Adult Caregivers Research Articles

Finding PEACE: Development and Pilot Testing of the Positive and Enjoyable Aspects of the Caregiving Experience Measure with Caregivers of Older Adults

Finding PEACE: Development and Pilot Testing of the Positive and Enjoyable Aspects of the Caregiving Experience Measure with Caregivers of Older Adults

Caregiving Intensity, Duration, and Subjective Financial Well-Being Among Rural Informal Caregivers of Older Adults with Chronic Illnesses or Disabilities

Introduction: Rural informal caregivers (IC) experience major financial and economic constraints in caring for their older family members. Rurality combined with increased caregiving demands and intensity, poor economic opportunities, and limited financial resources and policies create multiple financial stressors and can lead to poor financial well-being. A cross-sectional survey was conducted to understand how caregiving demands, intensity, and duration impact the subjective financial well-being of rural caregivers of older adults. Methods: Informal caregivers (N = 196) residing in 12 rural counties in the central North Region of the Midwestern US participated in the survey. Ordinary Least Squares and Linear Probability Model regressions were conducted to measure the association among the study variables. Results: Our findings showed a moderate level of subjective financial well-being among informal caregivers (average = 51.62; SD 14.52). Caregiving intensity negatively affected financial well-being (β = −1.470, p < 0.05). More than half of informal caregivers (58%) were not satisfied with their household income, and 30% found it difficult to meet their family’s needs with their current income status. Discussion and Conclusions: Longer hours of care are associated with financial burden and insecurity and can significantly influence the financial health and well-being of rural informal caregivers of older adults. Older caregivers were found to manage their financial constraints more effectively. Future comparative and longitudinal studies with a more diverse sample are required to infer long-term interactions among the different variables in this study.

Silicon caregivers: a multilevel analysis of European perspectives on robotic technologies for elderly care

ABSTRACT As populations age, women's workforce participation grows and AI advances, understanding attitudes towards care technologies becomes increasingly important. This study examines attitudes towards robot caregivers for older adults across 28 European countries, using 2017 Eurobarometer data from working-age adults (20–59; n = 13,839). We investigate how individual characteristics (gender, education, occupation) and local-level factors (GDP, female labour participation, over 65s as % of the population, spending on old age) are associated with comfort levels with domestic care robots. The results show that men, individuals with higher levels of educational attainment, and those in professional or managerial occupations report greater comfort with robot caregivers. Additionally, local context plays a significant role. Those living in local communities with higher female employment rates and lower spending on old-age support demonstrate higher acceptance of robotic care solutions. These findings highlight the dual influence of individual and community factors in shaping attitudes towards automated care technologies.

Sharing in caring: Family caregiving task sharing patterns for older adults in Singapore.

Research on family caregiving for older adults has largely focused on primary caregivers. We identify caregiving task sharing patterns among multiple caregivers, including family members and live-in hired workers. In addition, we investigate caregiver and care-recipient characteristics associated with these patterns. We interviewed 278 primary family caregivers of home-dwelling older adults in Singapore about who provides what assistance across three domains: activities of daily living, health and social services use, and socio-emotional and other needs. Latent class analysis was used to identify caregiving task sharing patterns. Three patterns were identified: a) 'Shared-Diverse' (39%) - multiple caregivers assisting in all three domains, b) 'Shared-Domestic' (32%) - multiple caregivers assisting with activities of daily living and socio-emotional and other needs, and c) 'Solo-Diverse' (29%) - a sole caregiver assisting in all three domains. 'Solo-Diverse' caregivers were less likely to be employed and had higher depressive symptoms relative to 'Shared-Diverse' primary family caregivers. The predominance of caregiving task sharing patterns involving multiple caregivers calls for expansion of research, policies, and programs beyond primary caregivers. Greater attention should be given to how families and live-in hired workers share caregiving tasks for older adults, and how this varies across cultural settings, especially in familial Asian societies. The findings further highlight the vulnerabilities of solo caregivers, whose employment capacity and mental health may be adversely affected by their caregiving duties. Policymakers should ensure that solo caregivers have access to support programs that address their financial and mental health needs.

Factors Associated With Caregiver Burden in Family Caregivers of Older Adults: A Cross-Sectional Study.

