Female Noncaregivers Research Articles

The trajectory of frailty index among spousal caregivers: longitudinal evidence from China

Abstract Background Very few studies have investigated the association between providing unpaid caregiving to a spouse and the frailty of caregivers. This study aims to examine the impact of providing spousal care on frailty among the middle aged and older Chinese population. Methods Data were derived from the 2011, 2013, 2015, and 2018 waves of China Health and Retirement Longitudinal Study (CHARLS) including 4,008 participants aged 50 and above. Frailty was assessed using a composite mean score based on 41 indicators according to Rockwood frailty criteria, including self-reported health, medically diagnosed conditions, medical symptoms, functional activities assessment, Activities of Daily Living (ADLs), and Instrumental Activities of Daily Living (IADLs). A growth curve model was employed to investigate the differences in frailty among caregivers and non-caregivers. Results Compared to non-caregivers, spousal caregivers were more likely to have a higher frailty when adjusted for all covariates (Beta=0.010, SE = 0.003, p < 0.001). Furthermore, female caregivers exhibited a higher rate of change of frailty index over time (Beta=0.002, SE = 0.001, p < 0.05) compared to female non-caregivers, while no such effect was found in males. Conclusions The findings of this study reveal that providing unpaid care to a spouse is associated with an increase in the frailty index over time particularly among female caregivers. These insights underline the necessity for Chinese policymakers to develop and implement targeted interventions aimed at reducing burden on spousal caregiving, thereby preventing an increase in frailty among these caregivers. Such measures would also align with the broader objective of promoting healthy ageing. Key messages • Chinese policymakers need to develop and implement targeted interventions to reduce the burden on female spousal caregivers and prevent increased frailty. • Focusing on the frailty of female spousal caregivers is crucial for promoting healthy aging.

The effect of long-term care insurance on women’s health outcomes in China: evidence from a disability inclusion action

BackgroundLong-term care insurance (LTCI) in China provides financial and care security for persons with disabilities and includes caregivers in the paid labour workforce. However, it is unclear how the LTCI affects health outcomes in female recipients, female caregivers, and female non-recipients and female non-caregivers.MethodsUsing the China Health and Retirement Longitudinal Study data and staggered difference-in-differences method, we evaluated the effect of LTCI on health outcomes in women with different roles, including female recipients, female caregivers, and female non-recipients and female non-caregivers, and discussed the heterogeneity of the effect on women’s health outcomes.ResultsLTCI statistically significant increased self-rated health and reduced depression in women and improved the health in women with different roles by increasing self-rated health in female recipients, reducing chronic diseases in female caregivers, and reducing depression in female non-recipients and female non-caregivers. There was a more pronounced improvement in health outcomes among women in the west and northeast and women in rural village.ConclusionsAfter the implementation of LTCI, health outcomes in female recipients, female caregivers, and female non-recipients and female non-caregivers were improved. LTCI’ improvement on women’s health outcomes was heterogeneous geographically and socially. Our findings highlight the importance of delivering differentiated health interventions for women with different roles in the implementation process of LTCI and minimizing women’s health inequalities in geography and society.

Interactions Between Caregiving and Sex and the Antibody Response to COVID-19 Vaccination.

Antibody response to vaccination is a powerful paradigm for studying the effects of chronic stress on immune function. In the present study, we used this paradigm to examine the interaction between caregiving (as a type of chronic stress) and sex on the antibody response to a single dose of a COVID-19 vaccination; recent research has called for examination of sex differences on health outcomes among family caregivers. A three-way interaction between caregiving, sex, and psychological distress was also examined. COVID-19 antibody data were extracted from 165 caregivers (98 females) and 386 non-caregivers (244 females) from the UK's Understanding Society COVID-19 study. Relevant sociodemographics, health and lifestyle, and distress variables were gathered as potential covariates. In a 2 × 2 ANOVA, we found that the interaction between caregiving and sex was significant; male caregivers had a lower antibody response to the vaccine compared to female caregivers ( F (1,547), =24.82, p < .001, η2p = 0.043). Following adjustment, male caregivers had the lowest antibody response relative to all other groups. The three-way interaction model, controlling for covariates, was also significant ( R2 = 0.013, p = .049); the conditional effects for the three-way interaction revealed that male caregivers, compared to the other groups, had a lower antibody response at both low and medium levels of psychological distress. This study found evidence of a three-way interaction between caregiving, sex, and distress on antibody response. Male caregivers had poorer antibody response to a single shot of the COVID-19 vaccination than female caregivers and male and female non-caregivers, and this was evident at low and medium levels of distress. Our findings will be discussed in relation to the caregiver and sex interactions during the pandemic.

Offspring in Squeeze: Health and Sick Leave Absence among Middle-aged Informal Caregivers

This paper is motivated by the major future challenges that an ageing population would bring on a demand for an increase in the workforce and potential health outcomes on informal caregivers. Understanding the individual health and sick leave costs of caregiving is important for improving work and family policy and for ensuring that eldercare policies do not counteract other public goals. The main concern of this article has been to illuminate the relationship between full-time working caregivers and their health and sick leave absence outcomes. Using probit estimation, we found that that those combining full-time work with parental care were more prone to report poor health and had a higher probability of sick leave absence. However, the effect of giving parental care on health and sickness absence was differently distributed between male and female caregivers. For instance, male caregivers had a higher probability of reporting poor health compared to male non-caregivers. We did not find any significant differences in self-reported poor health among female caregivers and non-caregivers. In contrast, giving parental care indicated a higher probability of sick leave absence among female caregivers compared to female non-caregivers, while no significant difference was found among male workers.

