Abstract
Using the stress process model and data from the 2011–2018 China Health and Retirement Longitudinal Study (CHARLS), this study examined the effect of spousal caregiving intensity on the depression level of older caregivers in China. The moderating role that socioeconomic status plays in the relationship between spouses was explored by constructing multilevel growth models (MGMs). The care intensity for a spouse was found to relate to significantly increased depression levels in older caregivers, while the degree of disability of the spouse being cared for (B = 0.200, p < 0.001) having a greater effect on depression than the duration of care (B = 0.007, p < 0.01). There was a threshold effect where the provision of more than 10 h of care per week for a spouse (B = 0.931, p < 0.001; B = 0.970; p < 0.01) or caring for a disabled spouse with limited ADLs (B = 0.709, p < 0.01; B = 1.326; p < 0.001; B = 1.469, p < 0.01) increased depression in older caregivers. There were moderating influences, including higher professional prestige before retirement (B = −0.006, p < 0.05) and higher annual family income (B = −0.037, p < 0.10), that increased depression related to the spouse’s degree of disability. It was considered that active familism measures should be formulated for older spousal caregivers, especially those with lower socioeconomic status.
Highlights
The stress of caring for older adults within the context of population aging has become a major factor affecting the health of caregivers
The unique approach of this study can be seen in the following three points: first, unlike most previous studies that were based on regional and cross-sectional data, this study aimed to assess the effect of care intensity on the depression levels of older caregivers by using national tracking data and constructing multilevel growth models (MGMs); second, previous studies focused on the caregivers of people with specific medical conditions such as dementia and stroke, with little attention paid to older spousal caregivers in China; third, previous studies treated caregivers as a homogeneous group, and the intensity of caregiving stressors was usually ignored, whereas this study focused on the intensity measures of caregiving from the perspectives of both the caregiver and care recipient
The results showed overall that the longer the time spent on care and the higher the disability degree, the higher the depression level in the older caregivers
Summary
The stress of caring for older adults within the context of population aging has become a major factor affecting the health of caregivers. In EU countries, life expectancy after reaching the age of 65 is estimated to be 18 years for men and 22 years for women. Home has always been an important place for disabled older adults to receive care. This is due to the scarcity of formal care resources, the high cost, and the preference of older adults for continuing to live at home. In China, due to the influence of social customs and filial values, as well as the promotion of the Marriage Law and Law on Protection of the Rights and Interests of the Elderly, caring for older adults is considered an obligation of family members [5]
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