A Care Paradox: The Relationship Between Older Adults' Caregiving Arrangements and Institutionalization and Mortality.

TitleA Care Paradox: The Relationship Between Older Adults' Caregiving Arrangements and Institutionalization and Mortality.
Publication TypeJournal Article
Year of PublicationForthcoming
AuthorsJordan, M, Latham-Mintus, K, Patterson, SE
JournalRes Aging
Pagination1640275241229416
ISSN Number1552-7573
KeywordsCaregiving, Family caregiving, Mortality, Nursing homes
Abstract

We investigate how the type of caregiving arrangement is associated with older Americans' outcomes. We use the Health and Retirement Study (2004-2018) and discrete-time event history analysis to assess the odds of institutionalization or death over a 14-year period among older adults with limitations in Activities of Daily Living (ADLs; e.g., bathing). We consider caregiving arrangements as conventional (i.e., spouse or adult child), unconventional (e.g., extended family, employee, friend), or self-directed (i.e., no caregiver). We find a "care paradox" in that self-directing one's own care was associated with a lower risk of institutionalization or death compared with having conventional care (spouse/adult caregiver) and unconventional care (employee). Relative to conventional care, having an employee caregiver was associated with increased risk of institutionalization. Findings are still observed when controlling for level of impairment and various health-related factors. More research is needed to understand older adults who self-direct their own care.

DOI10.1177/01640275241229416
Alternate JournalResearch on Aging
Citation Key13727
PubMed ID38253335