SHAPE OF CARE: PATTERNS OF FAMILY CAREGIVING ACTIVITIES AMONG OLDER ADULTS FROM MIDLIFE TO LATER AGES IN CHINA AND THE U.S.

This dissertation consists of three papers that investigate the long-term family caregiving patterns
among Chinese and American older adults. Family caregiving has long been an essential fabric
of long-term care services. Due to the prolonged life expectancy and the declined family size,
older adults today are more likely to care for multiple family members for longer years than the
previous cohorts. However, studies on caregiving predominately focus on singular care
experiences over a short period time. As older adults transition into and out of multiple care
roles, the overall caregiving patterns are overlooked. Leveraging two rich longitudinal datasets
(the China Health and Retirement Study and the Health and Retirement Study), this dissertation
aims to fill this current research gap by developing long-term family caregiving typologies. The
first paper develops a care typology for Chinese older adults, and thoroughly assesses how
gender, hukou status, living arrangement, and significant life transitions are associated with the
long-term caregiving patterns. In the second paper, using linear mixed-effects models, I continue
exploring the positive and negative health consequences of each caregiving pattern among
Chinese older adults. The third paper focuses on developing a long-term family caregiving
pattern for American older adults. In addition to prolonged life expectancies and the decline in
family size, the U.S. has experienced complex transitions in family structures over the past few
decades, leading to more diverse family networks and international relations in later life. After
establishing the long-term care typology, the third paper pays closer attention to the variations of
family caregiving patterns across the War Babies cohort, Early Baby Boomer, and the
Middle/Late Baby Boomer cohort. Moreover, I explore how gender, race, and socioeconomic
status are linked with these patterns. In the context of global aging, this dissertation highlights
the heterogeneity in the family caregiving experiences and identifies the most vulnerable
demographic groups who shoulder the heaviest care burden over time. In the end, the findings
from the dissertation provide guidance for the investment and design of long-term care services
in rapidly aging contexts.