The implications of today's family structures for support giving to older parents

Social networks and health behaviors during the COVID-19 pandemic: a qualitative study among older adults in the Netherlands

Aim

Social networks, all social relationships that people have, may influence people's health behavior and well-being, which was evaluated in this qualitative study in older adults. Furthermore, we evaluated people's needs for strengthening social networks.

Subject and methods

For this qualitative study, semi-structured interviews were conducted between May and July 2021 among 24 adults aged 60 years and older.

Results

Respondents provided information on social network structure (number and types of relations) and function (social support). They received informational support from friends, emotional support from their partner/spouse, and all types of support (including practical support) from family. Respondents stated that their health behavior was mainly influenced by a partner/spouse. Family and friends were mostly for socializing. To strengthen networks, in-person bilateral or small group interactions were preferred.

Conclusion

Family and friends were important social supporters and positively influenced health behaviors. This study emphasizes the importance of social networks in health promotion.

The impact of different care dependencies on people's willingness to provide informal care: a discrete choice experiment in Germany

BACKGROUND

Informal care provided by family members, friends, or neighbors is a major pillar in the German long-term care system. As the number of care-dependent older adults grow, ensuring their future care still relies on the willingness of family members, friends, or neighbors to assume the role of an informal caregiver. This study aimed to investigate the impact on people's willingness to provide informal care to a close relative with predominately cognitive compared to physical impairments.

METHODS

An online survey was distributed to the general population in Germany, which resulted in 260 participants. A discrete choice experiment was created to elicit and quantify people's preferences. A conditional logit model was used to investigate preferences and marginal willingness-to-accept values were estimated for one hour of informal caregiving.

RESULTS

Increased care time per day (hours) and expected duration of caregiving were negatively valued by the participants and reduced willingness to care. Descriptions of the two care dependencies had a significant impact on participants' decisions. Having to provide care to a close relative with cognitive impairments was slightly preferred over caring for a relative with physical impairments.

CONCLUSIONS

Our study results show the impact of different factors on the willingness to provide informal care to a close relative. How far the preference weights as well as the high willingness-to-accept values for an hour of caregiving can be explained by the sociodemographic structure of our cohort needs to be investigated by further research. Participants slightly preferred caring for a close relative with cognitive impairments, which might be explained by fear or discomfort with providing personal care to a relative with physical impairments or feelings of sympathy and pity towards people with dementia. Future qualitative research designs can help understand these motivations.

Informal Care and Subjective Well-Being among Older Adults in Selected European Countries

A person’s health status is one of the strongest determinants of well-being. The negative impact of poor health on subjective well-being may be moderated by providing care to individuals in need. In this paper, we investigate the relationships between receiving informal care and the amount of care received and subjective well-being among people aged 65 or older in selected European countries. Our analysis of data from the 6th wave of the Survey of Health, Ageing and Retirement in Europe (SHARE) showed that receiving regular informal care was associated with higher subjective well-being among older people in Northern European countries, and with lower subjective well-being among older males in Southern European countries. Moreover, we found that the perception of the amount of help received affected the subjective well-being of older people, as those who reported that the support they received was either insufficient or met their needs had lower subjective well-being than those who were not in need of care. Our results also showed that receiving formal care was negatively related with subjective well-being among older adults in Northern Europe and Central and Eastern Europe. In the context of population ageing and the growing need for care, social policies that support both sides of the caregiving relationship could enhance subjective quality of life.

