Work as Overload or Enhancement for Family Caregivers of Older Adults: Assessment of Experienced Well-Being Over the Day

Objective

This study examines work and care patterns and their association with experienced well-being over the course of the day and tests a moderating effect of gender.

Background

Many family and unpaid caregivers to older adults face dual responsibilities of work and caregiving. Yet little is known about how working caregivers sequence responsibilities through the day and their implications for well-being.

Method

Sequence and cluster analysis is applied to nationally representative time diary data from working caregivers to older adults in the U.S. collected by the National Study of Caregiving (NSOC) (N=1,005). OLS regression is used to test the association with well-being and a moderating effect of gender.

Results

Among working caregivers, five clusters emerged, referred to as: Day Off, Care Between Late Shifts, Balancing Act, Care After Work, and Care After Overwork. Among working caregivers, experienced well-being was significantly lower among those in the Care Between Late Shifts and Care After Work clusters relative to those in the Day Off cluster. Gender did not moderate these findings.

Conclusion

The well-being of caregivers who split time between a limited number of hours of work and care is comparable to those who take a day off. However, among working caregivers balancing full-time work - whether day or night - with care presents a strain for both men and women.

Implications

Policies that target full-time workers who are balancing care for an older adult may help increase well-being.

Something's Gotta Give: The Relationship Between Time in Eldercare, Time in Childcare, and Employee Wellbeing

While existing research indicates that “sandwiched” employees (those with both childcare and eldercare demands) have lower wellbeing than employees with only eldercare demands, there is little understanding how childcare and eldercare demands interact to create those differences. Drawing on two studies, we hypothesize childcare demands amplify the negative impact of eldercare demands on wellbeing. Study 1 operationalizes childcare as a dichotomous variable (i.e., has childcare or not), and examines the relationship between hours per week in eldercare and wellbeing for two groups of employees: those with eldercare and those in the sandwich generation. Study 2, which operationalizes childcare as a continuous variable (i.e., hours in childcare per week), explores how time in childcare moderates the relationship between time in eldercare and wellbeing. Findings show time in eldercare is negatively associated with wellbeing, and the impact of childcare on the relationship between time in eldercare and wellbeing is dependent on how one operationalizes wellbeing and childcare constructs.

Partner care arrangements and well-being in mid- and later life: The role of gender across care contexts

Objectives

We assess gender moderation in the association between partner care arrangements and individuals’ well-being, and the extent to which gender differences vary across European care contexts.

Methods

We use 2015 data from the Survey of Health, Ageing and Retirement in Europe for 3,465 couples aged 50+, where at least 1 partner receives care. We assess gender differences in individuals’ life satisfaction and depressive symptoms across 5 partner care arrangements: solo-; shared formal; shared informal; outsourced formal; and outsourced informal care. We explore heterogeneity in the gendered associations across 4 care contexts: Northern, Western, Southern, and Eastern Europe.

Results

Sharing care with formal providers is associated with lower well-being among women than men, with a significant well-being “penalty” among Southern European women with partners in shared formal care. Outsourcing partner care to informal providers is associated with higher well-being than other care arrangements for men across care contexts, but with lower well-being for women in Southern Europe.

Discussion

Policies to support caregivers’ well-being need to be sensitive to the coordination of formal and informal caregiving support for men and women in their respective care contexts.

Co-Resident Grandparent: A Burden or a Relief? A Comparison of Gender Roles between Italians and Migrants

In the international literature, the principal task of grandparents is generally recognized as helping their children in providing childcare. Most of those studies analyzed grandparental childcare on the whole population, and few have focused on co-resident grandparent(s), which turns out to be an understudied topic in the European context. Further, most of them investigated the effect of childcare on grandparents’ health status. However, the elderly population can both provide and receive care. Using two Italian surveys released by the Italian National Institute of Statistics, the “Social Condition and Integration of Foreign Citizen (2011–2012)” and the “Multiscopo–Aspetti della vita quotidiana (2011)”, the study aims to analyze differences in grandparental childcare provided by co-resident grandparents between Italian and migrant households, considering both the role played by grandparents’ self-rated health (SRH) and gender. We identify four grandparents’ profiles by combining grandparents’ SRH and their attitude towards looking after their grandchild(ren). Subsequently, we apply multinomial logistic regressions, and we compute average marginal effects to facilitate results interpretations. Results display that migrant co-resident grandparents are less likely to declare bad SRH and no-childcare and are more likely to declare good SRH and to provide childcare than Italian grandparents. Moreover, when considering gender differences, the real role is revealed: we find that women have a higher probability to report poor health and care for their grandchild(ren) than men. Such findings illustrate that grandparents’ cohabitation decision is based upon the difference between their need for care and offer to care, and second, in addition to migrant status and SRH, gender is a determinant of grandparents’ childcare: women look after their grandchild(ren) more than men, whatever their health status.

