The effects of social factors on adult children caring for older parents

Abstract

This study was designed to test a model of the effects of selected social factors and caregiving tasks on caregiving outcomes for 100 adult children caring for frail, elderly parents or in-laws. Results are analyzed using path analysis. Social factors included relationship quality, duty, caregiver support upset, and caregiving satisfaction. Caregiving outcomes included caregiver perceived burden, caregiver mental health, and likelihood of nursing home placement. Care-receiver dementia and caregiver income were added during model testing.Both caregiver perceived burden and care-receiver dementia increased likelihood of nursing home placement while duty decreased it. Relationship quality, caregiver support upset, and caregiving tasks indirectly affected likelihood of nursing home placement through their effects on caregiver perceived burden. Relationship quality reduced perceived burden, while caregiver support upset and caregiving tasks increased it. Relationship quality also indirectly reduced the likelihood of nursing home placement by increasing duty. Higher income reduced perceived burden by decreasing caregiving tasks. Caregiver mental health, as measured by the Mental Health Inventory, had no effect on likelihood of nursing home placement when caregiver perceived burden was taken into account.Caregiving satisfaction was shown to be redundant and was dropped from the model. Relationship quality appeared to measure the same underlying construct and had stronger associations with the other variables.That caring for a parent can be burdensome is evidenced by the relatively low scores on the Mental Health Inventory and by the strong association between caregiver perceived burden and mental health.Subjects were also asked whether they were having problems with relatives over caregiving. Forty percent reported experiencing conflict or resentment toward another family member; in the majority of the cases (65%) the relative was a brother or sister. The most frequently reported source of the problem was lack of sufficient caregiving assistance. Caregivers reporting conflict or resentment evidenced significantly poorer mental health, poorer relationship quality with their care-receivers, higher perceived burden, and were more likely to be considering nursing home placement for their care-receivers than were those not reporting conflict even when controlling for caregiving tasks. Those having conflict with relatives were also much more likely to prefer alternatives to family care for themselves should they become disabled.This study shows that, with the exception of duty, social factors in caregiving impact likelihood of nursing home placement through their effects on caregiver perceived burden. Family conflict also appears to have an important impact on caregiving outcomes.