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Consequences of different types of informal caregiving for mental, self-rated, and physical health: longitudinal findings from the German Ageing Survey

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Abstract

Purpose

This study aims at extending current knowledge on consequences of informal caregiving by analyzing the influence of different caregiving types on mental, physical, and self-rated health longitudinally.

Methods

Data from wave 2008, 2011, and 2014 of the nationally representative German Ageing Survey were used, drawing on 16,412 observations aged 40–95 years in fixed effects (FE) regression analyses. Three informal caregiving types (helping around the house, looking after someone, nursing care services), which we used as explanatory variables and four health outcomes (depressive symptoms, self-rated health, pulmonary function, and morbidity), were assessed with structured interviews and written questionnaires. FE regression analysis was used for our calculations.

Results

Results revealed that none of the caregiving types was significantly associated with pulmonary function or morbidity. However, helping around the house and looking after someone were significantly associated with increased depressive symptoms. Additionally, all three types of informal caregiving were significantly associated with decreased self-rated health.

Conclusion

The results of this study indicate that the impact of care on health differs. First, it differs in dependence on the health outcome focused; only mental and self-rated health are negatively associated with care. Second, the impact depends on the caregiving type performed. This knowledge might help to develop support options which are specific to the caregiving type and the health aspects in order to reduce negative health consequences.

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References

  1. Heuchert, M., König, H. H., & Lehnert, T. (2016). Die Rolle von Präferenzen für Langzeitpflege in der sozialen Pflegeversicherung - Ergebnisse von Experteninterviews [The role of preferences in the german long-term care insurance - results from expert interviews]. Das Gesundheitswesen. https://doi.org/10.1055/s-0041-111839.

    Article  PubMed  Google Scholar 

  2. Lehnert, T., Heuchert, M. A. X., Hussain, K., & König, H.-H. (2018). Stated preferences for long-term care: A literature review. Ageing and Society. https://doi.org/10.1017/S0144686X18000314.

    Article  Google Scholar 

  3. Hajek, A., Lehnert, T., Wegener, A., Riedel-Heller, S. G., & Konig, H. H. (2017). Factors associated with preferences for long-term care settings in old age: Evidence from a population-based survey in Germany. BMC Health Services Research, 17(1), 156. https://doi.org/10.1186/s12913-017-2101-y.

    Article  PubMed  PubMed Central  Google Scholar 

  4. Lavela, S. L., & Ather, N. (2010). Psychological health in older adult spousal caregivers of older adults. Chronic Illness, 6(1), 67–80. https://doi.org/10.1177/1742395309356943.

    Article  PubMed  Google Scholar 

  5. Pinquart, M., & Sörensen, S. (2003). Differences between caregivers and noncaregivers in psychological health and physical health: A meta-analysis. Psychology and Aging, 18(2), 250–267.

    Article  PubMed  Google Scholar 

  6. Schulz, R., O’Brien, A. T., Bookwala, J., & Fleissner, K. (1995). Psychiatric and physical morbidity effects of dementia caregiving: Prevalence, correlates, and causes. The Gerontologist, 35(6), 771–791. https://doi.org/10.1093/geront/35.6.771.

    Article  CAS  PubMed  Google Scholar 

  7. Berglund, E., Lytsy, P., & Westerling, R. (2015). Health and wellbeing in informal caregivers and non-caregivers: A comparative cross-sectional study of the Swedish general population. Health and Quality of Life Outcomes, 13, 109. https://doi.org/10.1186/s12955-015-0309-2.

    Article  PubMed  PubMed Central  Google Scholar 

  8. Vitaliano, P. P., Zhang, J., & Scanlan, J. M. (2003). Is caregiving hazardous to one’s physical health? A meta-analysis. Psychological Bulletin, 129(6), 946–972. https://doi.org/10.1037/0033-2909.129.6.946.

    Article  PubMed  Google Scholar 

  9. Allen, A. P., Curran, E. A., Duggan, A., Cryan, J. F., Chorcorain, A. N., Dinan, T. G., et al. (2016). A systematic review of the psychobiological burden of informal caregiving for patients with dementia: Focus on cognitive and biological markers of chronic stress. Neuroscience and Biobehavioral Reviews, 73, 123–164. https://doi.org/10.1016/j.neubiorev.2016.12.006.

