Predictors and consequences of perceived lack of choice in becoming an informal caregiver

Abstract

Objectives Using data from a national sample of informal caregivers to older adults, we identify predictors of lack of choice and the consequences of lack of choice in taking on the caregiving role. Methods A national telephone survey with 1397 caregivers was carried out to assess whether respondents had a choice in taking on the caregiving role, their demographic characteristics, the nature and duration of their caregiving experience, and its impact on their physical and psychological well-being. We compare caregivers who felt they had no choice in taking on the caregiving role to those who did. Results Forty-four percent of caregivers reported a lack of choice in taking on the caregiving role. Highly educated, older caregivers caring for a younger care recipient with emotional or behavioral problems were most likely to report that they had no choice in taking on the caregiving role. Lack of choice is associated with higher levels of emotional stress, physical strain, and negative health impacts, after controlling for multiple confounds including level of care provided, relationship type, primary health condition of the care recipient, and demographic characteristics. Conclusion Lack of choice is an independent risk factor for the negative effects of caregiving, and clinicians should be vigilant to lack of choice as a marker of caregiver distress.

Positive and negative evaluation of caregiving among three different types of informal care relationships

“…The lack of alternative caregivers as a motive only applied to 5 % of the child caregivers (Table 1), but appeared to be a very special reason to feel more burdened. It reflects that these child caregivers may feel forced into the caregiving tasks and that lack of choice is associated with worse outcomes for care evaluation as it is for health and wellbeing (Schulz et al 2012). Helping them to mobilize other informal and formal caregivers may reduce the level of burden in this particular group of caregivers.…”

“…Whereas the current knowledge on care evaluation is mostly focused on spouses and adult children as caregivers (Kramer 1997a;Lawton et al 1991;Marks et al 2002;Pinquart and Sörensen 2011;Raschick and Ingersoll-Dayton 2004;Savundranayagam et al 2011), we added more insight into the characteristics of the group of other caregivers, a rather unexplored type of caregiver so far (cf Schulz et al 2012). In addition, the study explored the impact of many different types of correlates, which provided more insight in differential effects on burden and positive evaluation and the degree to which the caregiver stress model is applicable to both positive and negative care evaluation.…”

“…Adult children, in contrast, have more choice to decide whether or not to provide care (Raschick and Ingersoll-Dayton 2004;Schulz et al 2012) and may vary more in their level of commitment. Some of them may feel obliged to give care, either normatively (filial obligation) or structurally (lack of alternative caregivers), resulting in a stronger association between caregiver motivation and care burden.…”

“…Some studies show that the transition into the caregiving role is experienced more positively among non-kin caregivers than among spouses and adult children (Cohen et al 2002;Marks et al 2002). Such differences in caregiving evaluation may arise because spouses, adult children and other types of caregivers differ in the opportunities they have to provide care as well as in their motivation for caring (Lyonette and Yardley 2003;Pinquart and Sörensen 2011;Schulz et al 2012), both of which are important predictors of caregiver evaluation. Some aspects of the care context (such as behavioural problems on the part of the care receiver) show stronger associations with caregiver burden among spousal caregivers than among adult children (Pinquart and Sörensen 2003).…”

Choosing when choices are limited: The role of perceived afforded choice and autonomy in prisoners’ well-being.

“…A smaller number of studies have found beneficial effects of choice on individuals' well-being (e.g., Meng & Ma, 2015;Quine, Wells, de Vaus, & Kendig, 2007). Conversely, experiencing a lack of choice has been found to relate to maladjustment, including emotional stress, physical strain, and decreased health (Schulz et al, 2012).Having a sense of choice may be particularly important in autonomy-restrictive settings, where afforded choice can increase individuals' rather limited sense of autonomy. In a now-classic study, Langer and Rodin (1976) experimentally examined the role of afforded choice in an autonomy-restrictive context, namely among nursing home residents.…”