Being a Parent or Having a Parent? The Perceived Employability of Men and Women Who Take Employment Leave

We explore one way family caregiving shapes inequality at work by analyzing the evaluations of men and women who took employment leave to care for a newborn or elderly parents or to recover from a personal injury. Roughly 500 undergraduate students evaluated the employability, qualifications, responsibility, and adherence to leave policies of a fictitious applicant for a professional job. Evaluators rated fathers and male elder caregivers as the most employable. This advantage was not explained by evaluators’ thinking that fathers and male elder caregivers were qualified, responsible, and policy abiding, suggesting the operation of taste discrimination. Likewise, accounting for these factors widens the gap in perceived employability between male and female noncaregivers. We discuss what these findings reveal about the family-work link as well as their methodological and policy implications.

Physical and mental health among caregivers: findings from a cross-sectional study of Open University students in Thailand.

BackgroundCaregivers constitute an important informal workforce, often undervalued, facing challenges to maintain their caring role, health and wellbeing. Little is known about caregivers in middle-income countries like Thailand. This study investigates the physical and mental health of Thai adult caregivers.MethodsThis report derives from distance-learning students working and residing throughout Thailand and recruited for a health-risk transition study in 2005 (N=87,134) from Sukhothai Thammathirat Open University. The cohort follow-up questionnaire in 2009 (N = 60,569) includes questions on caregiver status which were not available in 2005; accordingly, this study is confined to analysis of the 2009 data. We report cross-sectional associations between caregiver status and health.ResultsAmong the study participants in 2009, 27.5% reported being part-time caregivers and 6.6% reported being full-time caregivers. Compared to male non-caregivers, being a part-time or full-time male caregiver was associated with lower back pain (covariate-Adjusted Odds Ratios, AOR 1.36 and 1.67), with poor psychological health (AOR 1.16 and 1.68), but not with poor self-assessed health. Compared to female non-caregivers, being a part- or full-time female caregiver was associated with lower back pain (AOR 1.47 and 1.84), psychological distress (AOR 1.32 and 1.52), and poor self-assessed health (AOR 1.21 and 1.34).ConclusionsAdult caregivers in Thailand experienced a consistent adverse physical and mental health burden. A dose–response effect was evident, with odds ratios higher for full-time caregivers than for part-time, and non-caregivers. Our findings should raise awareness of caregivers, their unmet needs, and support required in Thailand and other similar middle-income countries.

Gender differentials on the health consequences of care-giving to people with AIDS-related illness among older informal carers in two slums in Nairobi, Kenya

Informal caregivers, most often older people, provide valuable care and support for people ill due to AIDS, especially in poor-resource settings with inadequate health care systems and limited access to antiretroviral therapy. The negative health consequences associated with care-giving may vary depending on various factors that act to mediate the extent of the effects on the caregiver. This paper investigates the association between care-giving and poor health among older carers to people living with AIDS, and examines potential within-gender differences in reporting poor health. Data from 1429 men and women aged 50 years or older living in two slum areas of Nairobi are used to compare AIDS-caregivers with other caregivers and non-caregivers based on self-reported health using the World Health Organization disability assessment (WHODAS) score and the presence of a severe health problem. Women AIDS-caregivers reported higher disability scores for mobility and the lowest scores in self-care and life activities domains while men AIDS-caregivers reported higher scores in all domains (except interpersonal interaction) compared with other caregivers and non-caregivers. Multiple regression analysis is used to examine the association of providing care with health outcomes while controlling for other confounders. Consistently across all the health measures, no significant differences were observed between female AIDS-caregivers and female non-caregivers. Male AIDS-caregivers were however significantly more likely to report disability and having a severe health problem compared with male non-caregivers. This finding highlights a gendered variation in outcome and is possibly an indication of the differences in care-giving gender-role expectations and coping strategies. This study highlights the relatively neglected role of older men as caregivers and recommends comprehensive interventions to mitigate the impact of HIV and AIDS on caregivers that embrace men as well as women.

Sleep EEG patterns and fatigue of middle-aged and older female family caregivers providing routine nighttime care for elderly persons at home.

The sleep EEGs and fatigue of 9 female family caregivers (age M=65 yr.) and 9 female noncaregivers (age M=67 yr.) were measured during two successive nights at their houses. Perceived quality of sleep was measured by the Sleep Evaluation Questionnaire. Fatigue was measured by a self-rated questionnaire, the Perceived Symptoms of Fatigue, and by critical flicker fusion (CFF) frequency. The caregivers had a significantly higher percentage of Stage 1 and a lower percentage of Stage 2 during the 2nd cycle and a higher percentage of Stages 3+4 during the 3rd cycle than those of the noncaregivers. Caregivers had significantly higher percentages of EEG waves of 7-9 Hz in the 1st cycle and 6-9 Hz in the 2nd cycle and significantly lower percentages of 2-3 Hz in the 1st cycle than those of the noncaregivers. The caregivers reported a lower quality of sleep and higher perceived fatigue symptoms and also lower CFF frequency (increased physiological fatigue) than noncaregivers. The caregivers' sleep EEGs were associated with their higher sleep needs and fatigue.