. The disproportionate burden of depression was highest in women providing higher caring hours.
... In other cases, caregiving was related to a positive experience of psychological well-being (Ryff, 2014). For example, Marks, Lambert, and Choi (2002) found an increase in purpose in life in women who provided nonresidential care to their parents, compared to non-caregiving women. Similarly, in a longitudinal study, Leipold, Schacke, and Zank (2008) found that personal growth, another core dimension of psychological well-being, was more pronounced in individuals who provided care for a longer period. ...
... None of them was clustered in the HWB group. Even though previous literature reported both positive and negative relationships between caregiving and well-being (Bassi et al., 2014;Chow & Ho, 2015;Grossman & Gruenewald, 2017;Hansen & Slagsvold, 2015;Leipold et al., 2008;Marks, 1998;Marks et al., 2002;Verbakel, 2014), our results seem to indicate that caregiving may negatively influence both hedonic (life satisfaction) and psychological well-being in older age. This was further confirmed in the multivariate linear regression analyses, which showed that providing care and the presence of depressive symptoms negatively predicted both hedonic and psychological well-being (see Table 3). ...
Article
Objectives: Recent studies documented the protective role of hedonic and psychological well-being for mental and physical health of aging individuals. However, the combination of these two dimensions of well-being (conceptualized as optimal well-being) has been rarely evaluated in association with providing caregiving. This exploratory investigation aimed to: (1) cluster a group of community dwellers according to levels of hedonic and psychological well-being (low well-being-LWB; moderate well-being-MWB; high well-being HWB); and (2) to identify their psychosocial correlates of their optimal well-being, including providing daily caregiving. Methods: 217 community dwellers (60–90 years) completed questionnaires concerning psychological well-being, life satisfaction, and caregivers’ distress. They were classified into three groups (LWB, MWB, HWB), following a k mean cluster analysis. Chi-square and GLM were used to compare the three clusters. Regression analyses were performed to evaluate the correlates of hedonic and psychological well-being. Results: Fifty-two individuals belonged to the HWB cluster, 68 to the LWB cluster and 97 to the MWB cluster. Individuals in the LWB cluster showed higher levels of anxiety and depression, and 61 of them reported to provide caregiving. Members of the HWB cluster were the oldest. Psychological and hedonic well-being negatively correlated with depression and caregiving. Conclusions: These results indicate that only a small proportion of community dwellers reported optimal well-being. Clinical Implications: Addressing depression and alleviating caregiver distress may constitute ingredients for promoting optimal well-being among older community dwellers.
... Although caregiving has been usually described as a very stressful situation for many caregivers, studies also show that there are positive effects, including feeling positive about being able to help a disabled spouse, feeling appreciated by the care recipient, and feeling that their relationship with the care recipient had improved. 40,41 However this was not studied in the present research. Thus, to sustain family caregiving, mental health professionals need to know not only how to ameliorate caregivers negative experiences, but also how to synergise their positive experiences. ...
Article
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Background: Consequent to the high prevalence of psychiatric disorders in present day world, their caregivers form an important group in the public health. Research on the physical and psychological well-being of caregivers is being carried worldwide with varied results. Psychological health of these caregivers is usually ignored both by these persons themselves and the health-care providers. The objective of the study was to screen for psychiatric morbidity among caregivers of patients attending a psychiatric hospital in North India, and to study the clinical correlates of the same.Methods: A total of 205 patients and their caregivers were consecutively recruited over a one month period. Sociodemographic and clinical information of patients was obtained either from the hospital records or from the caregiver. Scoring of the patient’s global assessment of functioning (GAF) was done by clinicians. The caregivers were administered a sociodemographic questionnaire, general health questionnaire (GHQ-12) and Zarit Burden interview. The presence of psychiatric morbidity was confirmed by a consultant psychiatrist.Results: Among the caregivers, 32.2% had GHQ scores of 3 and above. Majority of caregivers in this study were females (59.0%) while as majority of the patients were males (61.9%). Factors associated with psychiatric morbidity among caregivers include the high level of subjective burden of care, low level of functioning, and comorbid medical and psychiatric conditions.Conclusions: The study reveals a high level of psychiatric morbidity among the caregivers of patients with mental health problems.
... The existing studies that have used this method have important limitations, including baseline differences on health risk and demographics between caregivers and noncaregivers 13 or a low threshold for transition to caregiving (e.g., any assistance with personal care over the previous month or year). [14][15][16] Previous cross-sectional research has identified subgroups of caregivers who may be at particularly high risk for negative outcomes from caregiving, including female caregivers 17,18 and spouse caregivers. 19,20 Conversely, Black caregivers often report lower levels of depressive symptoms than White caregivers. ...
Article
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BACKGROUND/OBJECTIVES Few studies have rigorously examined the magnitude of changes in well‐being after a transition into sustained and substantial caregiving, especially in population‐based studies, compared with matched noncaregiving controls. DESIGN We identified individuals from a national epidemiological investigation who transitioned into caregiving over a 10‐ to 13‐year follow‐up and provided continuous in‐home care for at least 18 months and at least 5 hours per week. Individuals who did not become caregivers were individually matched with caregivers on age, sex, race, education, marital status, self‐rated health, and history of cardiovascular disease at baseline. Both groups were assessed at baseline and follow‐up. SETTING REasons for Geographic And Racial Differences in Stroke study. PARTICIPANTS A total of 251 incident caregivers and 251 matched controls. MEASUREMENTS Perceived Stress Scale (PSS), 10‐Item Center for Epidemiological Studies‐Depression (CES‐D), and 12‐item Short‐Form Health Survey quality‐of‐life mental (MCS) and physical (PCS) component scores. RESULTS Caregivers showed significantly greater worsening in PSS, CES‐D, and MCS, with standardized effect sizes ranging from 0.676 to 0.796 compared with changes in noncaregivers. A significant but smaller effect size was found for worsening PCS in caregivers (0.242). Taking on sustained caregiving was associated with almost a tripling of increased risk of transitioning to clinically significant depressive symptoms at follow‐up. Effects were not moderated by race, sex, or relationship to care recipient, but younger caregivers showed greater increases in CES‐D than older caregivers. CONCLUSION Persons who began substantial, sustained family caregiving had marked worsening of psychological well‐being, and relatively smaller worsening of self‐reported physical health, compared with carefully matched noncaregivers. Previous estimates of effect sizes on caregiver well‐being have had serious limitations due to use of convenience sampling and cross‐sectional comparisons. Researchers, public policy makers, and clinicians should note these strong effects, and caregiver assessment and service provision for psychological well‐being deserve increased priority.
... Stress-coping theories propose that women are more likely to be exposed to caregiving stressors, and are likely to perceive, report and cope with these stressors differently from men [62,63]. ...
Chapter
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Hip-fracture (HF) patients are among the most vulnerable of hospitalised patients. The associated caregiving rehabilitation task often falls to a member of the patient’s family. Informal caregivers are an important resource for elderly patients suffering from a hip fracture because they play a key role during their recovery. A mutual relationship seems to exist between the patient’s psychological well-being and the caregiver’s burden, so that improvements in the state of health of the one boost that of the other, and vice versa. This datum confirms the importance of using a bio-psycho-social approach when dealing with both patients and caregivers and evaluating the HF patient’s and caregiver’s psychological status. In this chapter, we illustrate why the psychological status of patients and their caregivers is important in the management and outcome of hip fracture, how it should be assessed and how it could be positively influenced by the orthogeriatric team.
... In line with previous studies identifying increased levels of distress at the start of the caregiving period (Aneshensel et al., 1995;Hirst, 2005;Marks, Lambert, & Choi, 2002), it was found that the transition to the caregiver role was associated with a higher likelihood of sleep problems in older Europeans. Entering a new life stage and adopting the role of caregiver which has to be balanced with existing roles is a stressful experience (Keating et al., 2019;Pearlin, 1992), which is likely to disturb sleep at night. ...
Article
Informal caregiving is increasingly common in our ageing population and entering the role of informal caregiver generally marks an important life course transition. The adjustment to such transitions is considered important for the onset of sleep problems. Therefore, this study aims to establish how becoming a daily caregiver is associated with sleep problems, if changes in caregiving status are related to changes in sleep problems and how intersections with other social roles affect this association. Based on data from waves 1, 2, 4, 5 and 6 of the Survey of Health Ageing and Retirement in Europe (N=32,791), the analyses show how both current and former daily caregivers are more likely to report sleep problems than those not giving daily care. When change in sleep problems is assessed a transition to daily caregiving appears to be accompanied by increased sleep problems. Moreover, even individuals who ceased giving care experience more sleep problems than those who never gave care on a daily basis, which suggests a legacy of caregiving. No differences are found regarding employment status, but women who start giving care are more likely to experience sleep problems than their male counterparts.
... Findings in the current study stated that "other" caregivers were less likely to report a negative emotional burden and social strain than spousal caregivers, whether or not care recipients' dementia severity was considered. Unlike caregivers in a primary kinship (such as child, or spouse), who often have a greater perceived social obligation to care for the care recipients, "other" caregivers are less bound by an obligation to enter a caregiving relationship but rather often do by voluntary desire [42]. As a result, spousal caregivers may experience a more significant negative caregiving experience compared to "other" caregivers. ...