Patterns of help and care by adult only children and children with siblings

Adult children with siblings can share caring for older parents but adult only children face this responsibility alone. Given increased longevity and reliance on informal care-giving, as well as an increase in one-child families, there is a need to investigate only children's care-giving further. Using data from three large-scale British birth cohorts, this paper investigates patterns of parent-care, care intensity and wellbeing at ages 38 and 42 (N = 17,255, N = 16,703; born 1970), 50 and 55 (N = 12,775, N = 11,339; born 1958) and 63 (N = 2,364; born 1946), how sibling composition intersects with gender in relation to care-giving and whether different care-giving patterns are associated with wellbeing. Only children are more likely to provide parent-care and the pattern is consistent with an interpretation that differences by sibling status might increase with age. Provision is gendered, and the sibling group composition matters for involvement. Although care-giving is related to wellbeing, we found no evidence that this differs between only children and those with siblings. The literature on only children has hitherto focused largely on childhood, suggesting that on some outcomes they benefit from a concentration of parental resources. Our results suggest that in middle adulthood parental care needs may instead be concentrated for the only child without the ‘resource’ of siblings. This indicates a need to develop further our understanding of this growing demographic subgroup.

Gender and family structures affecting intergenerational support from adult children to older parents: A cross-national study in a developing country

In Latin America, informal support from adult children to their older parents ("upward support") is crucial with an aging population and insufficient coverage of social protection systems. This article examines variables associated with upward support, distinguishing by gender of parents and their children. The research design is quantitative, correlational, and cross-sectional. It is based on primary survey data collected by the authors for the study. The authors hypothesized that upward support depends on children's opportunities to provide support and on the needs of parents. The results show that upward support depends more on children's opportunities than on parents' needs, although upward support is higher for parents with poorer health. Daughters are more supportive than sons, but sibling characteristics do not moderate associations between children's gender and receipt of support. Cohabiting with the parent, receiving support from the parent, and having a good relationship were also associated with greater upward support. Therefore, policies should consider the gender of adult children when allocating resources to older people.

Applying the Dual Filial Piety Model in the United States: A Comparison of Filial Piety Between Asian Americans and Caucasian Americans

The definition and measurement of filial piety in existing research primarily focuses on the narrow conceptualizations of Asian filial piety, which would inflate cultural differences and undermine cultural universals in how people approach caring for their elderly parents. Employing the Dual Filial Piety Model (DFPM), this study aimed to examine the relationship between filial piety and attitude toward caring for elderly parents beyond the Asian context. In our study (N = 276), we found that reciprocal filial piety (RFP) does not differ across cultures while authoritarian filial piety (AFP) does. We also found that collectivism, rather than ethnicity, predicted RFP and AFP, which in turn predicted positive attitude toward caring for elderly parents. Our work demonstrates the cross-cultural applicability of the DFPM and highlights the universal and culture-specific aspects of filial piety.

Non-Financial Support Provided to Parents in Stepfamilies: Empirical Examination of Europeans 50

The aging of the population, coupled with increasing divorce and remarriage rates, are changing the structure of potential non-financial support for older parents. The purpose of this study was to examine support provided to parents aged 50+ in stepfamilies and to determine if the difference existed between help provided by natural children and stepchildren. The primary objective was to investigate whether blood ties were a significant determinant of the support if the quality of the relationship between the parent and a natural child or a stepchild was taken into account. The secondary objective was to answer the question to what extent the reciprocal exchange motive of support was observed in stepfamilies. The probability of non-financial support from children and stepchildren was estimated based on the sixth wave of the SHARE (Survey on Health, Ageing, and Retirement in Europe) database for European countries. Children in stepfamilies provided less non-financial help to parents than those in intact families. Stepchildren were less likely to be in stepparents' social networks, and stepparents provided less help with childcare for grandchildren than they did to their biological children. Relationship closeness and looking after grandchildren increased the probability of non-financial support to older parents, regardless of whether the donor was a natural child or a stepchild.