This study aimed to assess caregiver burden and identify factors associated with caregiver burden among family caregivers of older adults. This cross-sectional study included 140 older adults and their family caregivers. The study was conducted between February and November 2020 at a hospital in İstanbul. Data were collected using the Zarit Burden Interview (ZBI), Multidimensional Scale of Perceived Social Support (MSPSS), General Health Questionnaire-12 (GHQ-12), and Katz Activities of Daily Living Scale (Katz ADL). The mean age of the caregivers was 49.20 ± 10.75 years, and 72.9% were female. The mean ZBI score was 30.65 ± 9.31. Katz Activities of Daily Living Scale (β = -.579, p < .001), older adults' age (β = -.462, p < .001), caregiver's gender (β = .250, p < .001), MSPSS (β = -.195, p < .01), whether the caregiver had regular health check-ups (β = -.156, p < .05), and GHQ-12 (β = .147, p < .05) were found to be significant predictors of caregiver burden respectively. These variables explain 56.3% of the total variance for the caregiver burden (R2 = .563, p < .001). Being a female caregiver and experiencing poor mental health were associated with a higher caregiver burden. Regular health check-ups received by caregivers and good social support were associated with a lower caregiver burden. Older age and higher dependency of older adults were associated with a lower caregiver burden. Based on these findings, there is a need for interventions and social policies aimed at reducing caregiver burden among family caregivers of older adults.

Family caregiving experiences of medical school faculty: high prevalence, high strain, and low resource awareness.

Adult caregiving can be demanding and stressful, especially when the caregiver is employed. As the age of the U.S. population and workforce increases, more adults are providing care to aging family members. To understand the prevalence and aspects of the caregiving experience and caregiving strain among department of medicine faculty members, and to gauge their awareness and utilization of caregiving resources. We used a cross-sectional survey design. A questionnaire survey was developed and launched in Redcap in October, 2022, and an invitation was emailed followed by two reminders to all full-time and part-time faculty members (N = 1053) in our department of medicine. Faculty demographics, caregiver status, caregiving details, degree of mental or emotional strain, and knowledge of and use of employer and external caregiver resources. Of the 1053 faculty members who received up to three email survey invitations, 209 (20%) responded of which 76 (36%) were current caregivers and 117 (56%) were non-caregivers. Among the 76 current caregivers, 53 (70%) reported providing care for parents or parent-in-laws and 9 (12%) reported caring for a spouse. One-third of current caregivers reported caring for individuals with Alzheimer's disease or dementia/memory problems. Ninety-five% of current caregivers reported some or a lot of caregiving strain. A wide variation in knowledge of and use of employer and external caregiver resources was reported. Department of medicine faculty who provide adult caregiving report a high prevalence of strain and wide variation in knowledge of and use of employer and external caregiver support services, suggesting opportunity to better understand where gaps exist in providing support for caregivers.

Factors Associated with and Predictive Model for Resilience in Family Caregivers of Care-Dependent Adults

Background: Caring for dependent people is an intense task that leads family caregivers to suffer physical or mental pathologies. Resilience is a protective factor that makes an individual more resistant to adverse events. Some characteristics of the caregiver or the care provided predispose the caregiver to be less resilient. Knowing these characteristics will allow us to detect vulnerable caregivers. Aim: The aim of this study was to explore the factors associated with caregiver resilience and establish a predictive model, including the relationship between preparedness, burden, resilience, and anxiety. Materials and Methods: The study design was descriptive, observational, and cross-sectional, with purposive sampling. The sample included 172 family caregivers of care-dependent patients in Spain. Questionnaires were administered to assess caregiver resilience, anxiety, burden, and the preparedness of care-dependent patients. Correlation, univariate, and multiple linear regression analyses were performed to identify the factors associated with resilience. Results: We found that there is a correlation between resilience, preparation, and burden. Factors related to resilience include age, the caregiver’s health status, kinship, childcare, and state aid granted. Caregiver preparedness is the factor that most predicts caregiver resilience in our model. Caregivers with high levels of resilience also demonstrated high levels of preparedness and experienced less burden than those with low levels of resilience. Conclusions: These findings emphasize the relevance of improving the preparation of family caregivers to increase their resilience and, at the same time, the quality of care provided.

Certified Child Life Specialists in Hospice and Palliative Care Organizations: A State of the Profession.