Article
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Purpose To assess whether there was an association between care–recipient relationship type and health-related quality of life (HRQL) of older persons living with dementia (PLWD) and their informal caregivers, and whether this association was affected by PLWD’ dementia severity. Methods This was a secondary data analysis study. PLWD (n = 1230) and caregivers (n = 1871) were identified from participants in the National Health and Aging Trends Study (NHATS) Round 5 and the National Study of Caregiving (NSOC) II, respectively. A series of bivariate and multivariable regression models examined the associations among relationship type and HRQL in PLWD and caregivers, adjusted for socio-demographic variables and dementia severity. Results PLWD and caregivers’ HRQL outcomes varied by relationship type. PLWD cared for by an adult–child caregiver, or multiple caregivers experienced higher functional limitations than those cared for by a spousal caregiver (β = .79, CI [.39, 1.19]; β = .50, CI [.17, .82], respectively). “Other” caregivers, such as extended family members or friends, had lower odds of experiencing negative emotional burden and social strain than spousal caregivers (β = .79, CI [.39, 1.19]; β = .50, CI [.17, .82], respectively). Lower odds of experiencing negative emotional burden were also found with multiple caregivers. The effect of an adult–child caregiver on social strain was no longer significant when the dementia severity of PLWD was included in the analysis. Conclusion The type of care–recipient relationship impacts the HRQL in both PLWD and their informal caregivers. Dementia severity of the PLWD appears to affect this association.
... A study by Carmel (2019) found that women in late life tend to have generally lower scores on indicators of wellbeing and coping resources than do men, and that women present more symptoms of distress, loneliness, and disability than do men. Some reasons that may account for at least some of this gender disparity may be the fact that older women are more likely to take on stressful family caregiving roles compared to older men (Marks, Lambert, & Choi, 2002) and are more likely to be widowed than men (Pinquart & Sörensen, 2001). However, these disparities may be partly ameliorated by the fact that women also tend to be more involved in social support networks including extended family and religious communities (Francis & Penny, 2014;McLaughlin, Vagenas, Pachana, Begum, & Dobson, 2010). ...
Article
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This cross-sectional study aimed to examine the associations of sex, age, marital status, education attainment, religious involvement, perceived health, and income with psychosocial domains of wellbeing assessed using the Geriatric Depression Scale (GDS-15), Satisfaction with Life Scale (SWLS), Subjective Happiness Scale (SHS), and Spiritual Wellbeing Scale (SWBS). In total, 356 community-dwelling older adults from Greece, aged 65 years and above, completed a sociodemographic survey and psychosocial self-reported questionnaires. Bivariate and stepwise regression analyses helped to determine the sociodemographic factors’ associations with their wellbeing. These background predictors together explained a significant part of the variance in scores on all psychosocial domains: 31% for GDS-15, 44% for SHS, 63% for SWLS, and 58% for SWBS. After controlling for other sociodemographic factors, both being healthy and attending church were related to better outcomes in the domains of happiness, life satisfaction, and spiritual wellbeing. Higher income was related to better outcomes on all domains of wellbeing, while higher educational attainment was related to worse outcomes on all domains of wellbeing. Marital status was positively related to depression only. Thus, successful aging approaches may benefit from a deeper understanding of wellbeing and its predictors, which are essential to improve older adults’ psychosocial wellness.
... Given the current finding of a reliable association between kin care motivation and life's purpose, we might investigate exactly what kinds of kin care predict purpose and for whom. Some work has addressed nuanced kin care measures and PIL (e.g., Marks, 1998;Marks, Lambert, Choi, David, & Edgewood, 2017;Schwartz, Keyl, Marcum, & Bode, 2009), and found some differential links that depend on who gives the care and who receives the care. In general, caring for the unhealthy is associated with higher concurrent stress, which in turn lowers PIL, especially when the caregiver is married to the receiver. ...
Article
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Purpose in Life (PIL) is often associated with grand achievements and existential beliefs, but recent theory suggests that it might ultimately track gainful pursuit of basic evolved goals. Five studies (N=1,993) investigate the relationships between fundamental social motives and PIL. In Study 1, attribution of a life goal pursuit to disease avoidance, affiliation, or kin care motives correlated with higher PIL. Studies 2 and 3 found correlations of self-protection, disease avoidance, affiliation, mate retention, and kin care motives with PIL after controlling for potential confounds. Study 4 showed that writing about success in the status, mating, and kin care domains increased PIL. Study 5 replicated the effect for mating and kin care, but not for status. Results imply that fundamental motives link to PIL through a sense of progress, rather than raw desire. Overall, this set of studies suggests that pursuit of evolved fundamental goals contributes to a purposeful life.
... While existing studies are mainly focused on the comparison between groups of non-caregivers and (new) caregivers -or examined only transitions into caregiving (e.g. Marks et al., 2002) or out of it (e.g. Taylor et al., 2008) -only recently some attempts have been made to investigate the effects of transitioning versus providing care in general (e.g. ...
Article
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Spousal caregiving offers a unique opportunity to investigate how gender shapes the influence of care responsibilities on health at older ages. However, empirical evidence supporting a causal link between the transitions into and out of caregiving and health is mixed. This study investigates the influence of spousal care transitions on the health of older men and women living in 17 European countries. We use five waves of the Survey of Health, Ageing and Retirement in Europe (SHARE) between the years 2004 and 2015 for a total of 43,435 individuals and 117,831 observations. Health is defined as a Frailty Index calculated from 40 items. Caregiving is defined as intensive help with personal care provided to spouses. Results from asymmetric fixed-effects linear regression models show that the transitions into caregiving have a detrimental effect on health. On the contrary, the transitions out of caregiving have in most cases no beneficial consequences on health. Most importantly, we found evidence supporting differential effects of caregiving transitions by gender and welfare arrangement: the transitions out of caregiving are associated with better health conditions only for Southern and Eastern European women. Our study highlights the asymmetric and gendered nature of care transitions and suggests that the impact of caregiving is somewhat permanent and has long lasting effects for the caregiver. Policies should account for this asymmetry when assessing the impact and consequences of caregiving.
... gender differences in the physical and mental health impact of caregiving(Pinquart and Sörensen, 2006), especially after transition into it or during the continuous caregiving (Coe and Van Houtven, 2009;Marks et al., 2002Marks et al., , 2008. The majority of scholars refer to women as the most disadvantaged group in terms of health effect of parental caregiving at home (Morgan et al., ...
Thesis
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The family is a key source of support and strain for the health of family members. This thesis explores the family’s health effects by examining the relationship between various types of living arrangements and measures of men’s health over the life-course. With the example of Russia, this research is the first attempt at creating a comprehensive understanding of the interlinkages between men’s health and co-residing family members in the post-communist context of low male life expectancy and high reliance on family networks through intergenerational living arrangements (ILAs). Drawing on the theories and mechanisms of men’s health disadvantage, three papers of this thesis use rich and dynamic information on men, their household members and living arrangements from the Russian Longitudinal Monitoring Survey (RLMS, 1994-2016). The results identify the importance of an ILA and partnership status within this type of a living arrangement for men’s health disadvantage in Russia, while multilevel models point to the existence of both causality and selectivity in this relationship, which are overlooked in previous research. While co-residency with a partner protects men’s health within ILAs, living with an older generation in poor health can still be detrimental for men’s health. In turn, although living with a partner and adult children seems to benefit men’s health, multilevel models reveal selection effects of men’s transition to a living arrangement where all children left the parental home on their health status, binge drinking and heavy smoking. This thesis demonstrates how the complexity of the family’s co-residency and ‘linked lives’ can affect or select on health differently across the life-course. Despite the theorised protective effect of the family, the case of Russia suggests a need for further research on the possible burden of stress from living in ILAs, particularly with unhealthy parents(-in-law), as the potential causal or selection mechanism of offspring’s poor health or nest-leaving, respectively.<br/
... They are much less demanding of services for their families and themselves compared to their sons, as can be confirmed with their significantly lower service usage [47]. Across all ethnicities, spouses gave care for more hours and performed more tasks than other family members [48] and were most reluctant to hire professional helpers or use community services [49]. This reluctance to delegate tasks or use outside services rendered them vulnerable to exhaustion and distress [50][51][52]. ...
Article
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Men caregivers face caregiving burden, have weak support networks and are less likely to seek out programs which increase their caregiving capabilities and help them cope with this burden. Using the 2011 and 2015 National Study of Caregiving (NSOC) database and hierarchical regressions, we studied the emotional, financial, and physical burden of male caregivers as spouses, sons, and other caregivers by assessing the impact of caregiver characteristics, tasks and resources for each subgroup. We highlighted the importance of using a nationally representative database for men caregivers only and emphasized that these caregivers are not a monolithic group. We found that all caregivers experienced these three burden types, particularly elevated emotional stress, with sons reporting the highest emotional and financial strain levels. Assisting with personal care was the most stressful task and caregivers vastly under-utilized support and training. Our results suggest that burden suppressants included having family and friends help with caregiving, having time to decompress, and feeling appreciated by the care recipient. These findings offer insight for devising future policies that intentionally include relationship and burden type to encourage improved and more caregiving from men while supporting their well-being.
