Older spousal caregiving relationships involve support that may be affected by the health of either the caregiver or care recipient. We conducted a longitudinal analysis using pooled data from 4,632 community-dwelling spousal care recipients and caregivers aged ⩾50 from the 2002 to 2014 waves of the Health and Retirement Study. We specified logistic and negative binomial regression models using lagged predictor variables to assess the role of partner health status on spousal caregiver and care recipient health care utilization and physical functioning outcomes. Care recipients’ odds of hospitalization, odds ratio (OR): 0.83, p<.001, decreased when caregivers had more ADL difficulties. When spouses were in poorer versus better health, care recipients’ bed days decreased (4.69 vs. 2.54) while caregivers’ bed days increased (0.20 vs. 0.96). Providers should consider the dual needs of caregivers caring for care recipients and their own health care needs, in adopting a family-centered approach to management of older adult long-term care needs.
AnkudaC. K.MaustD. T.KabetoM. U.McCammonR. J.LangaK. M.LevineD. A. (2017). Association between spousal caregiver well-being and care recipient healthcare expenditures. Journal of the American Geriatrics Society, 65, 2220-2226. doi:10.1111/jgs.15039
3.
BellJ. M. (2013). Family nursing is more than family centered care. Journal of Family Nursing, 19, 411-417. doi:10.1177/1074840713512750
4.
BirdittK. S.CranfordJ. A.ManalelJ. A.AntonucciT. C. (2016). Drinking patterns among older couples: Longitudinal associations with negative marital quality. The Journals of Gerontology, Series B: Psychological Sciences & Social Sciences, 73, 655-665. doi:10.1093/geronb/gbw073
5.
ChenK. H.ChenM. L.LeeS.ChoH. Y.WengL. C. (2008). Self-management behaviours for patients with chronic obstructive pulmonary disease: A qualitative study. Journal of Advanced Nursing, 64, 595-604. doi:10.1111/j.1365-2648.2008.04821.x
CovinskyK. E.NewcomerR.FoxP.WoodJ.SandsL.DaneK.YaffeK. (2003). Patient and caregiver characteristics associated with depression in caregivers of patients with dementia. Journal of General Internal Medicine, 18, 1006-1014.
8.
DwarswaardJ.BakkerE. J. M.van StaaA.BoeijeH. R. (2016). Self-management support from the perspective of patients with a chronic condition: A thematic synthesis of qualitative studies. Health Expectations, 19, 194-208. doi:10.1111/hex.12346
9.
ErikssonI.UndenA. L.ElofssonS. (2001). Self-rated health. Comparisons between three different measures. Results from a population study. International Journal of Epidemiology, 30, 326-333. doi:10.1093/ije/30.2.326
10.
FaesM. C.ReelickM. F.Joosten-Weyn BanninghL. W.GierM.EsselinkR. A.Olde RikkertM. G. (2010). Qualitative study on the impact of falling in frail older persons and family caregivers: Foundations for an intervention to prevent falls. Aging & Mental Health, 14, 834-842. doi:10.1080/13607861003781825
11.
FauthE. B.ZaritS. H.MalmbergB.JohanssonB. (2007). Physical, cognitive, and psychosocial variables from the disablement process model predict patterns of independence and the transition into disability for the oldest-old. The Gerontologist, 47, 613-624.
12.
GallagherR.LuttikM. L.JaarsmaT. (2011). Social support and self-care in heart failure. Journal of Cardiovascular Nursing, 26, 439-445. doi:10.1097/JCN.0b013e31820984e1
13.
GallantM. P. (2003). The influence of social support on chronic illness self-management: A review and directions for research. Health Education & Behavior, 30, 170-195.
14.
GauglerJ. E.KaneR. L. (Eds.). (2015). Family caregiving is the new normal. London, England: Academic Press.
15.
GoldmanD. P.ZissimopoulosJ.LuY. (2011). Medical expenditure measures in the health and retirement study. Forum for Health Economics & Policy, 14(3), Article 4. doi:10.2202/1558-9544.1267
16.