Certified Child Life Specialists (CCLSs) provide developmentally appropriate psychosocial care to children to promote positive coping. However, little is known about the current professional landscape and opportunities for professional growth, especially in hospice and palliative care. To conduct a needs assessment among CCLS and examine the role in hospice and palliative care. CCLSs were surveyed on their experience and needs in providing care in hospice and palliative care organizations. The online survey contained questions about demographics and work environment. The survey included multiple choice, yes/no, and open-ended questions. Descriptive statistics were generated from the survey items and comments/open-ended questions were coded and assessed for themes. Among the 191 respondents, most were females (96.3%), under 40 years of age (63.8%), Caucasian (87.4%), and non-Hispanic (95.3%) with under 12 years of full-time work experience (57.0%). CCLSs commonly worked in urban/suburban (67.5%) pediatric programs (62.3%) with clients ranging from perinatal (33.5%) to adult caregivers of children (60.2%). Themes from the open-ended questions were: (a) role clarification, (b) staffing, (c) funding, (d) training/education, (e) professionality, and (f) self-care. Key insights into the profession, along with challenges and opportunities of working within the hospice and palliative care setting were identified. The findings highlighted the unique need for professional development among CCLSs.

The psycho-social impact of cancer treatment on the caregivers of the patients

Objectives The incidence of cancer cases shows an increasing trend over the past two decades owing to several factors, such as increased life expectancy, aging population, behavioral, environmental, and occupational risk factors, and more. Consequently, a greater number of people are expected to take the role of principal caregivers in the near future. Cancer treatment can have a multifaceted impact on the quality of life and psychological well-being of not only the patients but also their families. Caregivers are expected and required to provide complex care and support for which they are neither prepared nor trained. The reports of feeling overwhelmed and stressed are high when the demands placed on them exceed their resources, resulting in a negative effect on the overall well-being of the caregivers, including the patients themselves. The impact covers a wide spectrum of emotional, physical, financial, social, cognitive, spiritual, and work-related effects. Material and Methods This is a cross-sectional study conducted (for over three months from May to July 2023) among the caregivers accompanying cancer patients attending a tertiary care hospital in a South Indian metropolitan city. All the adult caregivers of patients diagnosed with cancer at least two to six months before the time of the study were considered as the study population. A systematic random sample was applied to recruit a convenient sample of 150 caregivers, maintaining the enrollment of only one caregiver per patient. Sociodemographic details of the patients and their caregivers were collected. The Zarit Burden Interview (ZBI) based on a Likert scale was implemented to collect relevant data related to both the cancer patient and the family caregiver. Results Of the total 150 cancer patients, the most common type of cancer among the patients was head and neck (63, 42%), followed by cancers of the female reproductive system (44, 29.3%) and breast (24, 16%). Nearly 47% of caregivers were children of cancer patients, while 35.3% were spouses. Significantly higher burden scores on the “emotional strain” and “financial/physical strain” domains were observed among female caregivers. Higher burden scores on the “self-criticism” domain were independently associated with a shorter caregiver-patient contact time. Significantly higher burden scores on the “self-criticism” and “time/dependence” domains were observed among employed caregivers. Higher levels of burden on the “financial/physical strain” domain were reported by unemployed caregivers. Significantly higher burden scores on the “uncertainty” domain were observed among older caregivers and caregivers who were parents or spouses of the patients. Conclusion Caregiving impacts the physical, emotional, financial, and social aspects of the caregiver’s life. They adopt active coping strategies to overcome the impacts of caregiving. A majority of the caregivers experienced mild to moderate burden, while most scored low on quality of life. Attention to concerns and the psychological well-being of caregivers may improve the overall scenario.

Relationship Between Primary Caregiving Type and a Peaceful End-Of-Life Experience Among Older Adults in China

ABSTRACT Few studies have compared pain management provided by informal and formal caregivers of older adults in China at the end of life. This study aims to address this gap by investigating the association between formal and informal care and painfulness at the end of life among older adults in China. Specifically, the study focuses on the influence of various types of informal care. Data were obtained from the Chinese Longitudinal Healthy Longevity Survey (CLHLS) conducted from 2002 to 2018, which is the largest nationally representative study of older adults in China, with a sample size of 21,849 deceased participants. Results from multiple logistic regressions suggest that informal care is associated with a more painful end-of-life experience compared to formal care, with care provided by adult children being a more favorable option within informal care. These findings underscore the urgent need to prioritize education on death and dying, improve the formal care system, and enhance professionalism within informal care.