... Research assessing QOL and associated caregiver burden, strain, or distress seeks to ascertain specific elements within the caregiving experience that variably aggravate and mitigate perceptions of hardship in the caregiving experience. Causes and degree of caregiver burden or strain have been evaluated from the points of view of gender, relationship to patient, education level, socioeconomic status, age, personality traits and coping styles of the caregiver, objective senses of burden (e.g., daily tasks like bathing, transfer, toileting), and subjective senses of burden (e.g., worry, stigma, guilt) from the overall demands of the job (Adelman, Tmanova, Delgado, Dion, & Lachs, 2014;Cantor, 1983;Faison, Faria, & Frank, 1999;Lökenhoff, Duberstein, Friedman, Costa, & Paul, 2011;Marks, Lambert, & Choi, 2002;Parks & Pilisuk, 1991;Pearlin, Mullan, Semple, & Skaff, 1990;Sales, 2003;Weitzner, Jacobsen, Wagner, Friedland, & Cox, 1999;Weitzner, McMillan, & Jacobsen, 1999;Zarit et al., 1980;Zarit, Todd, & Zarit, 1986 inter alia). ...
Article
Informal caregivers immersed in the daily care of loved ones at end-of-life stages face such challenges as medical and household issues, worries, doubts, and uncertainties. Using a macro-mezzo-micro approach to discourse, we analyzed parent study interview data involving 46 caregivers facing end-of-life realities. At the mezzo level, we examined caregivers’ expressed perceptions of control. We then more finely analyzed discursive expressions of affective stances pertaining to caregivers’ emotions and feelings, and epistemic stances pertaining to their knowledge and belief states. Theories of uncertainty and control inextricably interweave areas of cognition, affect, and behavior regarding how caregivers perceive their realities and how they engage in or disengage from coping mechanisms in the process. The findings in this three-tiered approach make salient specific discursive patterns gleaned from systematic and fastidious attention to caregivers’ own ways of using language that methodically afford deeper entry into the emotional, physical, and cognitive challenges in their everyday lived experiences.
... Research also consistently shows that caregivers are more likely to suffer from depressive symptoms and mental health problems than non-caregivers (Marks et al. 2002;Pinquart and Sorensen 2003). In addition to a care recipient's health status , the literature identifies several other factors that affect caregiver burden, such as the intensity of caregiving, the presence of competing time demands, the personal relationship between the caregiver and care recipient, and work-family conflict (Chappell and Reid 2002;Lin et al. 2012;Pearlin et al. 1990;Pinquart and Sorensen 2011;Spillman and Pezzin 2000;Zuba and Schneider 2013). ...
Technical Report
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As the nation ages and more individuals live longer with chronic illness and disabilities, the need for long-term services and supports (LTSS) will rise. Roughly 9.8 million Americans ages 65 and older living in settings other than nursing homes need care and help with personal activities, with 2.7 million requiring assistance with at least three basic activities of daily living, such as bathing, dressing, or eating. Ninety-five percent of older adults with LTSS needs living in a community setting received help and care from unpaid caregivers. These caregiving activities clearly benefit the economy. Older adults with LTSS needs are more likely to enter nursing facilities, for example, if they do not receive family care than if they receive unpaid help from caregivers. Government programs, such as Medicaid, would have to cover some of the costs of additional paid LTSS, using state and federal funds. Although family caregivers are not generally paid for their services, spending time helping family and friends with LTSS needs may be costly. Some caregivers may have to reduce their work hours when they provide care, switch to part-time work, or temporarily drop out of the labor force. Government programs to support family caregivers could potentially limit some deleterious effects of caregiving. Programs that provide caregivers with training, counseling, information, and respite care or that provide care recipients with some paid help could relieve family caregivers, help them provide care more effectively, and perhaps enable them to increase their paid work hours. Support programs that enable caregivers to work more could in turn raise government tax revenue, partly offsetting part program costs. However, our results show that relatively few caregivers provide intensive care, although these intensive caregivers are most likely to experience significant caregiver burdens and conflict between employment and care responsibilities. We conclude that the macroeconomic benefits of caregiver supports on employment and subsequent economic feedback (through tax revenue) would likely be quite limited. Nearly one-third of family caregivers, and nearly one-half of family caregivers who provide intensive care without help from others, are ages 65 and older, and thus unlikely to work if they did not serve as family caregivers. The available empirical evidence suggests that relatively few younger caregivers would increase their labor supply much if they did not provide care. We found that the increase in earnings and tax revenue that might result from caregiver support programs would fall far short of the cost of providing those services.
... 2. These control variables were chosen based on prior research which shows subjective well-being is higher among females (Alesina, Di Tella, & MacCulloch, 2004), the married (Helliwell, 2003), the higher educated (Blanchflower & Oswald, 2004), those with higher income (Clark, Frijters, & Shields, 2008), better physical health (Shields & Wheatley Price, 2005) and fewer care responsibilities (Hirst, 2003(Hirst, , 2005Marks, Lambert, & Choi, 2002). Age has been found to influence subjective well-being in a non-linear manner, as younger and older people appear to enjoy higher levels of well-being than those in the middle age (Blanchflower & Oswald, 2004;Easterlin, 2006). ...
Article
Full-text available
Previous research shows that unemployment has lasting detrimental effects on individuals' subjective well-being. However, the issue of how well-being evolves after individuals switch back into the labor force has received little theoretical and empirical attention. This study examines the extent to which reemployment restores individuals' subjective well-being following a period of unemployment. Applying fixed effects models to the large-scale longitudinal data from the British Household Panel Survey, we find that recovery of subjective well-being upon reemployment is fast, complete and enduring, even when individuals take less favorable employment options to return to work. By contrast, transitions into economic inactivity following unemployment are accompanied by persistent scars on subsequent wellbeing trajectories. This study advances our understanding of well-being development over the entire employment- unemployment-reemployment cycle.
... Destacando que los efectos negativos en la salud mental pueden derivar en trastornos psicopatológicos, mostrándose con mayor intensidad en los siguientes supuestos, ante el acaecimiento de enfermedades o discapacidades físicas (Mateo et al., 2000), en segundo término, padecimiento de síntomas depresivos (Marks, Lambert y Choi, 2002). Y al respecto la mitad de los cuidadores somatizan estos trastornos (Family Caregiver Alliance, 2003) y en tercer término, la experimentación asidua y dilatada en el tiempo de sentimientos de ira y hostilidad. ...
Article
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Durante el transcurso de los cuidados y especialmente en los denominados de larga duración, es muy proclive el generarse determinadas situaciones conflictivas a consecuencia de diversos factores tales como, un excesivo volumen de trabajo, elevada responsabilidad, problemas relacionales entre cuidador y persona objeto de cuidados etc. Conllevando a la experimentación de cansancio, estrés y agotamiento principalmente. Todas esas situaciones negativas es lo que muchos autores definen con el concepto de carga o sobrecarga de los cuidados, constituyendo un habitual ámbito de estudio en las investigaciones que versan sobre esta temática. El propósito de este artículo, consiste en llevar a cabo una aproximación conceptual del término de carga, experimentada durante el transcurso de las actividades de cuidados, analizando las dimensiones más relevantes de la misma en primer término, haciendo una distinción entre los conceptos de carga objetiva y subjetiva en segundo término, analizar las principales consecuencias que generan a los cuidadores tales como, percibimiento de sentimientos negativos, problemas de salud física, psíquica, trastornos cardiovasculares e inmunológicos en tercer término, las principales variables asociadas al concepto de carga, y finalmente los principales instrumentos de evaluación de la carga del cuidador.
... Second, respondents are asked whether they provide -personal care, such as washing, getting out of bed, or dressing?‖ to anyone who is living with them in the household and what is their relationship to that person. I limit the analysis to care that is given to family members and assume that this care is provided daily because they co-reside with the recipient (Jang et al., 2012;Marks et al., 2002). ...
Article
Objectives Amid growing concerns about the economic implications of population aging and the sustainability of older adults’ working life, unpaid family care work receives less attention despite its direct relevance to population aging. This paper systematically compares the paid and unpaid working life expectancy at age 50 to understand the overlap and trade-off between paid and unpaid work among older European adults. Method Using data from the Survey of Health and Retirement in Europe (SHARE) with the Sullivan method, the paper presents gender differences across 17 countries in life expectancy at age 50 at various paid (employment) and unpaid (caregiving) role configurations. Results When work is defined to include unpaid family caregiving, women and men have similar working life expectancies at age 50, in contrast to prior research. However, its paid and unpaid components are gendered. The results also show that at age 50, women are expected to spend similar number of years providing grandchild care and ADL/IADL care and that most of these years take place after retirement. Discussion The results highlight that the gendered tension between paid and unpaid work persists into older adulthood and needs to be accounted for in working life expectancy measures. The results also underscore the gendered implications of population aging and unpaid work in older adulthood for retirement age policies and strategies for promoting gender equality in later life.
... The caregiving literature has consistently shown that female caregivers experience higher levels of stress and depressive symptoms and are more burdened than male caregivers (e.g. Caputo et al., 2016;Marks et al., 2002;Pinquart & Sörensen, 2003). Recently Swinkels et al. (2019) examined gender differences in the burden experienced by those caring for partners and found, similar to previous studies, that women feel a greater burden from caregiving than men. ...
Article
Previous research has indicated that administrative burdens are particularly high in personalised funding schemes such as the Australian National Disability Insurance Scheme (NDIS), because these schemes are predicated on very high levels of self-advocacy. Administrative burdens tend to be inequitably distributed, thereby entrenching existing social inequalities. This is the first study to look at the lived experiences of administrative burden within the NDIS explicitly—and particularly those of women, who are underrepresented within the scheme. The research involved qualitative interviews with 30 women with disability who were either NDIS participants or had considered applying for the NDIS. We argue that like other marginalised groups, women with disability are experiencing significant administrative burdens within the NDIS, which are barriers to obtaining sufficient disability support. Based on this finding, we recommend the NDIS implement a gender strategy, as well as address burdensome administrative processes in general.
