Informal Caregiving and Self-Reported Mental and Physical Health: Results From the Gazel Cohort Study (original) (raw)
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The Gerontologist, 2015
Considerable research and public discourse on family caregiving portrays it as a stressful and burdensome experience with serious negative health consequences. A landmark study by Schulz and Beach that reported higher mortality rates for strained spouse caregivers has been widely cited as evidence for the physical health risks of caregiving and is often a centerpiece of advocacy for improved caregiver services. However, 5 subsequent population-based studies have found reduced mortality and extended longevity for caregivers as a whole compared with noncaregiving controls. Most caregivers also report benefits from caregiving, and many report little or no caregiving-related strain. Policy reports, media portrayals, and many research reports commonly present an overly dire picture of the health risks associated with caregiving and largely ignore alternative positive findings. As the pool of traditional family caregivers declines in the coming years, a more balanced and updated portrayal...
The Journals of Gerontology Series A: Biological Sciences and Medical Sciences, 2009
This study aims to investigate the impact of caregiving on the health status and quality of life (QOL) of primary informal caregivers (PCGs) of elderly care recipients in Hong Kong. A total of 246 PCGs and 492 matched noncaregiver (NCG) controls were identifi ed in a population-based cross-sectional study through random telephone dialing. Their health status and QOL were assessed based on structured questionnaires and Short Form 36 (SF-36) Health Survey. Multiple conditional logistic regression analysis showed that compared with NCGs, PCGs had signifi cantly increased risks for reporting worse health, more doctor visits, anxiety and depression, and weight loss. Female PCGs were more likely to report chronic diseases, symptoms, and insomnia. PCGs, particularly women, had signifi cantly lower scores in all eight domains of SF-36 Health Survey. High caregiver burden score (Zarit Burden Scale) was positively associated with adverse physical and psychological health and poorer QOL. The results indicate that PCGs, particularly women, had an adverse physical and psychological health profi le and poorer QOL compared with NCGs.
PSYCHOLOGICAL SCIENCE Research Article Caregiving Behavior Is Associated With Decreased Mortality
2011
ABSTRACT—Traditional investigations of caregiving link it to increased caregiver morbidity and mortality, but do not disentangle the effects of providing care from those of being continuously exposed to an ailing loved one with serious health problems. We explored this possible confound in a national, longitudinal survey of elderly married individuals (N 5 3,376). Results showed that spending at least 14 hr per week providing care to a spouse predicted decreased mortality for the caregiver, independently of behavioral and cognitive limitations of the care recipient (spouse), and of other demographic and health variables. These findings suggest that it may be premature to conclude that health risks for caregivers are due to providing active help. Indeed, under some circumstances, caregivers may actually benefit from providing care. Approximately 21 % of the U.S. adult population provides unpaid care to an adult over age 18 (Pandya, 2005, par. 2). There is a growing consensus that car...
Differences between caregivers and non-caregivers in psychological health and physical health: a met
2003
Providing care for a frail older adult has been described as a stressful experience that may erode psychological well-being and physical health of caregivers. In this meta-analysis, the authors integrated findings from 84 articles on differences between caregivers and noncaregivers in perceived stress, depression, general subjective well-being, physical health, and self-efficacy. The largest differences were found with regard to depression (g ϭ .58), stress (g ϭ .55), self-efficacy (g ϭ .54), and general subjective well-being (g ϭ Ϫ.40). Differences in the levels of physical health in favor of noncaregivers were statistically significant, but small (g ϭ .18). However, larger differences were found between dementia caregivers and noncaregivers than between heterogeneous samples of caregivers and noncaregivers. Differences were also influenced by the quality of the study, relationship of caregiver to the care recipient, gender, and mean age of caregivers.
Correlates of Physical Health of Informal Caregivers: A Meta-Analysis
The Journals of Gerontology Series B: Psychological Sciences and Social Sciences, 2007
Effects of caregiving on physical health have received less theoretical and empirical attention than effects on psychological health. This meta-analysis integrates results from 176 studies on correlates of caregiver physical health. Caregiver depressive symptoms had stronger associations with physical health than did objective stressors. Higher levels of care recipient behavior problems were more consistently related to poor caregiver health than were care receiver impairment and intensity of caregiving. Higher age, lower socioeconomic status, and lower levels of informal support were related to poorer health. Predictors of physical health are not identical to predictors of psychological health. Associations of caregiving stressors with health were stronger among older samples, dementia caregivers, and men. In sum, negative effects of caregiving on physical health are most likely to be found in psychologically distressed caregivers facing dementia-related stressors.
