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Providing informal care next to paid work: explaining care-giving gratification, burden and stress among older workers
- Authors:
- GRUNWALD Olga, DAMMAN Marleen, HENKENS Kene
- Journal article citation:
- Ageing and Society, 41(10), 2021, pp.2280-2298.
- Publisher:
- Cambridge University Press
With an increasing retirement age, more older adults are combining employment with informal care-giving responsibilities. However, little is known about how older workers experience care-giving activities next to their paid jobs. This study aims to fill this gap by examining how the work situation (i.e. working hours, occupational status and perceived access to human resources practices) is associated with feelings of gratification, burden and stress in care-giving. Using data from the NIDI Pension Panel Survey, we study care-giving experiences – in other words, the extent to which care-giving activities are gratifying, burdensome or stressful – of 1,651 Dutch older workers (age 60–65) who provide care at least once per week. Multivariate analyses reveal that the work situation plays an explanatory role next to socio-demographic factors and indicators of the care-giving situation. Working care-givers who feel they have access to phased retirement and organisational health support experience care-giving as relatively less burdensome and stressful. Moreover, those with access to phased retirement experience relatively higher levels of gratification in care-giving. Our findings suggest that the availability of organisational support relates to lower levels of care-giving burden and stress, and to some extent to higher levels of gratification. Organisations thus play an important role in facilitating the combination of work and care-giving obligations in a context of longer working lives. (Edited publisher abstract)
Older adults’ experience of the COVID-19 pandemic: a mixed-methods analysis of stresses and joys
- Authors:
- WHITEHEAD Brenda R., TOROSSIAN Emily
- Journal article citation:
- Gerontologist, 61(1), 2021, pp.36-27.
- Publisher:
- Oxford University Press
Background and Objectives: The coronavirus disease 2019 (COVID-19) pandemic is experienced differently across individuals, and older adults’ different life experiences lead to a variety of ways of coping. The present study explores older adults’ reports of what about the pandemic is stressful, and what brings joy and comfort in the midst of stress. Research Design and Methods: An online survey asked 825 U.S. adults aged 60 and older to complete questionnaires assessing 3 psychological well-being indicators: perceived stress, negative affect, and positive affect. Participants also responded to open-ended questions about what was stressful and what brought joy or comfort at the time of the survey. A mixed-method approach first qualitatively analyzed the open-ended responses, content analysis identified themes most frequently reported, and quantitative analysis examined the associations between various stressors and joys and the psychological well-being indicators. Results: Qualitative analysis revealed 20 stress categories and 21 joy/comfort categories. The most commonly reported stressors were confinement/restrictions, concern for others, and isolation/loneliness; the most commonly reported sources of joy/comfort were family/friend relationships, digital social contact, and hobbies. Demographic comparisons revealed variations in experience. Independent t tests revealed stress from concern for others, the unknown future, and contracting the virus to be significantly associated with poorer psychological well-being; faith, exercise/self-care, and nature were associated with more positive psychological well-being. Discussion and Implications: Results are discussed in the context of stress and coping theory, highlighting the importance of understanding the unique stress experience of each individual for effective distress intervention. (Edited publisher abstract)
Age moderates perceived COVID-19 disruption on well-being
- Authors:
- CARNEY Amy Knepple, et al
- Journal article citation:
- Gerontologist, 61(1), 2021, pp.30-35.
- Publisher:
- Oxford University Press
Background and Objectives: It is not fully understood how large-scale events affect well-being. Older adults showed the highest levels of resilience following the September 11th (9/11) terrorist attacks, but during the severe acute respiratory syndrome outbreak, there were no age-related differences in well-being. The current study examined the Coronavirus Disease 2019 (COVID-19) disruption on well-being throughout adulthood. Research Design and Methods: Perceived stress and affect were examined in 166 community-dwelling adults (Mage = 35.65; SD = 15.53; range = 18–79) in relation to the perceived disruption of the COVID-19 pandemic to their lives. Results: A significant moderation was found for age and COVID-19 disruption on perceived stress [F(5, 153) = 8.88, p < .05, R2 = .22] and negative affect [F(5, 154) = 4.91, p < .05, R2 = .14], but not for positive affect. For participants over 50, those who rated COVID-19 as a low or high disruption had similar scores on stress and negative affect, but with younger aged participants, perceiving high disruption corresponded with higher levels of stress and negative affect. Discussion and Implications: Findings are consistent with the strength and vulnerability integration (SAVI) model, wherein older adults try to maintain positive emotional well-being, with middle-aged and older adults in the current study having experienced less negative impact on well-being. Middle-aged and older adults may be better able to regulate negative emotions from COVID-19 than younger adults. SAVI proposes a greater negative impact on older adults when they experience sustained stressors; as the challenges with COVID-19 continue, further data will need to be examined. (Edited publisher abstract)
The burden and benefits of caregiving: a latent class analysis
- Author:
- PRISTAVEC Teja
- Journal article citation:
- Gerontologist, 59(6), 2019, pp.1078-1091.