Effectiveness of transitional care in Inflammatory Bowel Disease; Development, Validation, and Initial outcomes of a Transition Success Score.

The effectiveness of transition programs from paediatric to adult healthcare in adolescents with inflammatory bowel disease is not clear, as prospective studies using validated outcome measures for transition are lacking. This study aimed to develop and validate a quantitative Transition Success Score, and to apply it in a multicenter setting to assess the effectiveness of transitional care. The Top 10 outcome items related to successful transition, identified through an international Delphi study with IBD stakeholders, were integrated into a generic questionnaire, the Transition Success Score. In a prospective, multicenter study, Transition Success Score was scored by adult healthcare providers, young adult patients and caregivers, 9-15 months after transfer of care. In seven Dutch hospitals, 160 patients completed the Transition Success Score. The mean score was 25 (range 17-27), 25.6% of patients achieving maximum score. Hypothesis testing for construct validity revealed significant associations with characteristics related to transitional care, such as knowledge, independence, and quality of life (p <0.005). Structural validation indicated the score was most effective at discerning lower levels of transition success. Internal consistency was acceptable (0.64). High disease burden, exacerbation during or after transfer, and certain personality profiles were associated with lower scores. The Transition Success Score serves as a quantitative tool to evaluate the effectiveness of transitional care interventions and to identify inflammatory bowel disease patients at risk of encountering challenges during the transition to adult healthcare.

Ambivalent ageism and the pains and gains of informal caregiving for older adults: Findings from Germany

Background and ObjectivesWe analyzed the associations between ambivalent ageism, burden and positive experiences of care among informal caregivers of older adults (aged ≥60 years), to advance understanding of its role as psychosocial risk or resilience factor for informal caregivers. Design and MethodsData of 433 informal caregivers (≥18 years) of adults with care needs (≥60 years) from the Attitudes towards Informal Caregivers (ATTIC) project was used. The Ambivalent Ageism Scale, Positive Aspects of Care Scale and the Burden Scale for Family Caregivers were used. Linear regression analyses adjusted for context and personal factors were conducted, with age and gender included as moderators in additional tests. ResultsHigh ageism (total score) was significantly associated with a high level of positive aspects of care and burden. Further analyses showed a significant positive association between benevolent ageism and positive aspects of care, while stronger hostile ageism was associated with less positive aspects of care. Hostile ageism was also significantly associated with more burden, while benevolent ageism and burden were not associated. Additional analyses indicated no moderation by gender, but by age. The association between hostile ageism and burden was weaker with caregivers’ higher age. Discussion and ImplicationsWhile hostile ageism and worse caregiver burden were associated, positive care experiences seemed to benefit from benevolent ageism. This highlights the complex associations between ageism and caregivers’ well-being, which need to be taken into account in theory and practice focused on improving the care situation for both caregivers and care recipients.

Sibling presence during fostering ameliorates endocrine stress profile changes in a social rodent species (Octodon degus) in a sex-specific manner

During early life, disruption of the parent-offspring bond can substantially impact development of offspring physiology and behavior. In rodents, it has been well-documented that parental separation, reduction in parental care, and cross-fostering can affect development of the endocrine stress response. For social species, however, several social factors may mitigate the stress of cross-fostering, such as remaining with other known adult caregivers or siblings. In this study, we cross-fostered a social rodent species (Octodon degus) with or without their siblings at postnatal day (PND) 8 and measured their endocrine stress response immediately after fostering (PND9) and at weaning (PND28). We found that female singly-fostered offspring displayed elevated baseline cortisol levels and reduced weight gain immediately after fostering. At weaning, female singly-fostered offspring continued to display elevated baseline cortisol levels compared to non-fostered female offspring, while singly-fostered males demonstrated weaker cortisol negative feedback strength compared to male offspring that were not fostered or were fostered with their siblings. These results suggest that sibling presence may help mitigate the stress of fostering, and that future studies should further examine other social conditions that may help reduce developmental consequences of long-term parental bond disruption.

