Carer Characteristics and Health, Wellbeing and Employment Outcomes of Older Australian Baby Boomers

Factors associated with being an older rather than younger unpaid carer of adults with a chronic health condition: Results from a population-based cross-sectional survey in South Australia

OBJECTIVE

To examine sociodemographic characteristics and caring experiences associated with being an older rather than younger carer of an adult with a chronic health condition.

METHODS

The population-based cross-sectional South Australian Health Omnibus survey was administered in 2016. Multiple logistic regression was used to identify sociodemographic characteristics and caring experiences associated with being an older (≥65 years) versus younger (<65 years) carer of one or more adult(s) with a chronic health condition.

RESULTS

Of 988 survey respondents who self-identified as carers, 198(20%) were 65 years or over. Characteristics associated with being an older carer included having a partner, having poor physical health, being born outside Australia, have no formal qualification, living in a household of 1-2 people, have an annual household income ≤$60,000, and owning one's home. Carer experiences associated with older carer status included providing ≥40 h of care per week, perceived control over caring, and caring for someone with a neurological condition, whereas caring for someone with a mental illness, reporting poor mental health of their own, and providing personal care were inversely associated.

DISCUSSION

Interventions directed at older carers should consider the increased likelihood that they may be investing large amounts of time in caring for someone with a neurological condition, and be culturally and linguistically diverse.

Understanding the use of Flexible Work Arrangements Among Older New Zealand Caregivers

Flexibility in the workplace has been suggested to promote prolonged employment among older workers. This study focuses on the question of whether the use of flexible work arrangements (FWAs) differs between caregivers and non-caregivers and how potential differences can be explained. Participants were 296 carers and 1611 non-carers (aged 55-70 years) who completed the 2018 Health, Work and Retirement survey and were in paid employment. Hierarchical regression was used to investigate caregiving as an independent predictor of use of FWAs after controlling for demographic and work-related variables. Results show that caregivers on average used more FWAs than non-caregivers, including flexible work hours, flexible schedules and time off. Differences in FWAs use between caregivers and non-caregivers cannot be explained by differences in socio demographic and work characteristics. The use of FWAs warrants attention in discussions about prolonged employment and reconciliation of care and work among older adults.

Grandparenting, health, and well-being: a systematic literature review

Whether grandparenting is associated with improved health or well-being among older adults is a salient question in present-day aging societies. This systematic review compiles studies that consider the health or well-being outcomes of grandparenting, concerning (1) custodial grandparent families, where grandparents are raising grandchildren without parental presence; (2) three-generation households, where grandparents are living with adult children and grandchildren; and (3) non-coresiding grandparents, who are involved in the lives of their grandchildren. Review was based on literature searches conducted in September 2019 via Web of Science, PubMed, PsycINFO, and Ebsco. We screened 3868 abstracts across four databases, and by following the PRISMA guidelines, we identified 92 relevant articles (117 studies) that were published between 1978 and 2019. In 68% of cases, custodial grandparenting was associated with decreased health or well-being of grandparents. The few studies considering the health or well-being of grandparents living in three-generation households provided mixed findings (39% positive; 39% negative). Finally, in 69% of cases, involvement of non-coresiding grandparents was associated with improved grandparental outcomes; however, there was only limited support for the prediction that involved grandparenting being causally associated with grandparental health or well-being. Despite this, after different robustness checks (counting all nonsignificant results, taking into account the representativeness of the data and causal methodology), the main finding remains the same: the most negative results are found among custodial grandparents and three-generation households and most positive results among non-coresiding grandparents.

Care to sleep? Daily caregiving and sleep problems in an ageing European population

Informal caregiving is increasingly common in our ageing population and entering the role of informal caregiver generally marks an important life course transition. The adjustment to such transitions is considered important for the onset of sleep problems. Therefore, this study aims to establish how becoming a daily caregiver is associated with sleep problems, if changes in caregiving status are related to changes in sleep problems and how intersections with other social roles affect this association. Based on data from waves 1, 2, 4, 5 and 6 of the Survey of Health Ageing and Retirement in Europe (N=32,791), the analyses show how both current and former daily caregivers are more likely to report sleep problems than those not giving daily care. When change in sleep problems is assessed a transition to daily caregiving appears to be accompanied by increased sleep problems. Moreover, even individuals who ceased giving care experience more sleep problems than those who never gave care on a daily basis, which suggests a legacy of caregiving. No differences are found regarding employment status, but women who start giving care are more likely to experience sleep problems than their male counterparts.