    Article  CAS  PubMed  Google Scholar 

  10. Wimo, A., & Nordberg, G. (2007). Validity and reliability of assessments of time: Comparisons of direct observations and estimates of time by the use of the resource utilization in dementia (RUD)-instrument. Archives of Gerontology and Geriatrics, 44(1), 71–81. https://doi.org/10.1016/j.archger.2006.03.001.

    Article  PubMed  Google Scholar 

  11. Garand, L., Dew, M. A., Eazor, L. R., DeKosky, S. T., & Reynolds, C. F., III (2005). Caregiving burden and psychiatric morbidity in spouses of persons with mild cognitive impairment. International Journal of Geriatric Psychiatry, 20(6), 512–522. https://doi.org/10.1002/gps.1318.

    Article  PubMed  PubMed Central  Google Scholar 

  12. Hirst, M. A. (2005). Carer distress: A prospective, population-based study. Social Science & Medicine, 61(3), 697–708. https://doi.org/10.1016/j.socscimed.2005.01.001.

    Article  Google Scholar 

  13. Coe, N. B., & van Houtven, C. H. (2009). Caring for mom and neglecting yourself? The health effects of caring for an elderly parent. Health Economics, 18(9), 991–1010. https://doi.org/10.1002/hec.1512.

    Article  PubMed  Google Scholar 

  14. Heger, D. (2016). The mental health of children providing care to their elderly parent. Health Economics. https://doi.org/10.1002/hec.3457.

    Article  PubMed  Google Scholar 

  15. Kaschowitz, J., & Brandt, M. (2017). Health effects of informal caregiving across Europe: A longitudinal approach. Social Science & Medicine, 173, 72–80. https://doi.org/10.1016/j.socscimed.2016.11.036.

    Article  Google Scholar 

  16. Hiel, L., Beenackers, M. A., Renders, C. M., Robroek, S. J., Burdorf, A., & Croezen, S. (2015). Providing personal informal care to older European adults: Should we care about the caregivers’ health? Preventive Medicine, 70, 64–68. https://doi.org/10.1016/j.ypmed.2014.10.028.

    Article  PubMed  Google Scholar 

  17. Kiecolt-Glaser, J. K., Dura, J. R., Speicher, C. E., Trask, O. J., & Glaser, R. (1991). Spousal caregivers of dementia victims: Longitudinal changes in immunity and health. Psychosomatic Medicine, 53(4), 345–362. https://doi.org/10.1097/00006842-199107000-00001.

    Article  CAS  PubMed  Google Scholar 

  18. Miyawaki, A., Tomio, J., Kobayashi, Y., Takahashi, H., Noguchi, H., & Tamiya, N. (2017). Impact of long-hours family caregiving on non-fatal coronary heart disease risk in middle-aged people: Results from a longitudinal nationwide survey in Japan. Geriatrics & Gerontology International, 17(11), 2109–2115. https://doi.org/10.1111/ggi.13061.

    Article  Google Scholar 

  19. Ory, M. G., Hoffman, R. R., III, Yee, J. L., Tennstedt, S., & Schulz, R. (1999). Prevalence and impact of caregiving: A detailed comparison between dementia and nondementia caregivers. The Gerontologist, 39(2), 177–185. https://doi.org/10.1093/geront/39.2.177.

    Article  CAS  PubMed  Google Scholar 

  20. Salive, M. E. (2013). Multimorbidity in older adults. Epidemiologic Reviews, 35(1), 75–83. https://doi.org/10.1093/epirev/mxs009.

    Article  PubMed  Google Scholar 

  21. Klaus, D., Engstler, H., Mahne, K., Wolff, J. K., Simonson, J., Wurm, S., et al. (2017). Cohort profile: The German ageing survey (DEAS). International Journal of Epidemiology, 46(4), 1105–1105g. https://doi.org/10.1093/ije/dyw326.

    Article  PubMed  PubMed Central  Google Scholar 

  22. Klaus, D., & Engstler, H. (2017). Daten und Methoden des Deutschen Alterssurveys [Data and methods of the German Ageing Survey]. In K. Mahne, J. K. Wolff, J. Simonson & C. Tesch-Römer (Eds.), Altern im Wandel: Zwei Jahrzehnte Deutscher Alterssurvey (DEAS) [Ageing in social change: Two decades of the German Ageing Survey (DEAS)] (pp. 29–45). Wiesbaden: Springer.