Caregiving across the lifespan: comparing caregiver burden, mental health, and quality of life
Psychogeriatrics, 2014
Background: Care can be considered a lifelong process, but caring for a child is different from caring for an older adult. The present study aims to compare the caregiving process from infancy through old age by evaluating differences in caregiver burden, mental health, and quality of life and to describe the factors that could impact these outcomes. Methods: To compare different groups of caregivers, we included 300 caregivers recruited from admissions to a tertiary acute hospital: 100 caregivers of children, 100 caregivers of adults, and 100 caregivers of older adults. A self-administered questionnaire was used that covered the following: sociodemographics, depression (Beck Depression Inventory), anxiety (Beck Anxiety Inventory), quality of life (Short Form Health Survey (SF-36)), religiosity (Duke Religion Index) and caregiver burden (Zarit Caregiver Burden Interview). Results: A comparison between groups was performed (through χ 2 and ANOVA), and a linear regression analysis was used to assess the related factors. We found that children's caregivers had more depressive symptoms (higher Beck Depression Inventory scores), better physical health (SF-36: physical functioning and SF-36: Physical Component Summary), and lower pain (SF-36: bodily pain) than other caregivers. We found that caregivers of adults had better mental health (SF-36: mental health and SF-36: Mental Component Summary) than other caregivers and that caregivers of older adult had a higher caregiver burden (Zarit Caregiver Burden Interview scores) than other caregivers. After we controlled for baseline characteristics, only depressive symptoms and caregiver burden remained statistically significant. Conclusion: In conclusion, there are important differences between caregiving across the lifespan. Caregiving for children was associated with more depressive symptoms, and caregiving for older adults was associated with higher caregiver burden. Further studies are needed to replicate these findings in other settings.
The Long-Term Effects of Caregiving on Women's Health and Mortality
Journal of Marriage and Family, 2016
Caregivers experience numerous mental and physical health effects from the stress of providing care, but we know little about whether these problems persist in the long term and whether longterm effects differ across caregiving contexts. Using the National Longitudinal Survey of Mature Women, we examine the relationship between caregiving and long-term patterns of depressive symptoms, functional limitations, and mortality. We also explore the health effects of caregiving in-home versus out-of-home and by caregiver/care-recipient relationship. Analyses show that inhome spousal and parental caregiving predict increased depressive symptoms and functional limitations in the long term but are unassociated with mortality, while caregiving out-of-home is unassociated with later depression and functional limitations but predicts lower risk of mortality. This study highlights the usefulness of approaching stressful experiences like caregiving from the life course perspective, viewing them as processes that unfold over time within specific contexts and may carry delayed or cumulative consequences. Keywords Aging; caregiving; depression; health The U.S. health care system relies heavily on unpaid care to meet the health needs of the ill and disabled. In 2009, the value of that care was estimated at 450billion,avaluefargreaterthanthe450 billion, a value far greater than the 450billion,avaluefargreaterthanthe361 billion spent on Medicare that year (Feinberg & Choula, 2012). Most adults provide care at some point in their lives and many do so multiple times, but women are especially likely to provide unpaid care. National estimates are that about 60 percent of unpaid caregivers are women (NAC, 2015). Women are more likely to help with personal care, devote more hours of care each week, spend more years providing care, and perform more care tasks than men (Pinquart & Sorensen, 2006). As the population ages, life
Differential Changes in Health Measures by Caregiving Status: Hierarchical Models
Work, Aging and Retirement, 2017
The purpose of this study is to compare the health trajectories/trends of caregivers and non-caregivers before and after the caregivers begin to provide informal services. In this case we focus on caregiving services provided to parents/parents-in-law. The study uses a sample of N = 19,943 observations (drawn from 1,813 unique individuals) observed over 11 waves of the Health and Retirement Study. Using Hierarchical Linear Model (HLM) Methods, the trajectories of health outcomes for caregivers are compared to those of non-caregivers. We examined trajectories related to general health, measures of mobility, motor skills, cognition and measures of depression. We control for education, wealth, occupation, gender, marital status, and race. For caregivers, there is a 0.027 (0.014 per year) increase in the mobility difficulty index and a 0.020 (0.010 per year) increase in large muscle movement difficulty index for every year after the commencement of caregiving, compared to non-caregivers. There is also a significant 0.7 percentage point increase in the probability of reporting a stroke and a 0.118 (0.059 per year) drop in the cognition summary score for each additional year after the start of caregiving. These findings provide evidence of the adverse health effects of caregiving on its providers, particularly with regard to the physical and mental well-being of caregivers.