... The caregiving literature has consistently shown that female caregivers experience higher levels of stress and depressive symptoms and are more burdened than male caregivers (e.g. [51][52][53][54]. Recently Swinkels et al. [49] examined gender differences in the burden experienced by those caring for partners and found, similar to previous studies, that women feel a greater burden from caregiving than men. ...
Article
Full-text available
Background Care services in industrialized nations are increasingly moving towards individualized funding models, which aim to increase individuals’ flexibility, choice and control over their services and supports. Recent research suggests that such schemes have the potential to exacerbate inequalities, however none has explored gendered dimensions of inequality. The Australian National Disability Insurance Scheme (NDIS) is a major individualized funding reform, and has a female participation rate of only 37%, despite women and girls making up half of the disability population. Methods The objective of the study is to explore possible gendered barriers to applying for and receiving adequate support through the NDIS, and to suggest directions for future research. We report on semi-structured interviews with 30 women with disability and explore their experiences with the NDIS and their perspectives on challenges associated with being a woman seeking disability support in Australia. We analyse the results using thematic analysis. Results Most women in our sample reported differences between the experiences of men and women seeking disability support in Australia. Commonly reported gendered barriers to women being able to access the right supports for their disability involve a) confidence, negotiation and self-advocacy, b) gendered discrimination in diagnosis and the medical system, which has implications for disability support access, and c) support for and recognition of caring roles. Conclusions These results suggest that women are not receiving equitable treatment with regard to the NDIS, and that further research and policy reform are needed to ensure that women with disability are not further disadvantaged as a result of the move toward individualized funding models.
... Videre kan det vaere noe i selve utøvelsen av å vaere forelder (hjelpe og stelle for andre, føle seg til nytte) som fostrer mer positive selvevalueringer blant kvinner. Tidligere forskning har funnet at å vaere nødvendig og til stede for andre, er viktigere for kvinners enn menns velvaere (Marks, Lambert, & Choi, 2002). ...
Chapter
I dette kapitlet undersøkes om omfanget av formell omsorg i kommunen påvirker individers holdninger til familieomsorg og sannsynligheten for at enkeltindivider gir familiemedlemmer jevnlig hjelp med pleieoppgaver. Vi finner at folk som bor i kommuner med omfattende formell omsorg er mindre positive til familieomsorg. Vi finner også at folk som bor i kommuner med omfattende formell omsorg er mindre tilbøyelige til selv å gi pleie. Motsatt er positive holdninger og det å gi pleie mer utbredt i kommuner med mindre omfattende omsorgstjenester. Resultatene peker i retning av en viss grad av substitusjon mellom formell og uformell omsorg, men pårørende trenger ikke ha trukket seg tilbake; de kan ha konsentrert seg om andre typer omsorgsoppgaver, og pleietrengende eldre kan selv foretrekke offentlig hjelp når den har blitt lettere tilgjengelig.
... We found being family members reduced the caregiver burden. Similarly, Marks et al. (23) reported that caregivers could acquire satisfaction from helping their family members. ...
... Studies have consistently shown that caregiving is associated with reduced attention to other family members, lower marital quality and decreased involvement in social activities. [9,10] Caregivers also often experience financial burdens as a result of caregiving, [11,12] this is because they often incur financial loss due to absenteeism from paid job, man-hour loss and logistics. In the extreme situation, caregivers may have to quit their jobs which may induce financial strain. ...
Article
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Background: Caring for patients in the hospital can cause a lot of stress for the caregivers, especially those who are involved with informal caregiving such as family members. Little is known in Nigeria on the stress of informal caregiving in the hospital environment. This study assessed the informal caregivers’ stress level and their determinants in a tertiary hospital in Ilorin, Nigeria. Methodology: This was a hospital‑based cross‑sectional study. Between September and October 2019, using a simple random sampling method, data were collected from 400 informal caregivers of patients in University of Ilorin Teaching Hospital with interviewer‑administered questionnaire which included socio-demographic characteristics, Caregivers Strain index (CSI) and caregivers’ stress from institution and other factors index (CSIOI). Analysis was performed, and prevalence and determinants of stress of informal caregiving were presented using descriptive statistics and logistic regressions. P < 0.05 was considered statistically significant. Results: The majority, 381 (95.2%) of the informal caregivers, reported great stress levels using CSI, while 227 (56.7%) experienced a great level of stress with the CSIOI. Predictors of caregiver stress were perception that staying around was stressful (odds ratio [OR] ‑ 17.5, P < 0.001), felt their patients will not be well cared for if not around (OR ‑ 6.1, P < 0.001), staying at the hospital for >30 days (OR ‑ 2.6, P = 0.001). Conclusion: The informal caregivers experienced a great level of stress taking care of their patients on admission in the hospital. It is, therefore, expedient that issues surrounding the comfort of the informal caregivers as they care for their patients should be included in hospital policies.
... Existing studies suggest that informal care-givers, considering their role and interactions with care recipients, are associated with the mental health of the care recipients (Marks and Choi, 2002;Buber and Engelhardt, 2008;Ejem et al., 2018). First of all, support from adult children benefits the mental health of older parents by reducing their depressive symptoms (Buber and Engelhardt, 2008;Byers et al., 2008). ...
Article
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Because of the exacerbation of population ageing, more family members are involved in the informal care-giving for older adults with disabilities to cater to their long-term care needs. As informal care-givers are associated with the mental health of the care recipient, this study, based on the theoretical framework of the Actor–Partner Effect, utilises a mixed method composed of quantitative and qualitative strategies to identify the relationship among gender and type of both care-giver and care recipient, and mental health of the recipient and explain its internal mechanism. In the quantitative research, ordinary least squares (OLS) regression results based on the basis of the Chinese Longitudinal Healthy Longevity Survey (CLHLS) data corroborate the existence of actor and partner effects within the care-giving dyad. The qualitative analysis further explains the socially constructed differences in gender role, trust relationship and perception towards filial piety of adult care-givers playing their role in the emergence of the Actor–Partner Effect. Finally, this study proposes a developed Actor–Partner Effect analysis framework, advocating to destigmatise disability and construct social support networks for the older adults with disabilities who receive informal care to promote their mental health based on the reflection of socially constructed gender difference.
... It leads to the emergence of depressive symptoms; these factors interacted and undermined each other, leading to a vicious cycle of worsening conditions for the elderly. 44 On the other hand, disability in personal care of the elderly may lead to negative bias formed by negative thoughts and judgments; the elderly may be at increased risk of depressive symptoms due to coping with stress during their health decline. ...
Article
Objective The acceleration of population aging has brought an unprecedented impact on China's health system. This study is designed to examine the association between depressive symptoms and activity of daily living disability among the elderly in China. Study design This is a cross-sectional study. Methods Data were drawn from the China Health and Retirement Longitudinal Study (CHARLS). The 10-item Center for Epidemiologic Studies–Depression (CES-D) scale was used to access depressive symptoms, and physical function was assessed by the Activity of Daily Living (ADL) scale. Multivariate logistic regression was used to assess the association between depressive symptoms and ADL among the elderly. Results Based on a sample of 5863 elderly people over 60 years old, our results showed that 1999 elderly people are with depressive symptoms, accounting for 34.1%. The mean score of ADL among the elderly with depressive symptoms (20.65 ± 7.14) was much higher than that in those without depressive symptoms (17.40 ± 4.87). After controlling potential confounders, multivariate logistic regression showed that ADL and its specific domains including personal care, transfer, medical care, household, and managing money were associated with depressive symptoms. Conclusion This cross-sectional study provides evidence of the association between depressive symptoms and ADL disability among the Chinese elderly. As a result, prevention or reduction of ADL disability may have a positive effect on the medical care of the elderly with depressive symptoms.
... According to results from another survey that focused on the caregivers of all adults, nearly half of caregivers (45 percent) experience stress, and one out of five reports that their health has deteriorated due to caregiving activities (National Alliance for Caregiving and AARP Institute 2015). Even after accounting for compositional differences between caregivers and noncaregivers, research consistently shows elevated levels of physical and mental health problems for caregivers (Marks et al. 2002;Pinquart and Sorensen 2007;Wolff et al. 2016). ...
... The estimated cost to a single female caregiver equals $324,044 (NAC & AARP, 2015), excluding other less easily quantifiable costs of their physical and psychological health. Employed caregivers face higher levels of depression and emotional stress, worse physical health, and a greater risk of chronic disease than their peers who are not caregivers (Ho, Collins, Davis, & Doty, 2005;Marks, Lambert, & Choi, 2002;Pinquart & Sörensen, 2003). Such effects profoundly impact women more than they impact men, since women live longer and comprise two-thirds of all caregivers (R.W. Johnson & Wiener, 2006;NAC & AARP, 2015). ...
Thesis
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This study investigated the associations between caregivers’ employment status and the use of a combination of informal and formal care among old Americans aged 65 and older, considering predisposing, enabling and need factors of older adults as well as of the caregivers. This study also examined whether such association differed by older adults’ gender and race/ethnicity. Data source included the 2010 and 2014 Health and Retirement Study. Multinomial logistic regressions were used to estimate probabilities of the combination of long-term care. Results indicated that although caregivers’ employment status was not significantly associated with older adults’ use of a combination of informal and community-based services, full-time employment status had significantly higher likelihoods of using a combination of informal and institutional care. Such association differed by older adults’ gender and race/ethnicity. In addition, older adults’ age, education, income and assets, chronic illnesses and functional limitations in relation to activities of daily living, and caregivers’ sole caregiving status were significantly associated with the use of informal care in combination with either community-based services or institutional care. Having fewer co-resident children or having cognitive impairments significantly increased the likelihoods of using a combination of informal and institutional care. Implications for social work, policy and research were discussed based upon these findings.