Community Music Therapy with Adult Female Caregivers:

Community Music Therapy with Adult Female Caregivers:

Caring for the child with a tracheostomy through the eyes of their caregiver: A photovoice study

PurposeThis qualitative descriptive study aimed to explore the daily experiences of caregivers of children with medical complexity with a tracheostomy at home. MethodsThis study used photovoice, a participatory action research methodology. Adult English-speaking caregivers of children with a tracheostomy, living in Texas, with access to a smartphone were recruited. Photographs taken by participants and an interview guide were used to guide semi-structured interviews with caregivers. ResultsEight participants were recruited. After analyzing photographs and caregiver interviews, four main themes were identified: role transition, daily challenges, finding support, and thriving in the new normal. ConclusionsCaregivers take on multiple roles, including providing medical care, advocating for their children, and educating others. While facing emotional challenges such as guilt, fear, and exhaustion, caregivers rely on external support systems, emphasizing the need for nurses and healthcare providers to provide comprehensive support and improve the accessibility of home nursing services. Practice implicationsThe findings of this study can inform nurse-led interventions and advocacy efforts aimed at supporting marginalized children with medical complexity with a tracheostomy and their families. These efforts may include enhancing communication and collaboration between families, healthcare workers, and the public, providing comprehensive, proactive support for caregivers, and improving access to home nursing services.

Changes in care provision to older parents during COVID-19 and the well-being of adult children: The moderating roles of the child-parent relationship and pandemic-related measures

Objective: The study addresses the associations between changes in care provision to older parents since the pandemic and worsened depression and anxiety in adult children. It also explores whether pandemic-related control measures and child-parent relationships moderated these associations. Background: Changes in informal care during the pandemic, such as increased or decreased caregiving frequency, may have affected caregivers’ psychological well-being. Limited research exists on how stressors and resources shape the well-being of adult children caregivers. Method: Data from 740 respondents in the first SHARE Corona Survey (SCS) who provided care for their parents during the pandemic were analyzed. Changes in depression and anxiety were assessed using data from SCS and pre-pandemic Wave. Logistic regression analyses were conducted, with added interactions between the moderators - pandemic measures and child-parent relationship characteristics - and changes in care frequency. Results: Increased caregiving frequency during the pandemic was associated with worsened depression. Stricter pandemic measures intensified this effect but also reduced the likelihood of anxiety for those who provided care less often. A higher quality of relationship with the mother in childhood was marginally associated with lower depression among those increasing caregiving but worsened depression for those decreasing it. Conclusion: To address post-pandemic caregiving challenges, efforts should focus on reducing caregiver stress and considering the enduring influence of early child-parent relationships.

Predictors of mental well-being among family caregivers of adults with intellectual and developmental disabilities during COVID-19.

Internationally, stresses related to the COVID-19 pandemic negatively affected the mental health of family caregivers of adults with intellectual and developmental disabilities (IDDs). This cross-sectional study investigated demographic, situational and psychological variables associated with mental wellbeing among family caregivers of adults with IDDs during the COVID-19 pandemic. Baseline data from 202 family caregivers participating in virtual courses to support caregiver mental well-being were collected from October 2020 to June 2022 via online survey. Mental well-being was assessed using total scores from the Warwick-Edinburgh Mental Wellbeing Scale. Demographic, situational and psychological contributors to mental well-being were identified using hierarchical regression analysis. Variables associated with lower levels of mental well-being were gender (women); age (<60 years old); lack of vaccine availability; loss of programming for their family member; social isolation; and low confidence in their ability to prepare for healthcare, support their family member's mental health, manage burnout and navigate healthcare and social systems. Connection with other families, confidence in managing burnout and building resilience and confidence in working effectively across health and social systems were significant predictors of mental well-being in the final regression model, which predicted 55.6% of variance in mental well-being (P < 0.001). Family caregivers need ways to foster social connections with other families, and support to properly utilise healthcare and social services during public health emergencies. Helping them attend to their needs as caregivers can promote their mental health and ultimately improve outcomes for their family members with disabilities.

