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Effects of Transitions to Family Caregiving on Well‐Being: A Longitudinal Population‐Based Study
Author(s) -
Haley William E.,
Roth David L.,
Sheehan Orla C.,
Rhodes J. David,
Huang Jin,
Blinka Marcela D.,
Howard Virginia J.
Publication year - 2020
Publication title -
journal of the american geriatrics society
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.992
H-Index - 232
eISSN - 1532-5415
pISSN - 0002-8614
DOI - 10.1111/jgs.16778
Subject(s) - medicine , epidemiology , depression (economics) , marital status , gerontology , population , mental health , center for epidemiologic studies depression scale , quality of life (healthcare) , stroke (engine) , longitudinal study , family caregivers , demography , depressive symptoms , psychiatry , cognition , mechanical engineering , nursing , environmental health , pathology , sociology , engineering , economics , macroeconomics
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.