Migrant Caregivers of Older People in Spain: Qualitative Insights into Relatives' Experiences

The traditional structure of families is undergoing profound changes, causing the so-called “crisis of family care.” This study describes the experiences and emotions of the family member who hires migrant caregivers for the older people. This is a qualitative study using a phenomenological design with nine women participants between 53 and 72 years of age. The data collection was carried out through two in-depth interviews and a focus group. There were three major topics: (1) the women in this study recognized that they were not able to take care of the family member directly, due to their responsibilities as female workers and mothers. The fact that migrant caregivers were chosen was conjunctural, where economic reasons were more important. (2) The family members supported the caregivers by teaching them about care and also resolving conflicts produced by culture shock. (3) Trusting the caregiver was a gradual process; the family members felt a complex set of emotions (insecurity, gratitude for the help, moral obligation). In conclusion, they wanted a caregiver who would provide the elder dependent with the love and compassion that they, as daughters, would provide if they had time to do so. The family became the caregiver’s managers and assumed the responsibility of training and helping them.

The pains and reliefs of the transitions into and out of spousal caregiving. A cross-national comparison of the health consequences of caregiving by gender

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.

Long-term Care Provision and the Well-Being of Spousal Caregivers: An Analysis of 138 European Regions

Objectives

The individual burden of caring for one’s relatives not only depends on care characteristics but is also related to contextual factors. The objective of this study is to determine whether regional formal long-term care provision is linked to the well-being of spousal caregivers introducing the concept of “control” as central pathway to explain this link.

Method

We applied multilevel analysis using data from the Survey of Health, Ageing and Retirement in Europe (SHARE) from over 29,000 Europeans and 1,800 spousal caregivers located in 138 regions in 11 countries to analyze the effects of regional contexts on caregiver well-being. The provision of formal care in a region was measured by the number of long-term care beds in nursing and residential homes among the older population.

Results

We found that spousal caregivers’ well-being, measured in terms of life satisfaction, loneliness, and depression, was positively linked to the regional availability of formal care, which is partly due to higher perceived control in regions with more formal care provision.

Discussion

Our results suggest that formal care supply is essential not only for care recipients but also for caregivers: perceived alternatives to the private care arrangement go along with greater well-being of informal caregivers.

Is caregiving by baby boomer women related to the presence of depressive symptoms? Evidence from eight national surveys

BACKGROUND

A common hypothesis is that caregiving is deleterious to women's mental health. International studies continue to emphasize the importance of mental health issues for women. Yet only a few researchers have used population-based surveys to explore the association between caregiving and depressive symptomatology in the context of the community, and even less is known about this aspect of Baby Boomer women in a global context.

METHODS

The present study uses eight international surveys covering nineteen nations (N = 15,100) and uses multilevel logistic models to examine possible linkages between caregiving and the likelihood of depressive symptoms among Baby Boomer women, when taking individual-level and country-level social factors into consideration.

RESULTS

The various analyses found a significant variation in the likelihood of depressive symptoms among these Boomer women across the nations investigated and across both individual-level and country-level characteristics. The significant association of caregiving by women and the likelihood of depressive symptoms is related to their social status in some nations (OR = 1.30; p < 0.001). Boomer women living in countries with high rates of female participation in managerial/professional work (OR = 1.04; p < 0.05) and living in countries where women are often in vulnerable employment (OR = 1.01; p < 0.05) are at greater risk of depressive symptomatology.

CONCLUSIONS

These findings demonstrate that the depressive consequences of caregiving by women are, to some degree, contingent upon social context and structure. Policies aimed at promoting mental health among female Baby Boomers should therefore be context specific.

To manage a complex dependency: The experience of caregiving after a fall

AIM

To understand the experience of family members of an older relative who has had a fall which required medical attention.

BACKGROUND

There is abundant bibliography in caregiving, but little is known about the problems faced by caregivers and how family members cope when their older relative has a fall.

DESIGN

Qualitative study that used a symbolic interactionism perspective.

METHODS

Twenty-two people with older relatives, who had had a fall and contacted health services in Spain, participated in the study. Data were obtained via written accounts, focus groups, and semi-structured interviews between February 2014 - December 2015. Analysis was guided by grounded theory procedures.

RESULTS

With the fall, dependency becomes a complex issue for the family. To manage a complex dependency is the core issue that emerges from the data analysis. It depicts family efforts to assist their relative in gaining autonomy after a fall, in the best conditions they can provide. They do this with little guidance and support from healthcare professionals.

CONCLUSIONS

Guides and protocols for the care of a fragile older person, particularly after a fall, should not only include care but also support to caregivers. Health professionals and especially nurses need to be aware and respond to the family caregivers needs after a fall. To the fall prevention initiatives already in place, it must be added that those who support family members to cope with the care of an older person who has had a fall.