... The busyness of caregiving further restricts the time, energy, and resources one may have to practice their own self-care and preventative health behaviors (Schulz et al., 1997). All of these effects appear to be more severe among female caregivers who make up the lion's share (66%) of caregivers in general (Marks, Lambert, & Choi, 2002). ...
Thesis
Science, technology, and medicine have advanced so far as to enable aging individuals to live longer lives of greater quality in their waning years. What continues to lag, however, is widespread policy within every state that ensures the ability to age is equitable, affordable, and rewarding for the elders and community alike. By the year 2030, it is projected that 1 in 5 Americans will be aged 65 years or more. Most individuals receiving care outside of a nursing home are receiving care and support from friends or family. This comparative policy analysis provides a basic overview of the trends, implications, and potential threats to Healthy Aging in the coming years. West Virginia, Kentucky, Louisiana, Arkansas, and Mississippi have continued to trail the rest of the US in Healthy Aging. By mimicking model plans, policies, programs from more successful states, the low-preforming states can improve the holistic wellbeing of their seniors and become an exemplar for Healthy Aging. These tailored improvements consider political feasibility, alignment to explicit aging priorities, and a pragmatic focus on populations with greater potential benefit. The predominate limitations and qualms to these propositions are summarized as financial feasibility. However, the data clearly predicts that without investment in the growing elder population, future generations will experience resultant economic burden to a far greater extent. The immediate and long-term benefits of creating a sustainable approach to aging far outweigh the investment cost. Healthy Aging programs will enable older Americans to age with dignity, protect the integrity of our economy, and preserve public health before the crash of the Baby Boomer Age Wave.
... In the absence of information about hours of caregiving, studies using a stylized frequency scale similar to the one in ESS2 classify caregiving that is provided daily or several times a week as intense (Bordone et al. 2017;Hank and Buber 2009;Igel and Szydlik 2011). Finally, some studies define any caregiving in which the caregiver resides with the care recipient as intense (Jang et al. 2012;Marks et al. 2002). ...
Article
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Amid growing concern regarding the potential added burden of care due to population aging, we have very little understanding of what is the burden of care in aging populations. To answer this question, we introduce a novel metric that encompasses demographic complexity and social context to summarize unpaid family care work provided to children, elderly, and other family members across the life cycle at a population level. The measure (Care Life Expectancy), an application of the Sullivan method, estimates the number of years and proportion of adult life that people spend in an unpaid caregiving role. We demonstrate the value of the metric by using it to describe gender differences in unpaid care work in 23 European aging countries. We find that at age 15, women and men are expected to be in an unpaid caregiving role for over half of their remaining life. For women in most of the countries, over half of those years will involve high-level caregiving for a family member. We also find that men lag in caregiving across most countries, even when using the lowest threshold of caregiving. As we show here, demographic techniques can be used to enhance our understanding of the gendered implications of population aging, particularly as they relate to policy research and public debate. Supplementary information: The online version contains supplementary material available at 10.1007/s11113-021-09640-z.
... De exemplu, unele studii arată că persoanele care îngrijesc bolnavi cronici prezintă și o rată crescută în ceea ce privește consumul de alcool și alte substanţe, cum ar fi medicamentele psihotrope, faţă de cei care nu sunt îngrijitori (National Alliance for Caregiving & Evercare, 2006). În plus, cei care îngrijesc bolnavi cronici în propria familie riscă să manifeste un nivel mai crescut de ostilitate, comparativ cu cei care nu trec prin astfel de experienţă (Marks, Lambert & Choi, 2002). Un alt studiu arată că îngrijitorii propriilor parteneri de viaţă riscă să sufere de depresie clinică, iar în situaţia în care aceștia trebuie să îngrijească un soţ sau o soţie cu tulburări cognitive și fizice semnificative ei sunt susceptibili a manifesta comportamente negative și dăunătoare chiar faţă de partener (Beach, Schulz, Williamson, Miller, Weiner & Lance, 2005). ...
Book
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The reader will find in this paper relevant topics for deciphering the link between stress and health and, more importantly, will progress in understanding that this link has strong intermediaries in terms of thoughts, attitudes, beliefs, relationships with others. The undeniable difficulty, suggested to anyone by the notion of stress, is especially a challenge to identification of resources, and the topics of health psychology in this volume can support the search and identification of psychological tools to consolidate the good condition of the healthy one, but also of the affected one already by a chronic medical condition, or existentially affected by difficult personal, family, professional experiences.
Article
This study examines the associations between the quality of adult filial caregivers’ intimate partner relationships and health behaviors, mental health, and physical health using structural equation modeling. Secondary data from the National Survey of Midlife Development in the United States were used to examine the health outcomes of adults (n = 224) who reported caregiving for a parent or parent-in-law in the past 12 months. Results indicated a significant mediation effect of close intimate partner relationship quality and physical health, through mental health; health behaviors did not produce a significant mediation effect.
Article
Eldercare demands (ECD) may result in stress when finite resources needed to fulfill life roles (i.e., family, work) become scarce. ECD may be acquired, continue over time, or be relinquished. They thus may represent acute stress (immediate, severe) or chronic stress (persistent, milder). Workers at six U.S. manufacturing companies completed surveys ( N = 520). ECD were operationalized as providing assistance to an adult aged 65+ years due to disability or illness. Workers were categorized into four ECD groups (persistent, relinquished, acquired, and none), and we examined the ECD groups’ association with person-centric and work-centric outcomes. Respondents with acquired ECD had worse mental health and greater depressive symptoms than those with none, and those with persistent ECD had greater work stress and family–work conflict than those with none. Findings suggesting that acute stress is more related to person-centric outcomes and chronic stress is more related to work-centric outcomes could inform development of tailored interventions.
Chapter
This chapter discusses two themes: care work and the ethics of care. In addition, it justifies the research methodology employed. The first part discusses care and its related concepts (caregiving, caring, caregiver, formal and informal care, and care burden, etc.) in its entirety. It then goes further to specify the type of care described in this book. The second part takes a closer look at existing literature on the ethic of care with an emphasis on the feminist ethics of care. It also justifies the employment of feminist ethics of care in the theoretical framework of this study. The third part presents the methodologies employed to collect the primary data in Darfur. The research that informs this case study is based on mixed-methods.
Article
Background Transitional care may have different effects in males and females hospitalized for heart failure. We assessed the sex-specific effects of a transitional care model on clinical outcomes following hospitalization for heart failure. Methods In this stepped-wedge cluster randomized trial of adults hospitalized for heart failure in Ontario, Canada, 10 hospitals were randomized to a group of transitional care services or usual care. Outcomes in this exploratory analysis were composite all-cause readmission, emergency department visit, or death at 6 months; and composite all-cause readmission or emergency department visit at 6 months. Models were adjusted for stepped-wedge design and patient age. Results Among 2494 adults, mean (SD) age was 77.7 (12.1) years, and 1258 (50.4%) were female. The first composite outcome occurred in 371 (66.3%) versus 433 (64.1%) males (hazard ratio [HR], 1.04 [95% CI, 0.86–1.26]; P =0.67) and in 326 (59.9%) versus 463 (64.8%) females (HR, 0.83 [95% CI, 0.69–1.01]; P =0.06) in the intervention and usual care groups, respectively ( P =0.012 for sex interaction). The second composite outcome occurred in 357 (63.8%) versus 417 (61.7%) males (HR, 1.03 [95% CI, 0.85–1.24]; P =0.76) and 314 (57.7%) versus 450 (63.0%) females (HR, 0.81 [95% CI, 0.67–0.99]; P =0.037) in the intervention and usual care groups, respectively ( P =0.024 for sex interaction). The sex differences were driven by a reduction in all-cause emergency department visits among females (HR, 0.66 [95% CI, 0.51–0.87]; P =0.003), but not males (HR, 1.10 [95% CI, 0.85–1.43]; P =0.46), receiving the intervention ( P <0.001 for sex interaction). Conclusions A transitional care model offered a reduction in all-cause emergency department visits among females but not males following hospitalization for heart failure. REGISTRATION URL: https://www.clinicaltrials.gov ; Unique identifier: NCT02112227.
Article
We assess whether gender differences in domestic time-use, including informal adult caregiving and housework, explain the gender gap in depression among older adults. Using data from the Panel Study of Income Dynamics, we model depressive symptoms as a function of informal adult caregiving and housework. The analytic sample includes 539 men and 782 women. Findings suggest informal adult caregiving is associated with increased depressive symptoms for women (p < .05) and men (p < .05). Time spent on housework is associated with decreased depressive symptoms for women and female caregivers (p < .01). Women may experience elevated depressive symptoms relative to men despite their domestic time-use.
Article
There has been a documented increase in the numbers of filial and sandwiched caregivers in the United States. However, past studies have overlooked the impact of work and family overload on caregiver well-being. This study investigates the moderating influences of the quality and directionality of work and family spillover on the well-being (e.g., positive affect and negative affect, psychological well-being, and global well-being) of 180 filial and sandwiched caregivers from the second wave of the Midlife in the United States Survey. Regression and moderation analyses revealed that sandwiched caregivers with high levels of negative work-to-family spillover exhibited higher negative affect than the comparison groups. Sandwiched caregivers with high levels of negative family-to-work spillover exhibited higher level of negative affect and lower level of self-acceptance than other caregivers. These findings can help create work programs that address spillover between work and home in the effort to promote caregiver well-being.
