Informal caregiving transitions, subjective well-being and depressed mood: Findings from the English Longitudinal Study of Ageing

Abstract

Objectives To prospectively investigate the impact of transitions in informal caregiving on emotional wellbeing over two years in a large population study of older people. Methods Information on provision of unpaid care in 2004/5 and 2006/7 was available for 6571 participants in the English Longitudinal Study of Ageing. Three wellbeing domains were also assessed on each occasion: Life satisfaction (measured with the Satisfaction With Life Scale); Quality of life (assessed with the CASP-19 scale); and depression symptoms (measured using the Centers for Epidemiologic Studies Depression Scale). Multivariable analyses of the impact on wellbeing of two-year caregiving transitions (caregiving entry and caregiving exit, or continued caring) were conducted separately for spousal/child carers and carers of other family/non-relatives. Results Compared to non-caregiving, entry into spousal/child caregiving was associated with decline in quality of life (B = −1.60, p < .01) whereas entry into caregiving involving other kin relations increased life satisfaction (B = 1.02, p < .01) and lowered depression symptoms (B = −0.26, p < .05). Contrary to expectations, caregiving exit was related to increased depression in both spousal/child (B = 0.44, p < .01) and non-spousal/child (B = 0.25, p < .05) carers. Continued spousal/child caregiving was also related to decline in quality of life (B = −1.24, p < .05). Other associations were suggestive but non-significant. Conclusion The emotional impact of different caregiving transitions in later life differs across kin relationships; notably, spousal and child carers’ wellbeing was consistently compromised at every stage of their caregiving career over the two-year study period.

Informal caregiving and quality of life among older adults: Prospective analyses from the Swedish Longitudinal Occupational Survey of Health (SLOSH)

“…Participants who began to provide care for more than 10 hours weekly or care that was sometimes or often burdensome experienced declines in their quality of life. These findings are in line with previous work that has shown that entry into caregiving is associated with reduced quality of life (Rafnsson et al 2017;Yiengprugsawan et al 2016). Strengthening the evidence from earlier small studies (Bond et al 2003;Seltzer and Li 2000), and in contrast to other studies not detecting changes (Rafnsson et al 2017;Yiengprugsawan et al 2016), we were able to observe that once participants ceased providing care, their quality of life improved.…”

“…The implications of this finding are stark, given that cessation of care provision may result from institutionalization or death of the person being cared for. No recoveries in quality of life occurred if carers continued providing care for more than one wave, indicating that carers are not adapting to caregiving (Lacey et al 2019;Rafnsson et al 2017). There is a suggestion that sustained caregiving might further erode quality of life, since the participants reporting lowest quality of life were those who repeatedly provided care that was sometimes or often burdensome at consecutive waves.…”

“…Transitions out of caregiving have been associated with poorer wellbeing (Dolan et al 2008;Hirst 2005), perhaps because this corresponds to the life event of a close family member entering an institution or passing away, but other studies found no change in quality of life (Rafnsson et al 2017;Yiengprugsawan et al 2016). A key question raised by Rafnsson et al (2017) is whether people who stop providing informal care experience full recovery to pre-caregiving level or longer-lasting effects can be observed. In addition, little is known about which aspects of the care situation might be generating such changes in quality of life: declines may be more marked if people begin high intensity care or burdensome care, and there may also be gender differences, e.g., women providing ≥20 hours of care weekly were particularly vulnerable to mental health decline (Hirst 2005).…”

Co-resident care-giving and problematic sleep among older people: evidence from the UK Household Longitudinal Study

“…This research therefore adds to evidence of the significant challenges to wellbeing experienced by many older care-givers (e.g. Rafnsson et al, 2017). The findings have policy and practical implications for the UK where access to formal state-funded home care and institutional care settings has been decreasing, and informal family care represents an essential pillar of social care (Vlachantoni et al, 2011).…”

The Effect of Current Family Situation on Slow Walking Speed at Old Age

“…As a consequence, they may stay more active, which has a positive impact on their walking speed. However, it was also reported that the well-being of a caregiving spouse was consistently compromised at every stage of the caregiving career, even after the death of the partner (Rafnsson et al 2015).…”