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Caregiving arrangements of older disabled women, caregiving preferences, and views on adequacy of care

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Abstract

The role of women in caregiving to elderly people has focused primarily on their involvement as givers of care. In contrast, this article focuses on older women as recipients of caregiving. Data from the WHAS and the WHAS Caregiving Study are used to describe: the relationship of caregiving arrangements among moderately to severely disabled older women to sociodemographic, health and functional status; the characteristics of primary family caregivers and the assistance they provide; preferences for caregiving arrangements among both care recipients and caregivers; and views on adequacy of caregiving among older women cared for by family. Overall, about one quarter of these women had no caregiver, reflecting the inclusion in the WHAS of women with only moderate functional difficulty, but close to two-thirds relied on family members, and 15% on paid help only. Greater reliance on family was associated with being age 80 or older, black, and living with others. Women with poorer functioning — more ADL and IADL difficulties, difficulty taking medications without help, low cognitive functioning, not emotionally vital — also were significantly more likely to be cared for by family. Caregiving preferences varied among older women and their husband and daughter caregivers. Husbands consistently viewed in-home family help as the best caregiving arrangement regardless of levels of need. Older women and daughter caregivers both saw nursing homes as the best option for people with dementia and substantial care needs. One-quarter of elderly women chose in-home paid help as the best arrangement for meeting ADL/IADL needs. Older women generally held positive views of the assistance they received from family members. Younger women and lower income women were more likely to indicate they received less help than needed.

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References

  1. Stone R., Cafferata G.L., Sangl J.: Caregivers of the frail elderly: A national profile. Gerontologist 27: 616–626, 1987.

    Article  CAS  PubMed  Google Scholar 

  2. Shanas E.: The family as a social support system in old age. Gerontologist 19: 169–174, 1979.

    Article  CAS  PubMed  Google Scholar 

  3. Stoller E.P., Earl L.L.: Help with activities of everyday life: Sources of support of the noninstitutionalized elderly. Gerontologist 23: 64–70, 1983.

    Article  CAS  PubMed  Google Scholar 

  4. Himes C.L.: Future caregivers: Projected family structures of older persons. J. Gerontol. 47: S17–S26, 1992.

    Article  CAS  PubMed  Google Scholar 

  5. Stone R.I., Short P.F.: The competing demands of employment and informal caregiving to disabled elders. Med. Care 28: 513–526, 1990.

    Article  CAS  PubMed  Google Scholar 

  6. Leon J., Lair T.: Functional status of the noninstitutionalized elderly: Estimates of ADL and IADL difficulties. DHHS Pub. No. 90-3462, National Medical Expenditure Survey Research Findings 4, Agency for Health Care Policy and Research, Rockville, Maryland, 1990.

    Google Scholar 

  7. Wright L.K., Clipp E.C., George L.K.: Health consequences of caregiver stress. Medicine, Exercise, Nutrition, and Health 2: 181–195, 1993.

    Google Scholar 

  8. Schulz R., Visintainer P., Williamson G.M.: Psychiatric and physical morbidity effects of caregiving. J. Gerontol. 45: P181–P191, 1990.

    Article  CAS  PubMed  Google Scholar 

  9. Newsom J.T., Schulz R.: Caregiving from the recipient’s perspective: negative reactions to being helped. Health Psychol. 17: 172–181, 1998.

    Article  CAS  PubMed  Google Scholar 

  10. Folstein M.F., Folstein S.E., McHugh P.R.: Mini-Mental State Examination: A practical method for grading the cognitive state of patients for the clinician. J. Psychiatr. Res. 12: 189–198, 1975.

    Article  CAS  PubMed  Google Scholar 

  11. Ory M.G., Hoffman R.R., Yee J.L., Tennstedt S., Schulz R.: Prevalence and impact of caregiving: a detailed comparison between dementia and nondementia caregivers. Gerontologist 39: 177–185, 1999.

    Article  CAS  PubMed  Google Scholar 

  12. Guralnik J.M., Fried L.P., Simonsick E.M., Kasper J.D., Lafferty M.E. (Eds): The Women’s Health and Aging Study: Health and social characteristics of older women with disability. National Institute on Aging, Bethesda, Maryland, NIH Pub. No. 95-4009, 1995.

    Google Scholar 

  13. Kasper J.D., Shapiro S., Guralnik J.M., Bandeen-Roche K., Fried L.P.: Designing a community study of moderately to severely disabled older women: The Women’s Health and Aging Study. Ann. Epidemiol. 9: 498–507, 1999.

    Article  CAS  PubMed  Google Scholar 

  14. Penninx B.W.J.H., Guralnik J.M., Simonsick E.M., Kasper J.D., Ferrucci L., Fried L.P.: Emotional vitality among disabled older women: The Women’s Health and Aging Study. J. Am. Geriatr. Soc. 46: 807–815, 1998.

    CAS  PubMed  Google Scholar 

  15. Simonsick E.M., Maffeo C.E., Rogers S.K., Skinner E.A., Davis D., Guralnik J.M., Fried L.P.: Methodology and feasibility of a home-based examination in disabled older women: The Women’s Health and Aging Study. J. Gerontol. 52: M264–M274, 1997.

    Article  CAS  Google Scholar 

  16. Shah B.V., Barnwell B.G., Bieler G.S.: SUDAAN User’s Manual: Software for Analysis of Correlated Data. Research Triangle Institute, Research Triangle Park, NC, 1995.

