The Receipt of Care and Depressive Symptoms in Later Life

Apace with the rapid increase in the aging population and steep reductions in federal funding for long-term care in the U.S., caregiving is emerging as an important issue for many families. Although caregiving relationships include both a caregiver and a care-recipient, existing research has focused heavily on caregivers and the experiences of care-receiving older adults have been less-well documented. This three-essay dissertation explores how the receipt of care influences depressive symptoms among older adults by analyzing nationally representative data from the Health and Retirement Study. Based on identity theory, the first essay examines the extent to which self-perceptions of aging explain the relationships among the receipt of care, perceived loss of control, and depressive symptoms among older adults. Structural equation modeling was used. Results indicated that self-perceptions of aging mediated the relationship between receipt of care and perceived loss of control as well as the relationship between receipt of care and depressive symptoms. That is, older adults who received a greater amount of care were more likely to perceive their aging negatively which, in turn, increased perceived loss of control and depressive symptoms. The second essay investigated whether older adults who receive care from their spouse are more vulnerable to the negative impact of their spouse's physical and mental health than older adults who do not receive care by using a linear mixed model. Results indicated that the receipt of care moderates only the impact of wives' mental health on husbands' depressive symptoms. Husbands who receive care from their wives are more sensitive to their wives' depressive symptoms than husbands who do not receive care. Finally, the third essay assessed to what extent the effects of positive and negative supxi port from spouses are stronger for caregiving couples than for non-caregiving couples. Structural equation modeling demonstrated that positive support from spouses is more important for wives who provide or receive care than for those in non-caregiving relationships. No differences in the effects of negative support from spouses were observed between caregiving and non-caregiving couples.