Adult children's gender, number and proximity and older parents’ moves to institutions: evidence from Sweden

Older people's ability to thrive independently of their adult children is an important feature of a universalistic welfare system. However, population ageing puts this notion under stress. In separate multinomial logistic regression models for older men and women, we examined whether adult children's gender, number and proximity were associated with older parents’ relocations into residential care facilities, and whether the effects of these children's characteristics on older parents’ institutionalisation vary by parents’ severe health problems, operationalised as closeness to death – specifically, dying within the two-year observation period. Analyses were based on the Swedish register data between 2014 and 2016 (N = 696,007 person-years). Older parents with at least one co-resident child were less likely to move or become institutionalised than those without a co-resident child. We did not find a relationship between older adults’ institutionalisation and the closest child's gender. The negative effect of having a non-resident child living nearby on the likelihood of becoming institutionalised was more pronounced for mothers than fathers. Having a child nearby decreased the likelihood of moving to an institution more for mothers who had severe health problems than for those in better health. We found no evidence of a relationship between number of children and likelihood of institutionalisation.

Factors influencing healthy menopause among immigrant women: a scoping review

Background

Many factors influence the menopausal transition and the complexity of this transition increases with the addition of immigration transition. This review aims to identify the factors that influence the menopausal transition for immigrant women based on ecosocial theory.

Methods

A scoping review of English publications was conducted according to PRISMA guidelines using CINAHL, AgeLine, MEDLINE, PsycINFO, ERIC, Nursing and Allied Health Database, PsycARTICLES, Sociology Database, and Education Research Complete. Thirty-seven papers were included for this review.

Results

The factors which influence the menopausal transition for immigrant women were grouped into three categories: (a) personal factors, (b) familial factors, and (c) community and societal factors. Personal factors include income and employment, physical and psychological health, perceptions of menopause, and acculturation. Familial factors include partner support, relationships with children, and balancing family, work, and personal duties. Community and societal factors encompassed social network, social support, healthcare services, traditional cultural expectations, and discrimination in host countries.

Conclusions

Interventions addressing the menopausal transition for immigrant women should be designed considering different psychosocial factors and actively work to address systemic barriers that negatively impact their transition.

Supplementary Information

The online version contains supplementary material available at 10.1186/s12905-021-01327-z.

Support Exchanges Among Very Old Parents and Their Children: Findings From the Boston Aging Together Study

BACKGROUND AND OBJECTIVES

Very old parents and their "old" children are a growing group in industrialized countries worldwide. Care needs of very old parents can be substantial, while children may also face their own age-related issues. Continued mutual support represents an important pathway to addressing emerging care needs. This study aimed to identify patterns of support exchanges occurring in very old parent-child dyads, and to ascertain associated individual and relationship factors.

RESEARCH DESIGN AND METHODS

Participants were 114 very old parents (age ≥ 90) and their children (age ≥ 65) from the Boston Aging Together Study. Data were collected using comprehensive, semistructured in-person interviews with both dyad members, including standardized assessments of support exchanges, relationship quality, health, and perceptions of family norms. Actor-Partner Interdependence Models (APIM) were used to predict upward and downward support reported by children and parents.

RESULTS

Both dyad members not only reported substantial upward support (child to parent) in all domains but also notable amounts of downward (parent to child) in the domains of emotional support, listening, and socializing. Findings showed significant associations of parent functional impairment, parent and child relationship quality, and child perceptions of family obligation with upward support, and of relationship quality with downward support.

DISCUSSION AND IMPLICATIONS

Continued support exchanges among very old parents and their children indicated that intergenerational theories still hold up in very late life relationships. Healthcare professionals should be aware that attention to relationship quality and family norms might be vital to ensure that support needs are met.

Childlessness, geographical proximity and non-family support in 12 European countries

The number of relatives and geographical proximity between them affects informal support provided to older persons. In this study, we investigate whether (a) childless persons and parents living remotely from their adult children experience similar shortages in informal support, and (b) whether neighbours, friends and other non-family helpers compensate for these shortages. On the basis of Survey on Health, Ageing and Retirement in Europe (SHARE) data for 12 European countries, we estimate the probability and amount of informal non-financial support received by persons aged 65 and over who remain childless or live at different distances to their children. The contribution of non-family individuals is rather complementary to the help from family. Parents residing in the proximity of their children rely almost exclusively on family; as the geographical distance between adult children and older parents increases, the probability and amount of non-family support increase as well. But childless individuals differ from parents of remotely living children: the former rely on smaller support networks and resort more often to other relatives than the latter. Non-family individuals compensate for the scarcity of informal support only in the case of parents of distant children, but not in the case of childless individuals.