    Google Scholar 

  23. German Research Foundation. (2010–2017). Informationen für Geistes- und Sozialwissenschaftler/innen [Information for humanities and social scientists]. Accessed May 9, 2017, from http://www.dfg.de/foerderung/faq/geistes_sozialwissenschaften/.

  24. Wurm, S., Tesch-Romer, C., & Tomasik, M. J. (2007). Longitudinal findings on aging-related cognitions, control beliefs, and health in later life. The Journals of Gerontology Series B: Psychological Sciences and Social Sciences, 62(3), P156–P164.

    Article  Google Scholar 

  25. Quail, J. M., Lix, L. M., Osman, B. A., & Teare, G. F. (2011). Comparing comorbidity measures for predicting mortality and hospitalization in three population-based cohorts. BMC Health Services Research, 11(1), 146. https://doi.org/10.1186/1472-6963-11-146.

    Article  PubMed  PubMed Central  Google Scholar 

  26. Nunn, A. J., & Gregg, I. (1989). New regression equations for predicting peak expiratory flow in adults. The BMJ, 298(6680), 1068–1070. https://doi.org/10.1136/bmj.298.6680.1068.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  27. Roberts, M. H., & Mapel, D. W. (2012). Limited lung function: Impact of reduced peak expiratory flow on health status, health-care utilization, and expected survival in older adults. American Journal of Epidemiology, 176(2), 127–134. https://doi.org/10.1093/aje/kwr503.

    Article  PubMed  PubMed Central  Google Scholar 

  28. Hautzinger, M., & Bailer, M. (1993). ADS - Allgemeine Depressions Skala [ADS - General Depression Scale]. Weinheim: Beltz.

    Google Scholar 

  29. Fayers, P. M., & Sprangers, M. A. G. (2002). Understanding self-rated health. The Lancet, 359(9302), 187–188. https://doi.org/10.1016/S0140-6736(02)07466-4.

    Article  Google Scholar 

  30. Zhu, C. W., Leibman, C., McLaughlin, T., Zbrozek, A. S., Scarmeas, N., Albert, M., et al. (2008). Patient dependence and longitudinal changes in costs of care in Alzheimer’s disease. Dementia and Geriatric Cognitive Disorders, 26(5), 416–423. https://doi.org/10.1159/000164797.

    Article  PubMed  PubMed Central  Google Scholar 

  31. Bullinger, M., & Kirchberger, I. (1998). Der SF-36-Fragebogen zum Gesundheitszustand. Handanweisung [SF-36-Questionnaire on health status. Manual]. Göttingen: Hogrefe.

    Google Scholar 

  32. Morfeld, M., Kirchberger, I., & Bullinger, M. (2011). SF-36 Fragebogen zum Gesundheitszustand: Deutsche Version des Short Form-36 Health Survey [SF-36-Questionnaire on health status: German version of the Short Form-36 Health Survey]. Göttingen: Hogrefe.

    Google Scholar 

  33. Cameron, A. C., & Trivedi, P. K. (2009). Microeconometrics using stata (Vol. 5). College Station: Stata Press.

    Google Scholar 

  34. Brüderl, J., & Ludwig, V. (2015). Fixed-effects panel regression. In H. Best & C. Wolf (Eds.), The Sage handbook of regression analysis and causal inference (pp. 327–357). London: Sage.

    Google Scholar 

  35. Schaffer, M., & Stillman, S. (2016). XTOVERID: Stata module to calculate tests of overidentifying restrictions after xtreg, xtivreg, xtivreg2, xthtaylor.

  36. Gangl, M. (2010). Causal inference in sociological research. Annual Review of Sociology, 36, 21–47.

    Article  Google Scholar 

  37. Cossette, S., & Lévesque, L. (1993). Caregiving tasks as predictors of mental health of wife caregivers of men with chronic obstructive pulmonary disease. Research in Nursing & Health, 16(4), 251–263. https://doi.org/10.1002/nur.4770160404.