- Publisher:
- Oxford University Press
Background and Objectives: Informal caregiving to older adults is a key part of the U.S. long-term care system. Caregivers’ experiences consist of burden and benefits, but traditional analytic approaches typically consider dimensions independently, or cannot account for burden and benefit levels and combinations that co-occur. This study explores how benefits and burden simultaneously shape experiences of caregiving to older adults, and factors associated with experience types. Research Design and Methods: 2015 National Health and Aging Trends Study (NHATS) and National Study of Caregiving (NSOC) data were linked to obtain reports from caregivers and recipients. Latent class and regression analysis were conducted on a nationally representative sample of U.S. informal caregivers to older persons. Results: Five distinguishable caregiving experiences types and their population prevalence were identified. Subjective burden and benefits level and combination uniquely characterize each group. Primary stressors (recipient depression, medical diagnoses), primary appraisal (activities of daily living, instrumental activities of daily living, medical task assistance, hours caregiving), and background/contextual factors (caregiver age, race, relationship to recipient, mental health, coresidence, long-term caregiving) are associated with experience types. Discussion and Implications: Findings highlight caregivers’ experience multiplicity and ambivalence, and identify groups that may benefit most from support services. In cases where it is not possible to reduce burden, assistance programs may focus on increasing the benefits perceptions. (Edited publisher abstract)
The emotional landscape of accessing and navigating formal supports for older adults in one Western Canadian city
- Authors:
- FUNK Laura M., HOUNSLOW Wanda
- Journal article citation:
- International Journal of Care and Caring, 3(4), 2019, pp.531-548.
- Publisher:
- Policy Press
Emotions may be pivotal to understanding how fragmented care systems for older adults can generate structural carer burden. Analysing 78 interviews with 32 carers who navigated formal services in a Western Canadian city, the research explores and distinguishes between emotional responses to navigation challenges and the emotion work that navigation entails. Emotional responses had a temporal dimension, and, at times, both positive and negative emotions coexisted simultaneously. Symbolic and normative understandings of interactions with providers, and of ‘caring well’, shaped emotion work throughout navigation. Discussion focuses on how broader contexts, through emotional processes, indirectly contribute to carer stress and strain. (Edited publisher abstract)
Valuing the health of the support worker in the aged care sector
- Authors:
- GEORGE Esther, HALE Leigh, ANGELO Jennifer
- Journal article citation:
- Ageing and Society, 37(5), 2017, pp.1006-1024.
- Publisher:
- Cambridge University Press
This study explored aged care support workers’ perceptions of how their health was influenced by their job, highlighting similarities and differences of those working in community-based and institution-based care. Support workers working in two institution-based and three community-based aged care organisations were invited to participate. Semi-structured interviews were undertaken with ten participants. Open-ended questions probed participants’ perceptions of their health as it related to their work. Data were analysed with the General Inductive Approach. Four central themes were identified, many of which related to mental, as opposed to physical health. ‘Love of the job’ described various sources of satisfaction for participants. These factors commonly overrode the negative aspects. ‘Stress’ encompassed the negative influences on all aspects of health. ‘Support’ described the positive influences on health, which supported participants in their job. ‘Physicality’ described the physical nature of the job and the positive and negative impact this had on participants’ health. Support workers perform numerous tasks, which often impact upon their health. Aspects of the job that may impact the health of the worker are improved communication and support from management, as well as recognition for support workers’ contribution to society. These could be targeted to enhance support worker health. Additional training and reduced time pressure may also represent aspects for improvement, to optimise support workers’ physical health. (Publisher abstract)
Ageism as a risk factor for chronic disease
- Author:
- ALLEN Julie Ober
- Journal article citation:
- Gerontologist, 56(4), 2016, pp.610-614.