Willingness and preparedness to provide care: interviews with individuals of different ages and with different caregiving experiences

Background

At present, the provision of informal care to older relatives is an essential pillar of the long-term care system in Germany. However, the impact of demographic and social changes on informal caregiving remains unclear.

Methods

Thirty-three semi-structured interviews were conducted with care consultants, informal caregivers and people without any caregiving experience to explore if people are willing to provide older adult care and how prepared these are with regard to the possibility of becoming care dependent themselves.

Results

In total, three main categories (willingness to provide care, willingness to receive care and information as preparation) with several sub-categories were identified during the content analysis. While almost all interviewees were willing to provide care for close family members, most were hesitant to receive informal care. Other factors such as the available housing space, flexible working hours and the proximity of relatives were essential indicators of a person’s preparedness to provide informal care. It is, however, unclear if care preferences change over time and generations. Six out of 12 informal caregivers and nine out of 14 care consultants also reported an information gap. Because they do not possess adequate information, informal caregivers do not seek help until it is too late and they experience high physical and mental strain. Despite the increased efforts of care consultants in recent years, trying to inform caregivers earlier was seen as almost impossible.

Conclusions

The very negative perception of caregiving as a burden was a reoccurring theme throughout all interviews and influenced people’s willingness to receive care as well as seeking timely information. Despite recent political efforts to strengthen home-based care in Germany, it remains unclear whether political efforts will be effective in changing individuals’ perceptions of informal caregiving and their willingness to be better prepared for the highly likely scenario of having to care for a close relative or becoming care dependent at a later stage in life.

Supplementary Information

The online version contains supplementary material available at 10.1186/s12877-021-02149-2.

Geographic mobility among older people and their adult children: The role of parents' health issues and family ties

This research examines the relationship between older parents' health issues and (i) their relocations closer to their faraway adult children, (ii) their relocations into institutionalised care facilities, or (iii) having distant children move closer. Additionally, we investigate how these relocations are structured by children's gender and location. We focused on parents aged 80 years and older and their distant children. Multinomial logistic regression models were employed for older men and women based on data from administrative registers of Sweden. Whereas severe health problems were associated with an increased likelihood of parent relocations closer to their children or into institutions, they were not associated with the likelihood of children's moves towards parents. Mothers were more likely to move towards daughters or towards distant children who had at least one sibling living nearby. Children moved closer to their parents when there was at least one sibling living near the parent or in response to their own life circumstances.

Long-term Care Provision and the Well-Being of Spousal Caregivers: An Analysis of 138 European Regions

Objectives

The individual burden of caring for one’s relatives not only depends on care characteristics but is also related to contextual factors. The objective of this study is to determine whether regional formal long-term care provision is linked to the well-being of spousal caregivers introducing the concept of “control” as central pathway to explain this link.

Method

We applied multilevel analysis using data from the Survey of Health, Ageing and Retirement in Europe (SHARE) from over 29,000 Europeans and 1,800 spousal caregivers located in 138 regions in 11 countries to analyze the effects of regional contexts on caregiver well-being. The provision of formal care in a region was measured by the number of long-term care beds in nursing and residential homes among the older population.

Results

We found that spousal caregivers’ well-being, measured in terms of life satisfaction, loneliness, and depression, was positively linked to the regional availability of formal care, which is partly due to higher perceived control in regions with more formal care provision.

Discussion

Our results suggest that formal care supply is essential not only for care recipients but also for caregivers: perceived alternatives to the private care arrangement go along with greater well-being of informal caregivers.

