Caregiving Behavior Is Associated With Decreased Mortality Risk

Abstract

Traditional investigations of caregiving link it to increased caregiver morbidity and mortality, but do not disentangle the effects of providing care from those of being continuously exposed to an ailing loved one with serious health problems. We explored this possible confound in a national, longitudinal survey of elderly married individuals (N = 3,376). Results showed that spending at least 14 hr per week providing care to a spouse predicted decreased mortality for the caregiver, independently of behavioral and cognitive limitations of the care recipient (spouse), and of other demographic and health variables. These findings suggest that it may be premature to conclude that health risks for caregivers are due to providing active help. Indeed, under some circumstances, caregivers may actually benefit from providing care.Approximately 21% of the U.S. adult population provides unpaid care to an adult over age 18 (Pandya, 2005, par. 2). There is a growing consensus that caregiving is harmful to physical health, so public-policy researchers have recommended that caregivers receive "relief from the relentless work of family caregiving and its debilitating effects" (Feinberg et al., 2004, Recommendation 3). As reported by Riess-Sherwood, Given, and Given (2002), the physical health consequences of providing care "have been so striking that federal legislation has been enacted to begin granting financial relief to those who provide care in the home in the hopes that this would relieve some of the health effects" (p. 111). These recommendations are based, in part, on evidence that caregivers may experience problems with immune regulation (e.g., see Vitaliano, Zhang, & Scanlan, 2003, for an overview), and Address correspondence to Stephanie L. Brown, Division of General Medicine, 300 N. Ingalls, Room 7D-13, Ann Arbor, MI 48109, stebrown@med.umich.edu. SUPPORTING INFORMATION Additional Supporting Information may be found in the on-line version of this article: Table S1 Table S2 Please note: Wiley-Blackwell are not responsible for the content or functionality of any supporting materials supplied by the authors. Any queries (other than missing material) should be directed to the corresponding author for the article. However, empirical evidence of worsened physical health among caregivers comes from studies that often equate providing active help with being continuously exposed to an ailing loved one with serious health problems (e.g., Christakis & Allison, 2006;Vitaliano et al., 2003). Christakis and Allison, for example, linked caregiving to increased mortality risk on the basis of increased mortality rates among individuals whose spouse had been hospitalized, as opposed to individuals who provided more hours of care to a spouse. In instances like these, it is impossible to know whether the adverse health consequences are due to stress arising from active helping (e.g., hours of care provided to another person), or to other features of the caregiving context that may be harmful, such as anticipatory bereavement ...

Kindness in the blood: A randomized controlled trial of the gene regulatory impact of prosocial behavior

“…The present findings are also consistent with literature that links prosocial behavior to favorable social outcomes such as peer acceptance (Layous et al, 2012), feelings of connectedness (Nelson et al, 2015), social adjustment (Crick, 1996), and eudaimonic well-being (Nelson et al, 2016), as well as to favorable health correlates including cardiovascular function and decreased mortality (Brown et al, 2003(Brown et al, , 2009. Our findings extend that literature by providing the first experimental evidence that prosocial behavior can causally impact CTRA gene expression.…”

“…Prosocial behavior can include acts directed at a specific other, such as purchasing coffee for a stranger, or individual efforts to better the world that are not directed at any specific individual, such as picking up litter. Beyond the general effects of social ties, observational epidemiology has also documented several health correlates of prosocial behavior in particular, including reduced risk of cardiovascular disease and mortality (Brown et al, 2003(Brown et al, , 2009Konrath et al, 2012;Poulin and Holman, 2013). These effects have been hypothesized to stem from neurophysiological correlates of prosocial behavior such as alterations in oxytocin and progesterone activity (Brown and Brown, 2015) or altered activity of the hypothalamus-pituitary-adrenal axis and sympathetic nervous system (Eisenberger and Cole, 2012).…”

“…Media, advertising, and other popular culture sources reinforce the idea that pampering oneself can lead to increased subjective well-being, reduced stress, and bolstered physical health. Despite these popular notions, however, empirical evidence suggests that prosocial, rather than selffocused, behavior is linked with positive health outcomes (Brown et al, 2003(Brown et al, , 2009Brown and Brown, 2015;Burr et al, 2016;Konrath et al, 2012). Given the strong links between prosocial behavior and broad, long-term physical health outcomes (i.e., cardiovascular disease risk, mortality), surprisingly few studies have experimentally tested whether increasing prosocial behavior leads to improvements in biological processes that may potentially mediate these long-term outcomes.…”

Caregiving, volunteering or both? Comparing effects on health and mortality using census-based records from almost 250,000 people aged 65 and over

“…Two recent overviews, by Brown & Brown [13] and Roth et al [14], have argued for more balance, suggesting that "policy reports, media portrayals, and many research reports commonly present an overly dire picture' while ignoring alternative positive findings. It is now recognised that many caregivers report benefit from caregiving [15,16] and population-based mortality studies generally find that caregivers have reduced mortality compared with non-caregivers [17][18][19][20][21][22].…”

Health-related quality of life of family caregivers—Evidence from Hesse

“…The responsibility for the care recipient led to personal growth (Leipold et al 2006) and provided intrinsic rewards as experienced self-gain of the caregivers (Foley et al 2002). In addition, one recently run study in the United States of America indicated that the caring for a disabled spouse more than 14 hours a week may even lead to an increased life expectancy (Brown et al 2009). …”