Caring hours and possible need for employment support among primary carers for adults with mental illness: Results from an Australian household survey

Intensive unpaid caring is associated with greater likelihood of not being employed, but impacts for mental health carers specifically remain unknown. This study aimed to: (a) examine the association between caring intensity and not being employed for primary mental health carers, (b) ascertain whether this relationship differs from that for other disability carers, (c) enumerate Australian primary mental health carers with a possible need for employment support and (d) describe these carers' unmet support needs and barriers to employment. Co-resident, working age primary mental health (n = 137) and other disability carers (n = 821) were identified in the Survey of Disability, Ageing and Carers (collected July-December 2015). Multiple logistic regression analyses examined associations between levels of caring intensity (1-9, 10-19, 20-39, 40+ hr/week) and not being employed. A 'possible need for employment support' indicator was derived from information about current employment status, caring hours, past impact of caring on employment and desire for more work or workplace accommodations. After controlling for demographic and caring role factors, mental health carers providing 40+ hr of care weekly had greater odds of not being employed compared to carers providing <10 hr (AOR 13.38, 95% CI: 2.17-82.39). For other disability carers, the odds of not being employed were also higher among those providing 20-39 hr of care (AOR 3.21, 95% CI: 2.18-4.73). An estimated 54.1% (95% CI: 43.1-64.8) of carers had a possible need for employment support, with the proportion increasing as level of caring intensity increased. Of carers who were not employed, 42.2% (95% CI: 30.3-55.0) reported a desire to work, and the main reported barrier was no alternative care arrangements or disruption to the person supported. Findings suggest that improving employment participation for mental health carers requires a greater balance between unpaid care and access to formal services for people with mental illness.

Health status of people who have provided informal care or support to an adult with chronic disease in the last 5 years: results from a population-based cross-sectional survey in South Australia

Objective The aim of the present study was to compare the health status of South Australians with recent experience of caring for an adult with chronic disease with non-carers drawn from the same population. Methods Data were collected via the South Australian Health Omnibus, an annual population-based, cross-sectional survey. Respondents were asked whether they had provided care or support in the last 5 years to someone with cancer, heart disease, respiratory disease, mental illness, neurological disease or dementia. Health status was measured using the Short Form-12 version 1 (SF-12) physical and mental component scale summary scores (PCS and MCS respectively), with poor health status defined as ≥0.5 standard deviation below the normative mean. Logistic regression explored characteristics associated with poor health status. Results Of 3033 respondents analysed, 987 (32.5%) reported caring experience. Poor PCS and MCS were associated with carer status, lower-than-degree-level education, employment status other than employed and annual household income less than A$60000. Being Australian born was a protective factor for PCS, whereas factors protective for MCS were being married or in a de facto relationship and age ≥65 years. Conclusions Providing care or support in the last 5 years is independently associated with poorer health status, but not with the magnitude found in studies of current carers. Future research should explore health status recovery after completion of the caring role, and investigate whether relationships between health and socioeconomic status differ for carers versus non-carers. What is known about the topic? Population-based survey studies in Australia and overseas have consistently found that informal carers have worse health status than non-carers. What does this paper add? Including recent as well as current carers in a population-based sample was associated with less effect on health status compared with studies focused on current carers only. This finding is consistent with the possibility that health status recovers during the 5 years after caring. What are the implications for practitioners? Support for Australian carers is warranted to ensure their continuing contributions to society and return to productivity after their caring role is completed.

An Analysis of Factors Associated With Older Workers' Employment Participation and Preferences in Australia

Australian government and organizational age-management policies continue to target employment participation among older workers in light of an aging population. Typically, efforts to reduce early retirement among older workers have focused on well-established factors, including the promotion of worker health, reducing injury, supporting caregivers, reducing age discrimination and enhancing skill development. This research extends on the former approach by examining established factors along with important emerging factors, namely work-life conflict, work centrality and person-job fit. Additionally, the research analyses the effects of gender and financial pressure on older workers’ employment participation and preferences. Logistic regression analysis of cross-sectional survey data involving 1,504 Australians aged 45–65, revealed that two established factors, physical health and caregiving, and all three emerging factors were associated with employment participation and preferences to be employed. However, important variations on the basis of gender and financial pressure were also identified. Caregiving was more strongly associated with the preference to remain employed for men (OR = 0.2.54, p < 0.01) than women (OR = 1.03, ns) and person-job fit was more strongly associated with the preference to remain employed for women (OR = 1.64, p < 0.001) than men (OR = 0.91, ns). Work-life conflict was more strongly associated with the preference to leave employment for those reporting limited financial pressure (OR = 0.60, p < 0.001) compared to those in poorer financial circumstances (OR = 0.87, ns). These findings suggest that organizational age management policies should focus on both established and emerging factors, particularly the provision of flexible working conditions and improving the psychosocial work environment. However, such efforts should carefully consider the different needs of men and women, and those under varying levels of financial stress. With respect to government policy to promote employment participation, the findings support a stronger focus on improving physical and psychosocial work conditions rather than increasing the pension eligibility age. This may require further collaboration between government and employers.