Mothers' Selection of Future Primary Caregivers in Rural West Java, Indonesia

This study analyzes mothers' preference of a future primary caregiver by using within-family analysis approach in the context of Sundanese population in rural West Java, Indonesia. This is a cross-sectional study involving healthy mothers (60-69 years old) with a perfect score of Instrumental Activity of Daily Living (IADL), and who had at least two living children. The within-family analysis of a selection of future caregivers was conducted based on the report from 177 mothers of their 904 children using multilevel modeling with binomial outcome. Being a daughter, older, emotionally the closest to the mother, having supported the mother in the past, being perceived as future bequest receiver, and being geographically closer to mother increased the chance of being selected as preferred future primary caregivers. There were also cross-level effects of socioeconomic status (SES) on the selection of future primary caregivers by mothers, where poor mothers tend to pick poor children as their future primary caregivers. The results were contrasted to the findings from a similar study conducted in the United States. In addition, the importance of knowledge about future care preference and its implications for intervention is discussed.

Number of children and social contacts among older people: the moderating role of filial norms and social policies

Social contacts offer opportunities for provision of emotional and instrumental support that enhances well-being throughout the life course, and the importance of these contacts is especially evident at advanced ages. In this paper, we take a cross-country comparative perspective to examine the association between the number of children and the frequency of social contacts among older people. Using data from the European Quality of Life Survey, we employ multilevel models with cross-level interactions between the number of children and macro-level indicators of filial norms and social policies supporting older people. Our results suggest that older adults with children are more likely than older adults without children to have frequent social interactions, but that the number of children does not affect social contact frequency. The magnitude of the association between having children and social contact frequency varies across European societies. The social contact frequency gap between older adults with children and older adults without children is larger in more familialistic countries with strong filial norms. Our results do not confirm that having children affects social contact frequency less in countries where the state provides more support for older people.

Translating Basic Research on the Aging Family to Caregiving Intervention: The Case of Within-Family Differences

Since its inception, the field of gerontology has sought to establish optimal connections between the scientific activities of researchers and the real-world concerns of practitioners and clinicians. The concept of translational research has emerged in recent years as a model for bridging the gap between science and service. This article provides an example of how basic research findings can be translated to provide guidance for intervention in the area of family caregiving. We review findings from an innovative program of research on within-family differences, which extends theory and research from the developmental psychological study of children to the family in later life. The within-family difference perspective focuses on how the individual parent–child dyads in a particular family differ from and are affected by other dyads. Basic research on this topic has revealed the extent of parental favoritism in later life, factors related to parental differential treatment of offspring, and the consequences of such favoritism and treatment on sibling relationship quality and psychological well-being. Four examples are provided of ways in which attention to within-family differences research could enhance caregiving interventions.

Aging, Disability, and Informal Caregivers: A Cross-sectional Study in Portugal

Objectives

Aging is pushing states to rethink long-term care policies in several dimensions. This study aims to characterize the reality of dependent older people regarding their demographic and health characteristics, to describe their informal carers and understand the availability of informal care.

Methods

A cross-sectional study was developed in Portugal in 2013. Descriptive statistical analyses and binary logistic analysis were conducted.

Results

Results show that the informal long-term care sector is primarily aimed at older people with severe limitations in their activities of daily living and at the chronically ill, particularly older women. Additionally, 39.5% of dependent older persons do not have informal care and only receive informal aid in cases of extreme need.

Discussion

Results show a critical situation for both social groups (older persons and caregivers) and the prospect of an alarming situation in the near future (aging and reduced availability of informal caregivers) unless a new approach for long-term care is developed.