HeislerM.ChoiH.PietteJ. D.RoslandA.LangaK. M.BrownS. (2013). Adults with cardiovascular disease who help others: A prospective study of health outcomes. Journal of Behavioral Medicine, 36, 199-211. doi:10.1007/s10865-012-9414-4
17.
HidayatB.PokhrelS. (2010). The selection of an appropriate count data model for modelling health insurance and health care demand: Case of Indonesia. International Journal of Environmental Research and Public Health, 7(1), 9-27. doi:10.3390/ijerph7010009
18.
HoffmanG. J.HaysR. D.WallaceS. P.ShapiroM. F.YakushevaO.EttnerS. L. (2017). Receipt of caregiving and fall risk in U.S. community-dwelling older adults. Medical Care, 55, 371-378.
19.
HoffmanG. J.LeeJ.Mendez-LuckC. A. (2012). Health behaviors among baby boomer informal caregivers. The Gerontologist, 52, 219-230. doi:10.1093/geront/gns003
20.
HoffmanG. J.WallaceS. P. (2018). The cost of caring: Economic vulnerability, serious emotional distress, and poor health behaviors among paid and unpaid family and friend caregivers. Research on Aging, 40(8), 791-809.
21.
Institute of Medicine. (2016). Families caring for an aging America (SchulzR.EdenJ., Eds.). Washington, DC: National Academies Press.
22.
IwarssonS.HorstmannV.CarlssonG.OswaldF.WahlH. W. (2009). Person—Environment fit predicts falls in older adults better than the consideration of environmental hazards only. Clinical Rehabilitation, 23, 558-567. doi:10.1177/0269215508101740
23.
KatzS. (1983). Assessing self-maintenance: Activities of daily living, mobility, and instrumental activities of daily living. Journal of the American Geriatrics Society, 31, 721-727.
24.
KayeH. S. (2014). Toward a model long-term services and supports system: State policy elements. The Gerontologist, 54, 754-761. doi:10.1093/geront/gnu013
25.
KershawT.EllisK. R.YoonH.SchafenackerA.KatapodiM.NorthouseL. (2015). The interdependence of advanced cancer patients’ and their family caregivers’ mental health, physical health, and self-efficacy over time. Annals of Behavioral Medicine, 49, 901-911. doi:10.1007/s12160-015-9743-y
26.
KimB.ParkS.Bishop-SaucierJ.AmorimC. (2017). Community-based services and depression from person-environment fit perspective: Focusing on functional impairments and living alone. Journal of Gerontological Social Work, 60, 270-285. doi:10.1080/01634372.2017.1310166
27.
KimY.KashyD. A.WellischD. K.SpillersR. L.KawC. K.SmithT. G. (2008). Quality of life of couples dealing with cancer: Dyadic and individual adjustment among breast and prostate cancer survivors and their spousal caregivers. Annals of Behavioral Medicine, 35, 230-238. doi:10.1007/s12160-008-9026-y
28.
LawtonM. P.BrodyE. M. (1969). Assessment of older people: Self-maintaining and instrumental activities of daily living. The Gerontologist, 9, 179-186.
29.
LawtonM. P.NahemowL. (1973). Ecology and the aging process. In EisdorferC.LawtonM. P. (Eds.), Psychology of adult development and aging (pp. 619-674). Washington, DC: American Psychological Association.
30.
LeeY. (2000). The predictive value of self assessed general, physical, and mental health on functional decline and mortality in older adults. Journal of Epidemiology & Community Health, 54, 123-129. doi:10.1136/jech.54.2.123
31.
LongJ. S.FreeseJ. (2006). Regression models for categorical dependent variables using Stata (2nd ed.). College Station, TX: Stata Press.
32.
LyonsK. S.MillerL. M.McCarthyM. J. (2016). The roles of dyadic appraisal and coping in couples with lung cancer. Journal of Family Nursing, 22, 493-514. doi:10.1177/1074840716675976
33.
MaedaU.ShenB. J.SchwarzE. R.FarrellK. A.MallonS. (2013). Self-efficacy mediates the associations of social support and depression with treatment adherence in heart failure patients. International Journal of Behavioral Medicine, 20, 88-96. doi:10.1007/s12529-011-9215-0
34.
