Lending a Helping Hand: Unconventional Caregiving Arrangements, Institutionalization, and Mortality among Older Americans

• In Event: 3148 - Unconventional Support and Care

Abstract

Objectives: This research explores various caregiving arrangements including conventional (e.g., spouse or adult child caregiver) and unconventional arrangements (e.g., friend/peer caregiver) among older Americans with disability. We assess whether different caregiving arrangements are associated with increased risk of death or institutionalization. Methods: Using data from the Health and Retirement Study (1998-2012), we employ discrete-time event history analysis to assess the odds of death or institutionalization (i.e., moving to a nursing home) over a twelve-year period. The analytic sample was restricted to age-eligible respondents with activities of daily living (ADLs) disability who were living in the community (N=21,056 person-intervals). A five-category caregiving arrangement measure was created using information about who helps most often with ADLs; the categories included spouse or adult child caregiver (reference), employee caregiver, extended family caregiver, friend/peer caregiver, and no caregiver. Results: Among the full sample of respondents, having no caregiver was associated with lower risk of death or institutionalization, relative to having a spouse or adult child, friend, or employee caregiver. Among the living alone sample, having an employee or friend caregiver increased risk of institutionalization, compared with having a spouse/child caregiver. Relative to having no caregiver, having an employee or friend caregiver increased the risk of death or institutionalization. Discussion: This research provides evidence that the type of caregiving arrangement influences risk of death or institutionalization.

Authors

• Kenzie Latham-Mintus, Indiana University-Purdue University Indianapolis (IUPUI)

• Meggan Jordan, California State University-Stanislaus