    Google Scholar 

  17. Murtaugh C.C., Kemper P., Spillman B.C.: Risk of nursing home use in later life. Med. Care 28: 951–962, 1990.

    Article  Google Scholar 

  18. Kemper P.: The use of formal and informal home care by the disabled elderly. Health Serv. Res. 27: 421–451, 1992.

    CAS  PubMed  Google Scholar 

  19. Mui A.C., Burnette D.: Long-term service use by frail elders: Is ethnicity a factor? Gerontologist 34: 190–198, 1994.

    Article  CAS  PubMed  Google Scholar 

  20. Miller B., Campbell R.T., Davis L., Furner S., Giachello A., Prohaska T., Kaufman J.E., Li M., Perez C.: Minority use of community long-term care services: A comparative analysis. J. Gerontol. 51B: S70–S81, 1996.

    Article  Google Scholar 

  21. Cagney K.A., Agree E.M.: Racial differences in skilled nursing care and home health use; The mediating effects of family structure and social class. J. Gerontol. 54B: S223–S236, 1999.

    Article  Google Scholar 

  22. U.S. Census Bureau: Poverty in the United States: 1997. Current Population Reports, Series P60–201. U.S. Government Printing Office, Washington DC, 1998.

  23. Chulis G.S., Eppig F.J., Hogan M.O., Waldo D.R., Arnett R.H.: Health insurance and the elderly: Data from the MCBS. Health Care Financing Review 14: 163–181, 1993.

    CAS  PubMed  Google Scholar 

  24. Pahor M., Salive M.E., Brown S.L.: Medication Use. In: Guralnik J.M., Fried L.P., Simonsick E.M., Kasper J.D., Lafferty M.E., (Eds.), The Women’s Health and Aging Study: Health and social characteristics of older women with disability. National Institute on Aging, Bethesda, Maryland, NIH Pub. No. 95-4009, 1995.

    Google Scholar 

  25. Cafferata G.L., Stone R.: Community caregivers’ attitudes toward nursing homes. J. Long Term Care Adm. 19: 33-35, 1991–92.

    PubMed  Google Scholar 

  26. Sundstrom G.: Care by families: an overview of trends. In: Caring for frail elderly people. Social Policy Studies No. 14, OECD, Paris, 1993.

    Google Scholar 

  27. Doty P.: Family care of the elderly: The role of public policy. Milbank Q. 64: 34–75, 1986.

    Article  CAS  PubMed  Google Scholar 

  28. Lee Y., Kasper J.D.: Age differences in ratings of medical care among older adults living in the community. Aging Clin. Exp. Res. 11: 12–20, 1999.

    CAS  Google Scholar 

  29. Katz-Olson L.: Public policy and privatization: long-term care in the United States. In: Katz-Olson L. (Ed.), The Graying of the World: Who will care for the frail elderly? The Haworth Press, NY, pp. 25–58, 1994.

    Google Scholar 

  30. Davey A., Femia E.E., Shea D.G., Zarit S.H., Sundstrom G., Berg S., Smyer M.A.: How many elders receive assistance? A cross-national comparison. J. Aging and Health 11: 199–220, 1999.

    Article  CAS  Google Scholar 

  31. Worobey J.L., Angel R.J.: Functional capacity and living arrangements of unmarried elderly persons. J. Gerontol. 45: S95–S101, 1990.

    Article  CAS  PubMed  Google Scholar 

  32. Habib J., Sundstrom G., Windmiller K.: Understanding the pattern of support for the elderly: a comparison between Israel and Sweden. J. of Aging and Social Policy 5:187–206, 1993.

    Article  CAS  Google Scholar 

  33. Short P., Leon J.: Use of home and community services by persons ages 65 and older with functional difficulties. DHHS Pub. No. 90-3455. National Medical Expenditure Survey Research Findings 5, Agency for Health Care Policy and Research, Rockville, Maryland, 1990.

    Google Scholar 

  34. Neuschler E.: Medicaid eligibility for frail elders. In: Rowland D., Lyons B. (Eds.), Financing home care: Improving protection for disabled elderly people. The Johns Hopkins University Press, Baltimore, Maryland.

  35. Coleman B.: European models of long-term care in the home and community. American Association of Retired Persons, Washington, D.C., 1994.

    Google Scholar 

  36. Hoek J.F., Penninx B.W.J.H., Ligthart G.J., Ribbe M.W.: Health care for older persons. A country profile: The Netherlands. J. Am. Geriatr. Soc. 48: 214–217, 2000.

    CAS  PubMed  Google Scholar 

  37. Freedman V.A.: Family structure and the risk of nursing home admission. J. Gerontol. 51B: S61–S69, 1996.

    Article  Google Scholar 

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Authors and Affiliations

  1. Department of Health Policy and Management, The Johns Hopkins University School of Hygiene and Public Health, 624 N. Broadway, Room 652, Baltimore, MD, 21205-1901, USA

    J. D. Kasper M.D. & A. Shore

  2. Institute for Research in Extramural Medicine, Vrije University, Amsterdam, The Netherlands

    B. W. J. H. Penninx

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  1. J. D. Kasper M.D.
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  2. A. Shore
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  3. B. W. J. H. Penninx
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Correspondence to J. D. Kasper M.D..

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Kasper, J.D., Shore, A. & Penninx, B.W.J.H. Caregiving arrangements of older disabled women, caregiving preferences, and views on adequacy of care. Aging Clin Exp Res 12, 141–153 (2000). https://doi.org/10.1007/BF03339900

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