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Caring for one’s parents can be good or bad for mental health. Guided by theories suggesting that caregiving work brings both demands and benefits, we examine if mental health outcomes depend on variations in caregiving arrangements. Using waves 5–17 from the Household Income and Labor Dynamics in Australia Survey (16,802 respondents; 115,176 person-years), we divide men and women caregivers into four groups based on their responsibility (main vs. secondary caregiver) and the location of the care recipient (inside or outside the caregiver’s household). We also examine how caregivers’ experiences are moderated by the social support they have. On average, caregivers experience no change in mental health. However, women with low social support who become main caregivers for resident parents experience declines in mental health. Men with low social support who become main caregivers for non-resident parents experience improved mental health. These results suggest that caregiver outcomes reflect different caregiving arrangements.
Article
Background Few studies have investigated the consequences of caregiving on the objectively measured physiological health outcomes in China. This study used population-based longitudinal data to examine the association between parental caregiving and blood pressure among Chinese women.Method This is a retrospective analysis of 2586 women using five waves of data from the Ever-Married Women Survey component of the China Health and Nutrition Survey (2000, 2004, 2006, 2009, and 2011). We applied growth curve models to examine trajectories of systolic blood pressure (SBP) and diastolic blood pressure (DBP) associated with parental caregiving among women in China.ResultsIn multivariable analyses of blood pressure trajectories adjusting for potential confounders, parental caregivers had higher systolic (β-coefficient (β) = 1.16; p ≤ 0.01) and diastolic blood pressure (β = 0.75; p ≤ 0.01) compared with non-caregivers across multiple waves. Caregivers and non-caregivers had similar levels of systolic blood pressure at baseline, but caregivers exhibited relatively higher growth rate over time. Diastolic blood pressure was much higher among caregivers at the baseline measure, and across time relative to non-caregivers. Moreover, low-intensity but not high-intensity caregivers showed higher growth rate compared with non-caregivers for both SBP and DBP.DiscussionOur results demonstrate the negative cardiovascular consequences of parental caregiving among Chinese women. Findings from the study can be used to develop future stress management interventions to decrease hypertension risk within women who provide care to their parents.
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In this study, the authors examined cancer family caregivers' life experience and the meaning of leisure, focusing on their difficulties and the role of leisure. We found four main themes related to cancer family caregivers' life and leisure experiences: stressors, adapting, the need of leisure, and leisure experiences. Our results showed that the caregivers experienced high levels of psychological and physical stress and conflicts while caring for cancer patients, resulting in a poor quality of life. They believed that leisure activity is necessary and can improve their quality of life; however, they felt a sense of guilt while engaging in personal activities.
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The economic instability of the Great Recession contributed to a rise in multigenerational households as more individuals took on unanticipated care responsibilities for older family members while navigating financial uncertainties. Guided by the life course perspective, this study compared the psychological and social well-being of family caregivers and examined the moderating influences of financial challenges experienced during the Great Recession. Filial and sandwiched caregivers ( N = 138; M age = 52.80; SD age = 11.25) from the Refresher Cohort of the Midlife in the United States (MIDUS) survey provided information on demographics, caregiving, financial challenges, and well-being. Findings from regression analyses showed that sandwiched caregivers exhibited lower environmental mastery and positive relations with others than filial caregivers ( p = .07). Moderation analyses showed that sandwiched caregivers with fewer than average financial challenges exhibited lower social actualization than the other family caregivers ( p = .01). Study findings underscore the need to support family caregivers’ psychosocial well-being as they navigate caregiving responsibilities and financial disruptions.
Article
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The COVID-19 pandemic has had a dramatic impact on global economies and societies. Although social distancing policies are needed to contain the spread and impact of COVID-19, they also impose a psychological and economic burden on people who are already experiencing increased distress such as caregivers. Yet, few measures have been developed and validated to measure the psychosocial impact of COVID-19. Utilizing item response theory (IRT), the purpose of this study was to develop and psychometrically validate a measure of psychosocial functioning—the Psychosocial Functioning during COVID-19 (PFC-19) Questionnaire—to assess changes in social interaction, mental health, health behavior, and global functioning among a sample of informal caregivers during the COVID-19 pandemic. The analytic sample ( n = 733) was recruited from Amazon Mechanic Turk (MTurk) (69% male, 55% white). Results suggest a two-factor measure, assessing global functioning (14 items) and affective response (8 items), with strong evidence for reliability, validity, and dimensionality. Future research should replicate this factor structure in other samples.
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Care in Chile, as in most Latin American countries, remains largely the responsibility of female family members in informal arrangements with little government support. The analysis of caring for a dependent older person has commonly been approached from the burden of care perspective, focusing on the tasks carried out, the time spent providing care and the negative (burdensome) consequences for the care-giver. This study reveals the daily experiences of family care-givers of older people through a thematic data analysis of 42 interviews with main family carers of an older person as experienced by the carers themselves. Findings highlight the complex nature of care work. Tasks carried out do not necessarily relate to the intensity of the care experience or a negative experience. Care-givers can work long hours providing care and still feel comfortable and find the experience emotionally rewarding. Care-givers might also carry out only a few tasks and experience pressure. The broader social and economic context can generate constraints that make a specific set of tasks easier or harder on the carer, but these contextual factors do not fully explain the experience of care. Relations, and particularly those that carry an emotional component such as the carer-older person, carer-siblings and carer-spouse, must be considered alongside the tasks and the difficulties or potential constraints of the context to understand the care experience.
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The gender-specific kinship relationship of patients and their care providers has not generally been investigated in studies of caregiver burden and well-being. In this study of 183 heart patient-caregiver dyads, gender and relationship were analyzed singly and jointly with respect to the process and outcome of caregiving. Strains caregivers experienced while caring for older heart patients six weeks and one year after hospital discharge were determined. Findings showed consistent patterns of strain. Women, nonspousal caregivers, and daughters, in particular, experienced the most severe aftereffects. These findings support a caregiving outcomes model proposing that the patient-caregiver relationship is an essential component of caregiver strain.
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The well-being of family caregivers of older memory-impaired adults was examined in four dimensions: physical health, mental health, financial resources, and social participation. Results indicated that, relative to random community samples, caregivers are most likely to experience problems with mental health and social participation. In addition, characteristics of the caregiving situation were more closely associated with caregiver well-being than were illness characteristics of the patients.
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This study uses longitudinal data to observe how life events, chronic life strains, self concepts, coping, and social supports come together to form a process of stress. It takes involuntary job disruptions as illustrating life events and shows how they adversely affect enduring role strains, economic strains in particular. These exacerbated strains, in turn, erode positive concepts of self, such as self-esteem and mastery. The diminished self-concepts then leave one especially vulnerable to experiencing symptoms of stress, of which depression is of special interest to this analysis. The interventions of coping and social supports are mainly indirect; that is, they do not act directly to buffer depression. Instead, they minimize the elevation of depression by dampening the antecedent process.
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A theoretical model of psychological well-being that encompasses 6 distinct dimensions of wellness (Autonomy, Environmental Mastery, Personal Growth, Positive Relations with Others, Purpose in Life, Self-Acceptance) was tested with data from a nationally representative sample of adults (N = 1,108), aged 25 and older, who participated in telephone interviews. Confirmatory factor analyses provided support for the proposed 6-factor model, with a single second-order super factor. The model was superior in fit over single-factor and other artifactual models. Age and sex differences on the various well-being dimensions replicated prior findings. Comparisons with other frequently used indicators (positive and negative affect, life satisfaction) demonstrated that the latter neglect key aspects of positive functioning emphasized in theories of health and well-being.
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This study compares the health of 42 grandparent, 44 spouse, and 130 adult-child caregivers with 1,669 noncaregivers in 1994 and 1974. In 1994, all three caregiver groups had poorer mental health than the noncaregivers; grandparent caregivers also had poorer physical health and greater activity limitations. Spouse and adult-child caregivers had not differed from the noncaregivers 20 years prior, but grandparent caregivers had experienced poorer health than the noncaregivers and more stressful life events than the other caregivers. Caregiving appears to add new burdens to otherwise normal lives for spouse and adult-child caregivers, while being yet another aspect of a difficult life course for grandparent caregivers.
Chapter
At present, more than 4 million adults over the age of 65 years receive some type of personal care from family members. This figure is expected to increase as the nation’s population of older adults grows to 67.5 million by the year 2050 (U.S. Senate, 1991). In such situations, the care recipient frequently benefits from the physical, emotional, and financial support provided by the family caregiver. However, the personal consequences to the caregiver of fulfilling this responsibility have received much attention in the research literature. This chapter will review the findings from studies with family care providers. We begin with a historical overview of the characteristics of individuals who comprise the majority of caregivers in this country, and review the problems, stresses and hardships they experience. Next, we review theoretical models that have been proposed to explain the process of caregiver distress and its interaction with moderating variables. Then, we examine the various psychologically oriented treatments and forms of intervention currently available, and address issues of their efficacy. Finally, we provide a brief review of the growing literature on special caregiving populations, with particular emphasis on the unique needs and concerns of male caregivers and caregivers of various ethnic or minority backgrounds. The chapter closes with recommendations for future research.