    Article  CAS  Google Scholar 

  38. Schüz, B., Wurm, S., Schöllgen, I., & Tesch-Römer, C. (2011). What do people include when they self-rate their health? Differential associations according to health status in community-dwelling older adults. Quality of Life Research, 20(10), 1573–1580. https://doi.org/10.1007/s11136-011-9909-4.

    Article  PubMed  Google Scholar 

  39. Ekwall, A. K., Sivberg, B., & Hallberg, I. R. (2005). Loneliness as a predictor of quality of life among older caregivers. Journal of Advanced Nursing, 49(1), 23–32. https://doi.org/10.1111/j.1365-2648.2004.03260.x.

    Article  PubMed  Google Scholar 

  40. van Campen, C., de Boer, A. H., & Iedema, J. (2013). Are informal caregivers less happy than noncaregivers? Happiness and the intensity of caregiving in combination with paid and voluntary work. Scandinavian Journal of Caring Sciences, 27(1), 44–50. https://doi.org/10.1111/j.1471-6712.2012.00998.x.

    Article  PubMed  Google Scholar 

  41. Neller, K. (2005). Kooperation und Verweigerung: Eine Non-Response-Studie [Cooperation and refusal: A non-response study]. ZUMA Nachrichten, 29(57), 9–36.

    Google Scholar 

  42. Brüderl, J. (2010). Kausalanalyse mit Paneldaten [Causal analysis with panel data]. In C. Wolf & H. Best (Eds.), Handbuch der sozialwissenschaftlichen Datenanalyse [Social science data analysis handbook] (pp. 963–994). Wiesbaden: VS Verlag für Sozialwissenschaften.

    Chapter  Google Scholar 

  43. Charlson, M. E., Pompei, P., Ales, K. L., & MacKenzie, C. R. (1987). A new method of classifying prognostic comorbidity in longitudinal studies: development and validation. Journal of Chronic Diseases. https://doi.org/10.1016/0021-9681(87)90171-8.

    Article  PubMed  Google Scholar 

  44. Reichert, M. (2016). Vereinbarkeit von Erwerbstätigkeit und Pflege – (k)ein Thema für Unternehmen? In G. Naegele, E. Olbermann & A. Kuhlmann (Eds.), Teilhabe im Alter gestalten: Aktuelle Themen der Sozialen Gerontologie (pp. 251–264). Wiesbaden: Springer.

    Chapter  Google Scholar 

  45. Höfner, R., & Meißner, T. (2008). Pflegerische Betreuungsformen [Types of nursing care]. In R. Höfner & T. Meißner (Eds.), Von Fall zu Fall — Ambulante Pflege im Recht: Rechtsfragen in der ambulanten Pflege von A-Z [As the case arises - Laws on Ambulatory Care: Legal questions about ambulatory care from A-Z] (pp. 195–199). Heidelberg: Springer.

    Google Scholar 

  46. Chien, L. Y., Chu, H., Guo, J. L., Liao, Y. M., Chang, L. I., Chen, C. H., et al. (2011). Caregiver support groups in patients with dementia: A meta-analysis. International Journal of Geriatric Psychiatry, 26(10), 1089–1098. https://doi.org/10.1002/gps.2660.

    Article  PubMed  Google Scholar 

  47. Ashworth, M., & Baker, A. H. (2000). ‘Time and space’: carers’ views about respite care. Health & Social Care in the Community, 8(1), 50–56. https://doi.org/10.1046/j.1365-2524.2000.00221.x.

    Article  Google Scholar 

  48. van Exel, N. J. A., de Graaf, G., & Brouwer, W. B. F. (2007). Care for a break? An investigation of informal caregivers’ attitudes toward respite care using Q-methodology. Health Policy, 83(2–3), 332–342. https://doi.org/10.1016/j.healthpol.2007.02.002.

    Article  PubMed  Google Scholar 

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Correspondence to Larissa Zwar.

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Informed consent was obtained from all individual participants included in this study.

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Zwar, L., König, HH. & Hajek, A. Consequences of different types of informal caregiving for mental, self-rated, and physical health: longitudinal findings from the German Ageing Survey. Qual Life Res 27, 2667–2679 (2018). https://doi.org/10.1007/s11136-018-1926-0

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