Mendez-LuckC. A.AmorimC.AnthonyK. P. (2016). Talk versus action: Comparing the narratives and behaviors of diabetes self-management in Latino caregiving dyads. Diabetes Educator, 42, 444-451. doi:10.1177/0145721716654007
35.
MillerL. M.SullivanD. R.LyonsK. S. (2017). Dyadic perceptions of the decision process in families living with lung cancer. Oncology Nursing Forum, 44, 108-115. doi:10.1188/17.onf.108-115
36.
MoninJ. K.DoyleM.LevyB.SchulzR.FriedT.KershawT. (2016). Spousal associations between frailty and depressive symptoms: Longitudinal findings from the Cardiovascular Health Study. Journal of the American Geriatrics Society, 64, 824-830. doi:10.1111/jgs.14023
37.
MoninJ. K.LevyB.ChenB.FriedT.StahlS. T.SchulzR.. . . KershawT. (2015). Husbands’ and wives’ physical activity and depressive symptoms: Longitudinal findings from the Cardiovascular Health Study. Annals of Behavioral Medicine, 49, 704-714. doi:10.1007/s12160-015-9705-4
NicklettE. J.LiangJ. (2010). Diabetes-related support, regimen adherence, and health decline among older adults. The Journals of Gerontology, Series B: Psychological Sciences & Social Sciences, 65, 390-399. doi:10.1093/geronb/gbp050
41.
PhillipsD. R.ChengH. C.YehA. G. O.SiuO. (2010). Person—Environment (P—E) fit models and psychological well-being among older persons in Hong Kong. Environment & Behavior, 42, 221-242.
42.
PinquartM.SorensenS. (2003). Differences between caregivers and noncaregivers in psychological health and physical health: A meta-analysis. Psychology and Aging, 18, 250-267. doi:10.1037/0882-7974.18.2.250
43.
PomeroyS. H.SchererY.RunkawattV.IamsumangW.LindemannJ.ResnickB. (2011). Person–Environment fit and functioning among older adults in a long-term care setting. Geriatric Nursing, 32, 368-378.
44.
RoslandA. M.HeislerM.ChoiH. J.SilveiraM. J.PietteJ. D. (2010). Family influences on self-management among functionally independent adults with diabetes or heart failure: Do family members hinder as much as they help?Chronic Illness, 6, 22-33. doi:10.1177/1742395309354608
45.
RoslandA. M.KiefferE.SpencerM.SincoB.PalmisanoG.ValerioM.. . . HeislerM. (2015). Do pre-existing diabetes social support or depressive symptoms influence the effectiveness of a diabetes management intervention?Patient Education & Counseling, 98, 1402-1409. doi:10.1016/j.pec.2015.05.019
46.
Schulman-GreenD.JaserS. S.ParkC.WhittemoreR. (2016). A metasynthesis of factors affecting self-management of chronic illness. Journal of Advanced Nursing, 72, 1469-1489. doi:10.1111/jan.12902
47.
SiminoffL. A.Wilson-GendersonM.BakerS.Jr. (2010). Depressive symptoms in lung cancer patients and their family caregivers and the influence of family environment. Psycho-Oncology, 19, 1285-1293. doi:10.1002/pon.1696
48.
UtzR. L.BergC. A.ButnerJ. (2017). It’s a family affair: Reflections about aging and health within a family context. The Gerontologist, 57, 129-135. doi:10.1093/geront/gnw081
49.
ZwerinkM.Brusse-KeizerM.van der ValkP. D.ZielhuisG. A.MonninkhofE. M.van der PalenJ.. . . EffingT. (2014). Self management for patients with chronic obstructive pulmonary disease. Cochrane Database of Systematic Reviews, 3, Article CD002990. doi:10.1002/14651858.CD002990.pub3
Supplementary Material
Please find the following supplemental material available below.
For Open Access articles published under a Creative Commons License, all supplemental material carries the same license as the article it is associated with.
For non-Open Access articles published, all supplemental material carries a non-exclusive license, and permission requests for re-use of supplemental material or any part of supplemental material shall be sent directly to the copyright owner as specified in the copyright notice associated with the article.