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This article examines the heterogeneity of the caregiving experience for female family caregivers, using a national probability sample. Caregiving was found to have negative associations for caregivers in a number of domains, with women who cared for their husbands reporting the most negative outcomes. Both a longer duration of caregiving and coresidence put the caregiver at risk for more negative outcomes. The implications of these findings for future research and service delivery are examined.
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This article examines kinkeeping and its relationship to distress. We document the extensive kin work—its breadth (number of kin helped) and depth (hours spent helping them)—performed especially by women but also by men. In support of a structural hypothesis, findings show that the breadth (but not depth) of kinkeeping is associated with depression for both women and men. In support of a normative hypothesis, analyses show that less normative kinkeeping increases distress while more normative obligations, such as caring for parents, may actually yield gratification. We find that role conflict—the interference of kinkeeping with both paid work and household obligations—helps explain the relationship of kinkeeping to distress.
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Most major population surveys used by social scientists are based on complex sampling designs where sampling units have different probabilities of being selected. Although sampling weights must generally be used to derive unbiased estimates of univariate population characteristics, the decision about their use in regression analysis is more complicated. Where sampling weights are solely a function of independent variables included in the model, unweighted OLS estimates are preferred because they are unbiased, consistent, and have smaller standard errors than weighted OLS estimates. Where sampling weights are a function of the dependent variable (and thus of the error term), we recommend first attempting to respecify the model so that they are solely a function of the independent variables. If this can be accomplished, then unweighted OLS is again preferred. If the model cannot be respecified, then estimation of the model using sampling weights may be appropriate. In this case, however, the formula used by most computer programs for calculating standard errors will be incorrect. We recommend using the White heteroskedastic consistent estimator for the standard errors.
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How does the family affect the health of its adult members? It is in the family that the macro-level social and economic order affects individual physical and emotional well-being. This review presents a general model of understanding family and health that describes patterns of well-being, and then asks, "what explains these patterns?" Explanations are found in causal chains, conditional effects, and "structural amplification." The review summarizes and synthesizes ideas and findings about four factors: marriage and parenthood (which define the family), and the wife's or mother's employment and the family's social status (which connect it to the larger social order). Overall, the married are in better health than the nonmarried, but parents are not better off than nonparents. Women's employment and high family socioeconomic status tend to be associated with good physical and psychological health. Under what circumstances are these basic patterns found, and what explains these patterns—what links structure to individual health? Economic well-being and social support are considered as the basic explanations. Concluding comments point to the need for more studies of the impact of family on the sense of control, which could be an important link to health.
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National Survey of Families and Households 1987-88 (N = 73,017) data were used to generate population estimates of in-and out-of-household caregiving for persons of all ages. More than 1 in 7 U.S. adults reported caring for relatives or friends during the previous year, including more than 1 in 5 women aged 35-64. About one third of this care was provided to nonelderly persons. Multivariate analyses revealed that gender, age, marital status, education, ethnicity, education, and employment status helped predict the likelihood of caregiving.
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The CES-D scale is a short self-report scale designed to measure depressive symptomatology in the general population. The items of the scale are symptoms associated with depression which have been used in previously validated longer scales. The new scale was tested in household interview surveys and in psychiatric settings. It was found to have very high internal consistency and adequate test- retest repeatability. Validity was established by pat terns of correlations with other self-report measures, by correlations with clinical ratings of depression, and by relationships with other variables which support its construct validity. Reliability, validity, and factor structure were similar across a wide variety of demographic characteristics in the general population samples tested. The scale should be a useful tool for epidemiologic studies of de pression.
Article
This research presents empirical findings concerning the extent to which older people in the inner city neighborhoods of New York City have an informal network of friends and neighbors and the nature of the interactions which occur. The characteristics associated with individuals possessing extensive friend-neighbor networks are discussed, and the preferences of older people for assistance from kin versus nonkin in a variety of situations are explored. Several theoretical models concerning the operation of the informal support system are considered, and the author postulates a new model - the hierarchical-compensatory model - as best fitting the empirical data at hand. The findings are from the largest cross-cultural study of the elderly in urban poverty, The Elderly in the Inner City of New York with an N of 1,552, including 49% white, 37% black, and 13% Hispanic elderly.
Article
This study examined the effects of caregiving for disabled children, spouses, parents, and other kin and nonkin on multiple positive and negative dimensions of psychological well-being and development using data from a population sample of employed, middle-aged men and women respondents in the Wisconsin Longitudinal Study 1992-1993 (n = 5,782). A life course role-identity theoretical framework was employed to hypothesize that contemporary social organization leads to conflicting demands across the role identities of employee and caregiver and that this conflict is an important factor in accounting for the negative effects of caregiving on well-being. Multivariate regression analyses confirmed these hypotheses and further revealed that if differences in work and family conflict between caregivers and noncaregivers were eliminated, the caregiving role would more often lead to positive effects on well-being.
Article
one of the most significant changes in family roles in recent history has been the assumption by large numbers of adult children of the responsibility for the welfare and direct care of their parents / provide a context within which patterns and consequences of caregiving by adult children can be considered sources of filial responsibility [legal mandates, affection and obligation] / the prevalence of daughters and sons as caregivers / differences in the caregiving role [types of tasks, caregiving roles, help for the helpers] / plausible reasons for gender differences [the time-available hypothesis, external-resources hypothesis, socialization/ideology hypothesis, specialization-of-tasks hypothesis, cultural taboos] / impacts of caregiving [burden and stress, role conflict, quality of the dyadic relationship, satisfaction with the caregiving role] / future patterns of parent care [the prevalence of children as caregivers, changes in the intensity of care, shared care] (PsycINFO Database Record (c) 2012 APA, all rights reserved)
Article
In "Balancing Work and Caregiving for Children, Adults, and Elders" the authors explore how employees with caregiver roles juggle the responsibilities of work and family. They suggest that, in our current socio/economic reality, dependent care needs to be addressed as a corporate, family, and community concern. Drawing from literature in the field, as well as their large-scale study, they present a thorough discussion of the stressors experienced by workers caught in the often conflicting demands of dual roles. The authors consider multiple factors that contribute to the experience of stress and work-related outcomes such as absenteeism. . . . Policies, benefits, and services are reviewed, along with the advantages and disadvantages of each for both the employee and the employer. The authors also analyze methods for assessing employee needs and provide recommendations for national and local policies, along with directions for further research. (PsycINFO Database Record (c) 2012 APA, all rights reserved)
Article
Reigning measures of psychological well-being have little theoretical grounding, despite an extensive literature on the contours of positive functioning. Aspects of well-being derived from this literature (i.e., self-acceptance, positive relations with others, autonomy, environmental mastery, purpose in life, and personal growth) were operationalized. Three hundred and twenty-one men and women, divided among young, middle-aged, and older adults, rated themselves on these measures along with six instruments prominent in earlier studies (i.e., affect balance, life satisfaction, self-esteem, morale, locus of control, depression). Results revealed that positive relations with others, autonomy, purpose in life, and personal growth were not strongly tied to prior assessment indexes, thereby supporting the claim that key aspects of positive functioning have not been represented in the empirical arena. Furthermore, age profiles revealed a more differentiated pattern of well-being than is evident in prior research. (PsycINFO Database Record (c) 2012 APA, all rights reserved)
Article
examines the experiences of husbands and wives caring for disabled partners / summarizes research contrasting spouses with other caregivers / special attention is given to the ways in which gender structures the meaning and consequences of the role of caregiver / explores similarities and differences in the caregiving experiences of husbands and wives comparisons of caregiving husbands and wives [the meaning of care, the impact of caring on the division of labor, impact on social support networks, impact on support to the caregiver, impact on financial resources] (PsycINFO Database Record (c) 2012 APA, all rights reserved)
Article
Many claims concerning extent and consequences of litigation have been made, despite a lack of comprehensive and widely available data. It has been suggested that a rapidly increasing rate of litigation has caused problems in the recruitment and retention of obstetricians, and has also caused practitioners to practice ‘defensively’. This article discusses meaning and significance of defensiveness within obstetrics and midwifery and quantifies the incidence of certain examples of defensive practice. Based on large-scale postal surveys of obstetricians and midwives in Scotland and England, as well as follow-up interviews, it clarifies the significance of what has become known as defensive medicine in maternity care, notably in relation to caesarean sections. It then examines the role of clinical risk management, and the growth of protocols and guidelines in particular, in trying to limit litigation.
Article
This study applies meta-analysis techniques to the results of 14 descriptive studies of gender differences in caregiving to determine the size and significance of gender differences in caregiving stressors (level of elder impairment and level and type of task involvement) and in caregiver burden. There were essentially no significant gender differences in functional impairment of the frail care recipient, total caregiver involvement in care, or in money management tasks. Female caregivers were more likely to carry out personal care and household tasks and more likely to report greater burden. Given the relatively small size of the effects found, we conclude that future research should focus on the part that gender-role explanations play in assigning meaning to caregiving behaviors.
Article
Results from a 2-year (4 waves) longitudinal study show strong evidence for patient decline and high levels of depressive symptomatology among caregivers. Female caregivers reported high, stable rates of depressive symptomatology throughout the study, whereas male caregivers exhibited significant increases in depression over time. Cross-sectional multivariate analyses revealed significant positive relationships between depression and number of patient problem behaviors, negative social support, and concern about financial resources; negative relationships were found between depression and social support, quality of prior relationship, and satisfaction with social contacts. Three significant independent predictors of change in depression were found: Lower depression scores at Time 1 were related to increases in depression over time; men were more likely than women to experience increases; and a decline in social support resulted in increased depression.
