Psychosocial Moderators of the Effects of Transitioning Into Filial Caregiving on Mental and Physical Health

Abstract

A life-course theoretical perspective guided this study to examine how effects on mental and physical health (depressive symptoms, hostility, global happiness, self-esteem, personal mastery, psychological wellness, self-rated physical health) of transitioning into filial caregiving for a sole surviving parent are moderated by prior relationship quality, filial obligation, race or ethnicity, education, income, employment status, marital status, and parental status. Results from models estimated using longitudinal data from 1,060 adults aged 25 to 65 years at baseline (National Survey of Families and Households, 1987 to 1994) suggested that life-course and contextual factors do contribute to patterning health risks of caregiving, often in different ways for men and women: For example, low income puts daughter caregivers at greater risk for decline in physical health, combining employment with filial caregiving is more problematic for daughters' mental health, and being an unmarried filial caregiver is more problematic for men. Heterogeneity in the experience of filial care needs further attention in future research. Keywordscaregiving; parent; mental health; physical health; filial Assuming the role of caregiver for a frail or disabled parent is becoming an increasingly probable occurrence for both women and men traversing middle adulthood (Brody 1990;Marks 1996; National Alliance for Caregiving and AARP 2004;Stone, Cafferata, and Sangl 1987), and providing care to disabled elderly parents has been linked to considerable strain, burden, psychological distress, and sometimes poorer health (e.g., Brody 1990; George and Gwyther 1986;Horowitz 1985;Hoyert and Seltzer 1992;Pinquart and Sorensen 2003;Schulz, Visintainer, and Williamson 1990;Schulz and Williamson 1991;Stephens and Townsend 1997;Young and Kahana 1989). Overall, most studies suggest that women providing parent care experience more burden and distress than men (Montgomery 1992;Yee and Schulz 2000). A number of additional life-course contextual factors beyond gender that might moderate the effects of filial caregiving have been suggested and to some extent examined, for NIH-PA Author ManuscriptNIH-PA Author Manuscript NIH-PA Author Manuscript example, race or ethnicity, socioeconomic status, relationship quality, attitudes toward filial responsibility, marital status, parenthood status, and employment status. However, a systematic examination of all of these moderators across a national sample of caregivers has not been previously undertaken.The transition into filial caregiving has been the least frequently studied phase of the caregiving career to date, because it requires a prospective research design. The aim of this study was to contribute to a population and life-course perspective on filial caregiving by using longitudinal U.S. national data to examine how multiple psychosocial life-course contextual factorsgender, relationship quality, filial obligation, race or ethnicity, educational attainment, household income, marital status, employment,...

Identification of stress and coping risk and protective factors associated with changes in adjustment to caring for an adult with mental illness

“…A similar pattern has emerged in longitudinal research with other carer populations with respect to both social support (Goode, Haley, Roth, & Ford, 1998;Soskolne, Acree, & Folkman, 2000) and relationship quality (Marks, Lambert, Jun & Song, 2008).…”

Adult Child Caregiver Health Trajectories and the Impact of Multiple Roles Over Time

“…Findings add to previous research by demonstrating that adult children who have provided care to their aging parents report increasingly worse psychological and physical health trajectories throughout their life courses (Amirkhanyan & Wolf, 2006;Marks et al, 2002Marks et al, , 2008. Study findings provide additional insight by illustrating that caregivers' declining health trajectories are explained by consistent and inconsistent long-term patterns of caregivers' attained roles and ascribed statuses.…”

“…Most studies have established that caregiving was related to higher levels of depression (Chumbler et al, 2004;Marks et al, 2008;Pinquart & Sorenson, 2003a). Depression has been the most commonly assessed indicator of caregivers' psychological health, which has most often been measured with the Center for Epidemiological Studies Depression Scale (CES-D; Marks et al, 2008;Pinquart & Sorenson, 2003a). Three studies, using two to three waves of nationally representative data, found that caregivers reported higher levels of depression over time as a result of transitioning into the caregiving role (Amirkhanyan & Wolf, 2006;Marks et al, 2002;Marks et al, 2008).…”

“…Ascribed statuses (i.e., age, gender, race/ethnicity, education, and income) have also accounted for variability in caregivers' psychological and physical health, suggesting that these statuses should be statistically controlled for in order to better understand caregivers' multiple roles and health over time. Regarding age, Marks, Lambert, Jun, and Song (2008) found a negative relationship between caregivers' age and depressive symptoms using longitudinal research, whereas Chumbler and colleagues (2004) found a positive relationship between caregivers' age and depressive symptoms using cross-sectional research; further contrasting research found no statistically significant difference between older and younger adult child caregivers' psychological health (McConaghy & Caltabiano, 2005). Using nationally representative data, Kang (2006) found that male caregivers reported higher levels of depression than female caregivers, whereas a meta-analysis on caregiver gender differences and health found that female caregivers had higher levels of depression and lower levels of physical health than male caregivers (Pinquart & Sorenson, 2006).…”

“…Few robust differences in health outcomes have been found between White and non-White caregivers due to the use of convenience and cross-sectional samples (Kang, 2006;Marks et al, 2008;Roff et al, 2004). Longitudinal research has found that caregivers with less education have better psychological health over time (Marks et al, 2008), whereas cross-sectional research has found that caregivers with less education have worse psychological health (Chumbler et al, 2004). Finally, having a lower income has been associated with greater declines in caregiver psychological and physical health due to increased strains in addressing caregiving demands (Chumbler et al, 2004;Marks et al, 2008).…”