- Publisher:
- Oxford University Press
Ageism is one of the most socially condoned and institutionalised forms of prejudice in the United States. Older adults are discriminated against in employment, health care, and other domains. Exposure to unfavourable stereotypes adversely affects the attitudes, cognitions, and behaviour of older adults. Recurrent experiences with negative stereotypes combined with discrimination may make ageism a chronic stressor in the lives of older adults. The way stress influences physical health is gaining increasing support. The weathering hypothesis (Geronimus, A. T. (1992). The weathering hypothesis and the health of African-American women and infants: evidence and speculations. Ethnicity and Disease, 2, 207–221) posits that the cumulative effects of chronic objective and subjective stressors and high-effort coping cause deterioration of the body, premature ageing, and associated health problems such as chronic diseases. Researchers have found empirical support for the weathering hypothesis as well as its theorised contribution to racial and ethnic health disparities. Although ageism is not experienced over the entire life course, as racism typically is, repeated exposure to chronic stressors associated with age stereotypes and discrimination may increase the risk of chronic disease, mortality, and other adverse health outcomes. I conclude with implications for practice in the helping professions and recommendations for future research. Ageism warrants greater recognition, social condemnation, and scientific study as a possible social determinant of chronic disease. (Edited publisher abstract)
Live-in versus live-out home care in Israel: satisfaction with services and caregivers’ outcomes
- Authors:
- AYALON Liat, GREEN Ohad
- Journal article citation:
- Gerontologist, 55(4), 2015, pp.628-642.
- Publisher:
- Oxford University Press
Purpose: This study provides a preliminary examination of the relationship between the type of home care services (live-in vs. live-out; i.e., round the clock vs. several hours per week), the caregiver’s satisfaction with services, and the caregiver’s burden, distress, well-being, and subjective health status within a conceptual framework of caregiving outcomes. Design and Methods: A random stratified sample of family caregivers of older adults more than the age of 70 who receive live-in (442) or live-out (244) home care services through the financial assistance of the National Insurance institute of Israel was selected. A path analysis was conducted. Results: Satisfaction with services was higher among caregivers under the live-in home care arrangement and positively related to well-being. Among caregivers, live-in home care was directly associated with higher levels of subjective health and indirectly associated with better well-being via satisfaction with services. Implications: The study emphasises the potential benefits of live-in home care services for caregivers of older adults who suffer from high levels of impairment and the importance of assessing satisfaction with services as a predictor of caregivers’ outcomes. (Edited publisher abstract)
The effects of caregiver emotional stress on the depressive symptomatology of the care recipient
- Authors:
- EJEM Deborah B., DENTATO Michael P., CLAY Olivio J.
- Journal article citation:
- Aging and Mental Health, 19(1), 2014, pp.55-62.
- Publisher:
- Taylor and Francis
Objectives: Previous research widely neglects caregiver emotional stress as a probable contributing factor of depression in older people. Using the life stress paradigm as the theoretical foundation, this study investigates caregiver emotional stress as a chronic life stressor of an elderly care recipient. Methods: The relationships between caregiver emotional stress and care receiver depressive symptoms, as well as other social and psychological mediation factors, were investigated using the 2004 wave of the National Long-Term Care Study (NLTCS). The NLTCS is a nationally representative longitudinal study used to identify frail and disabled elderly Medicare recipients living in the United States. The analytic sample of this study included 1340 caregiver–care receiver dyads who were asked a series of questions concerning their mental health (i.e. emotional stress and depressive symptoms), as well as the availability of social and psychological resources. Results: Overall, the results showed that high levels of emotional stress reported by the caregiver were associated with a higher likelihood of the disabled care receiver reporting depressive symptoms. Conclusion: The findings of this investigation point to the importance of studying caregivers and care receivers as dyads as the stress associated with the caregiving role affects each member. (Edited publisher abstract)
The transition to living alone and psychological distress in later life
- Authors:
- STONE Juliet, EVANDROU Maria, FALKINGHAM Jane
- Journal article citation:
- Age and Ageing, 42(3), 2013, pp.366-372.
- Publisher:
- Oxford University Press
Background: Living alone in later life has been linked to psychological distress but less is known about the role of the transition into living alone and the role of social and material resources. Methods: A total of 21,535 person-years of data from 4,587 participants of the British Household Panel Survey aged 65+ are analysed. Participants provide a maximum 6 years' data (t0−t5), with trajectories of living arrangements classified as: consistently partnered/ with children/alone; transition from partnered to alone/with children to alone. General Health Questionnaire (GHQ)-12 caseness (score >3) is investigated using multi-level logistic regression, controlling for sex, age, activities of daily living, social and material resources. Results: After a transition from partnered at t0 to alone at t1, the odds for GHQ-12 caseness increased substantially, but by t3 returned to baseline levels. The odds for caseness at t0 were highest for those changing from living with a child at t0 to living alone at t1 but declined following the transition to living alone. None of the covariates explained these associations. Living consistently alone did confer increased odds for caseness. Conclusions: Living alone in later life is not in itself a strong risk factor for psychological distress. The effects of transitions to living alone are dependent on the preceding living arrangement and are independent of social and material resources. This advocates a longitudinal approach, allowing identification of respondents' location along trajectories of living arrangements. (Publisher abstract)