Article
Existing empirical literature on the prolonged or cumulative consequences of exposure to the stresses of caregiving is reviewed. Specific goals are to identify psychiatric and physical morbidity effects, report the magnitude of those effects, evaluate research and analytic methods used to assess morbidity, and make recommendations for future research. Overall, the literature indicates increases in self-report psychiatric symptomatology and increases in psychiatric illness among most caregivers when compared to population norms or appropriate control groups. However, there is little information on the population prevalence or incidence of clinically significant psychiatric conditions attributable to caregiving. Studies of physical health effects as assessed by self-report, health care utilization, and immune function are less conclusive but, nevertheless, suggest increased vulnerability to physical illness among caregivers. We conclude with a discussion of why morbidity effects are difficult to obtain in caregiver studies and with recommendations for future research.
Article
The 1982 National Long-Term Care Survey and Informal Caregivers Survey provided data for the first national estimates of informal caregivers to noninstitutionalized disabled elders. The descriptive profile confirmed previous research findings that informal caregivers are predominantly female, that a sizeable proportion is over age 65, and that a minority use formal services. There also was evidence for competing demands: 21% reported child care responsibilities, 9% indicated that they had quit their jobs, and 20% reported other work conflict.
Article
Nine subscales of the Brief Symptom Inventory (BSI) were examined for caregivers of dementia patients. Caregivers (N = 184) were divided into groups on the basis of age (less than or equal to 59 and 60+ ) and gender. Their scores were compared with age-matched norms. All of the caregiving groups were significantly elevated on the Hostility subscale. Both younger and older women scored higher than the norms on the Anxiety subscale, and the older women were significantly elevated on three other subscales as well. The Anxiety and Hostility subscales of the BSI were most strongly correlated with the Burden Interview, a measure of the demands imposed by caregiving activities. This relation between burden and symptomatology highlights the stressful nature of caregiving.
Article
This study demonstrates the utility of incorporating a life course, role context approach in investigations of the ties between particular roles and psychological well-being, using the links between women's caregiving and well-being as a case in point. We draw on panel data from a random sample of 293 women interviewed in 1956 and 1986, considering both current role occupancy and the duration of caregiving as well as a number of factors that may moderate the effects of caregiving on well-being. We find, using ordinary least squares regression, that the effects of caregiving on women's emotional health are moderated by their previous psychological well-being, with caregivers with high prior well-being reporting high subsequent well-being. Other moderators are previous social integration (in the form of religiosity and multiple-role involvements) and other nonfamily roles (worker and volunteer) currently occupied. What women bring to caregiving (in terms of their previous social integration and psychological well-being) shapes its significance for their emotional health. Moreover, the duration and timing of caregiving in women's lives also relate to its effects on their well-being. These findings point to the importance of examining the impacts of particular social roles, such as caregiving, in the context of other roles and resources.
Article
This study drew on a life course approach and a sample of 293 women from four birth cohorts in upstate New York to examine the relationship over time between women's paid work and their informal caregiving of aging or infirm relatives. We find that such caregiving is an increasingly likely role for women, both as they age and across birth cohorts. One in four (24%) women became caregivers at some time between ages 35—44, and over one in three (36%) of these same women became caregivers between ages 55—64. Only 45 percent of the oldest cohort (born 1905—1917) were ever caregivers, compared to 64 percent of the most recent cohort (born 1927—1934), an increase of almost 20 percent. Clearly changes in the labor force participation of more recent cohorts of women do not appear to alter their caregiving responsibilities. In fact, women in this sample were equally likely to become caregivers, regardless of whether or not they were employed.
Article
Sociological literature on gender, work, and families has focused on both conflict and benefits created by combining the spouse, parent, and paid worker roles, whereas research by family gerontologists has focused on stress experienced by those who provide care to frail elderly parents as well as other roles associated with being in the “middle generation.” We examine consequences of adding middle generation roles to other major life roles during the middle years. We find that giving help to parents increases men's distress, while giving help to adult children enhances women's well-being. When help to biological parents is examined separately, it is found to increase both men's and women's distress. Women are unaffected by the multiplicity of roles while, for men, there is evidence of both role buffering and strain from conflicting demands. We discuss further directions for research on consequences of roles for well-being.
Article
The dementia caregiving literature is reviewed with the goals of (a) assessing the prevalence and magnitude of psychiatric and physical morbidity effects among caregivers, (b) identifying individual and contextual correlates of reported health effects and their underlying causes, and (c) examining the policy relevance of observed findings. Virtually all studies report elevated levels of depressive symptomatology among caregivers, and those using diagnostic interviews report high rates of clinical depression and anxiety. The evidence is more equivocal and generally weaker for the association between caregiving and physical morbidity, such as self-rated health, number of illnesses, symptomatology, health care utilization, preventive health behaviors, and cardiovascular functioning. Across studies, psychiatric morbidity in caregivers was linked to patient problem behaviors, income, self-rated health, perceived stress, and life satisfaction. Physical morbidity was associated with patient problem behaviors and cognitive impairment, and with caregiver depression, anxiety, and perceived social support. Possible causes of reported effects and policy implications are discussed.
Article
This article analyzes cross-sectional data collected from 1,585 employed caregivers of parents and parents-in-law. Hierarchical regression models were used to examine the additive and multiplicative effects of relationship status (parent or parent-in-law) and gender on caregiving activities, resources, and costs. Findings indicate that both the caregiver's gender and the elder's gender are associated with care provided to and from parents and parents-in-law. Results also show that daughters-in-law are especially vulnerable because they receive few resources from elders. Practice implications and directions for future research are discussed.
Article
This critical review of 29 studies published through 1996 on the gain experienced among informal caregivers of older adults, identifies 13 conceptual (i.e., definitions and theoretical frameworks) and methodological (i.e., sampling, design, measurement, analysis) observations. Key limitations of prior research are highlighted and recommendations necessary for the advancement of research in this area of inquiry are made. Drawing upon relevant theoretical frameworks and the observations noted in this review, a conceptual framework is proposed to bring some consistency to the ways in which future research on positive aspects of caregiving proceeds.
Article
Data were collected from 252 coresident caregiving daughters and daughters-in-law and their husbands. We hypothesized that biological children would give more care than children-in-law and that children-in-law would have very different caregiving experiences and resultant appraisals than biological children. Contrary to our hypotheses, we found that the experiences are very similar for biological children and children-in-law in caregiving families. We suggested that the important factor is not the relationship to the elder that has the impact–it is the quality of the relationship with the elder that is consistently significant.
Article
Fuzzy cluster analysis (FCA) was used to classify 166 outpatient positive treadmill stress tests as mildly, moderately, or severely abnormal. The method combines ST-segment change with five other stress test variables, and then computes a similarity measure to determine how closely each patient's stress test resembles a prototypical mildly, moderately, or severely abnormal stress test. All patients had coronary angiography within 1 month of their stress tests. For the 45 patients with triple vessel disease (TVD), FCA classified 34 of these stress tests as severely abnormal (sensitivity = 75%). For the 22 patients with left main disease (LM), FCA classified 19 stress tests as severely abnormal (sensitivity = 86%). For the combined group with high-grade disease (TVD + LM), the sensitivity was 79%. A literature review shows that for stress echocardiography, multiple exercise-induced wall motion abnormalities have a sensitivity in the 70-80% range for patients with high-grade disease. For nuclear stress testing, the high-risk pattern of multiple reversible defects, with or without increased lung uptake, has a sensitivity in the range of 70-80% for patients with high-grade disease. Thus classification of a positive stress test as severely abnormal by FCA has a sensitivity comparable to high-risk patterns on stress echocardiography and nuclear stress testing in patients with TVD or LM.
Article
This prospective study (n = 476) examined 3 types of caregiving transitions experienced by wives and daughters of older persons: entry, institutionalization, and bereavement. Daughters were more likely to enter the caregiving role than wives, but the impact of entering the role was more pronounced for wives. After becoming a caregiver, wives decreased in their participation in leisure activities, perceptions of quality of family relations, and marital satisfaction. Daughter caregivers were more likely than wives to place their care recipient in an institution, and they increased in social participation and decreased in subjective burden after placement. Roughly the same percentage of wife and daughter caregivers were bereaved during the study period, and for wives bereavement was accompanied by an increase in social involvement and personal growth. The results underscore the highly dynamic nature of the caregiving career and the importance of the kinship relationship between caregiver and care recipient in conditioning the effects of caregiving transitions.
Article
The major goal of this article was to review and synthesize the empirical research on caregiver gender and psychiatric morbidity, with the aim of answering three questions: (a) Is there greater psychiatric morbidity among female than male caregivers, (b) is the excess psychiatric morbidity among female caregivers attributable to caregiving, and (c) what factors in the caregiving situation contribute to the excess psychiatric morbidity among female caregivers? In almost all studies reviewed, women caregivers reported more psychiatric symptoms than men caregivers. Comparisons with noncaregiving community samples suggest that female caregivers experience excess psychiatric morbidity attributable to caregiving. Using a stress process model as an organizing framework, the study demonstrated that at all stages of the stress process, women are at greater risk for psychiatric morbidity than men. Directions for future research and implications for interventions and public policy are discussed.
Profiles in caregiving: The unexpected career Symptoms of psychological distress among caregivers of dementia patients
  • C S Aneshensel
  • L I Pearlin
  • J T Mullan
  • S H Zarit
  • C J Whitlatch
  • C R Anthony-Bergstone
  • S H Zarit
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