A National Profile of Caregivers for the Oldest-Old

Abstract

Limited research has examined caregivers for the oldest old (85+), a distinct group among older adults who are most likely to experience functional and cognitive limitations that require care. To profile socio-demographic characteristics of the oldest-old and their informal caregivers and assess their caregiving situations, we used data from 3163 care recipients with at least one functional limitation from the 2004 National Long-Term Care Survey and 1363 caregivers who were either adult children or spouses of care recipients. The oldestold with functional disabilities were less likely to be married and more likely to be women living alone. Compared with those under 85, the oldestold group were likely to have more extensive IADL and ADL limitations. However, with the exception of dementia, the oldest-old had a lower prevalence of chronic illness than younger elders. The oldest-old care recipients also tended to use more formal care service. While caregivers for the oldest old were less likely to be a sole caregiver and more likely to use formal care service, their physical and emotional stress from caregiving remained the same with their counterpart group of caregivers. Comparison of caregivers by their relationships to care recipients also indicated that adult children who cared for the oldest-old parents tended to express the most stress from caregiving. We contend that formal services need to be better incorporated with informal caregiving to attenuate negative caregiver outcomes, especially for the oldest-old whose informal caregiving network is rather limited.

Trajectories of Informal Caregiving to the Oldest-old: A One-year Follow-up Study

“…This profile was somewhat expected due to the presence of a high number of health-related problems in care recipients that tend to characterize long-lived individuals who also present increased dependency (Wang et al, 2019). Nevertheless, informal caregivers also evidenced a vulnerable condition (Takagi et al, 2013). The presence of concomitant diseases, intake of many medicines, and lower scores of self-perception of health are important aspects to consider in the profile of this sample of informal caregivers as such conditions have been reported to interfere in the caregiving dynamics, like, for instance, its availability and provision (Laporte Uribe et al, 2017; Takagi et al, 2013).…”

“…In particular, these demands could increase when care is provided to the oldest-old individuals once the caregivers’ characteristics and caregiving context tend to be more challenging than in older younger people’s care provision. Takagi et al (2013), for example, described a sample of informal caregivers of oldest-old individuals and found that they were significantly older than informal caregivers of younger old individuals, more likely to be female, and with increased length of care provision, though with fewer caregiving hours. Additionally, they found worse overall conditions: higher levels of burden, lower self-perception of health, and lower social support networks, suggesting the presence of increased difficulties for these caregivers.…”

Transition to bereavement: A prospective longitudinal study of health-related quality of life in informal caregivers of oldest-old individuals

“…Regarding Spain, a country with similar context (e.g., location, culture, familial culture), a proportion of 14.0% was found, which is quite near from that observed in Portugal ( 3 ). Notwithstanding, the absence of a clear information of the magnitude of informal care provision in Portugal, it is well acknowledge that caring for oldest old individuals can have a significant impact in the informal caregivers’ physical and mental health status ( 4 – 6 ). Previous research reported that caregivers of oldest-old individuals tend to show higher levels of burden, lower self-perception of health, and weaker social support networks ( 7 ).…”

“…The current literature on informal caregiving issues ( 4 , 6 , 17 ) – including the study of informal caregiving of oldest-old individuals – tend to focus on describing the negative impacts associated with the experience (e.g., depression, physical and mental burdens). How caregivers may experience grief and bereavement has received significantly less attention.…”

“…Some differences across the results relate to time spent on caregiving (higher length of caregiving was related to a difficult bereavement), relationship to the person being cared for (adult children experienced a stronger form of grief, while the spouses’ grief was found to be quiet and sad), and/or related to the caregivers’ health condition and burden (poorer health condition and higher burden increased caregiver grief). These findings suggest that this period can be particularly demanding for informal caregivers of oldest-old individuals because care provision is usually long-lasting ( 20 , 31 ), intensive ( 21 , 32 ), more burdening ( 5 ) and the caregiver usually presents a vulnerable health condition (e.g., concomitant diseases, many medicines intake) ( 4 , 17 ). Besides, high mortality rates are found in oldest-old individuals ( 33 , 34 ) which probably increases the proportion of informal caregivers experiencing such an event and therefore may also increase the number of individuals at risk.…”