Systematic review of burden&amp;quality of life in caregivers of children with schizophrenia (SyREN)

Abstract Background Schizophrenia is a chronic, disabling disorder that affects 23.6 million people worldwide, with patients often needing extensive assistance and care. Main caregivers are frequently family members who may present a reduced quality of life (QoL) due to the high-level burden of care. Literature mostly focuses on the burden caused by other mental disorders or by schizophrenia in both the adult and child population. We aim to assess the burden and QoL in caregivers of children and adolescents with schizophrenia. Methods We conducted a Systematic Review of articles published between 2013 and 2023 on MEDLINE, Scopus, Web of Science, APA PsycARTICLES, CINAHL. We included studies in which a validated instrument was used to measure the burden of caregiving and QoL for adult caregivers of children and adolescent schizophrenic patients. The results were reported following the PRISMA guidelines. Results We identified 1388 studies. We removed 610 duplicates. After screening 788 studies on title and abstract and 52 for full-text, we included one cross-sectional study in China based on the STROBE Checklist. Significant correlations between burden of care and schizophrenia severity, children’s age, period of care, education, sex, residence, and income were reported. Additionally, we screened 7 qualitative studies. Social stigma and struggle were the most frequently reported feelings, and financial burden was the most common external factor associated with a worse quality of life. Conclusions This review revealed a significant research gap in this field. This lack of focused research underscores the urgent need for targeted investigations into the experiences of caregivers of children and adolescents with schizophrenia. Addressing these knowledge gaps will improve support systems and interventions tailored to the unique needs of this population, such as disease-specific advisory, mental health services, social and financial support, and self-help groups. Key messages • We identified a research gap for burden and quality of life in informal caregivers of children with schizophrenia. Education, sex and income of caregivers relate to the burden of care. • Further research is needed to develop strategies to improve support systems and interventions tailored to the unique needs of this population.

An evaluation over time: Dipsalut’s “Program for families”

Abstract Issue Dipsalut’s “Program for Families” is a parental skills and positive parenting program aimed at all fathers, mothers, and other adult caregivers of children aged 3 to 12 in the province of Girona, Spain. The Program is based on the Convention on the Rights of the Child (1989), which recommends that states promote programs that develop parenting styles that respect children’s rights to be heard and recognized. Research supports that offering parenting skills to parents contributes to the child’s well-being throughout the growth stage. Description The program began in 2018 in a pilot phase that lasted until 2019, when the first evaluation was done to compare different methodologies. After selecting a definitive one (based on the method of Adele Faber and Elaine Mazlish), in 2023, an external evaluation was done, with a follow-up of participants from previous editions. In this evaluation process, we considered the durability of the contents over time, evolutions of assistance, and comparison of the modalities of 4 and 6 sessions. A quantitative methodology has been used through a self-administered questionnaire addressed to the participants (387 responses). Results Impact of the program: 78% of parents value the program as having a positive impact on their parenting skills. Durability: there are differences in how the passage of time affects content retention. Impact of attendance: the parenting skills of those who have attended all program sessions last longer. The attendance percentage at all sessions was higher (61.4%) in the four-session modality. Lessons Although families do not remember all the tools learned, their confidence, the improvement in the family atmosphere, and the fact that they feel more skilled are maintained over time. Main messages: Families have improved their parenting skills since the program gives them more tools to manage family conflicts, to promote their children’s self-esteem and to encourage their autonomy. Key messages • With the positive parenting program, parents increase their self-confidence to manage the challenges of parenting, especially in intra-family communication and conflict management. • It is essential to promote positive parenting programs with an experiential methodology and maintained over time.

Mental health impacts of spousal caregiving intensity in the US.

In the US, spouses are a major source of informal care for older adults and, therefore, key to the US national strategy to provide long-term care to the growing population of older adults. Understanding the mental health impacts of spousal caregiving is therefore critically important. Existing studies on the topic have often been limited by methodological limitations, and most overlook the role of caregiving intensity. In this study, we assess the impact of providing different intensities of caregiving to a spouse on mental health outcomes using data from the Health and Retirement Study. We address the endogeneity of the decision to provide different caregiving intensities using an augmented inverse probability weighted (AIPW) estimator adapted to handle multivalued treatments. We check the robustness of our estimates to the AIPW's identifying assumptions by re-estimating the model using a dynamic fixed effects estimator. We find strong evidence that becoming a caregiver is associated with worsened mental health outcomes for women, while the evidence for men is weaker. When disaggregating by caregiving intensity, we find that transitions into high-intensity caregiving lead to large increases in depression symptoms and the probability of exhibiting major depression for both men and women. The overall mental health impact of transiting into caregiving is driven almost exclusively by the negative impact of high-intensity caregiving, as transitions into low- and moderate-intensity caregiving are not associated with worsening mental health in most specifications. This study provides timely insights that can inform the targeting of long-term care policies and programs aimed at supporting family caregivers of older adults.