Changing the balance of social care for older people: simulating scenarios under demographic ageing in New Zealand

The demographic ageing of New Zealand society, as elsewhere in the developed world, has dramatically increased the proportion of older people (aged 65 years and over) in the population. This has major policy implications for the future organisation of social care. Our objective was to test the effects on social care use, first, of putative changes in the overall disability profile of older people, and second, of alterations to the balance of their care, i.e. whether it was community-based or residential. In order to undertake these experiments, we developed a microsimulation model of the later life course using individual-level data from two official national survey series on health and disability, respectively, to generate a synthetic version which replicated original data and parameter settings. A baseline projection under current settings from 2001 to 2021 showed moderate increases in disability and associated social care use. Artificially decreasing disability levels, below the baseline projection, only moderately reduced the use of community care (both informal and formal). Scenarios implemented by rebalancing towards informal care use moderately reduced formal care use. However, only moderate compensatory increases in community-based care were required to markedly decrease the transition to residential care. The disability impact of demographic ageing may not have a major negative effect on system resources in developed countries like New Zealand. As well as healthy ageing, changing the balance of social care may alleviate the impact of increasing demand due to an expanding population of older people.

Providing informal care in a changing society

The ageing of society is leading to significant reforms in long-term care policy and systems in many European countries. The cutbacks in professional care are increasing demand for informal care considerably, from both kin and non-kin. At the same time, demographic and societal developments such as changing family structures and later retirement may limit the supply of informal care. This raises the question as to whether the volume of informal care (in people) will increase in the years ahead. This paper aims to provide a theoretical answer to this question in two steps. First, based on different care models and empirical literature, we develop a behavioural model on individual caregiving, the Informal Care Model. The model states that, in response to the care recipient’s need for care, the intention to provide care is based on general attitudes, quality of the relationship, normative beliefs, and perceived barriers. Whether one actually provides care also depends on the care potential of the social context, being the family, the social network, and the community. Second, we discuss how current policy and societal developments may negatively or positively impact on these mechanisms underlying the provision of informal care. Given the increased need for care among home-dwelling individuals, the model suggests that more people will take up the caregiver role in the years ahead contributing to larger and more diverse care networks. It is concluded that long-term informal care provision is a complex phenomenon including multiple actors in various contexts. More research is needed to test the Informal Care Model empirically, preferably using information on care recipients, informal caregivers and community care in a dynamic design and in different countries. Such information will increase insight in the developments in informal care provision in retrenching welfare states.

Intergenerational cohesiveness and later geographic distance to parents in the Netherlands

Although spatial proximity no doubt facilitates interaction and assistance, no research to date has addressed the extent to which children who are emotionally closer to parents choose to live nearby. Using the Netherlands Kinship Panel Study (N = 1055), this research evaluates the relationship between parent-child cohesion at age 15 (measured retrospectively among individuals 18-35 in 2002-2004) and later geographic distance between young adults and their parents in 2006-2007. Importantly, this research is the first to consider the relationship between intergenerational solidarity and young adult's later geographic proximity to parents, proximity known to contribute to exchanges of support between the generations. For both mothers and fathers, each model yielded qualified evidence of the cohesion-proximity relationship. These findings highlight a potential selection issue related to intergenerational support and contact as it is facilitated by geographic proximity.

‘As long as it's good’: An intergenerational family perspective of bridging gaps between reality and ideality of second couplehood as a problem and as a solution

Second couplehood in old age following widowhood or divorce is a phenomenon developing with the increase in life expectancy and is yet to be accepted as part of the normative ageing process. The aim of this paper is to examine how family members of three generations perceive second couplehood in old age as a new phenomenon within a changing society and a dynamic family structure. The multigenerational families of 19 second-couplehood dyads (a total of 38 multigenerational families) were recruited using criterion sampling. The second-couplehood dyads were composed of men who repartnered at age 65+ and women at 60+, with children and grandchildren from a lifelong marriage. We tape recorded and transcribed verbatim 107 semi-structured qualitative interviews with older partners, their adult children and grandchildren. Analysis was based on grounded theory and dyadic-analysis principles adapted to families. Two main themes were found that presented gaps between reality and ideality experienced by the participants regarding second couplehood: as a problem through its disadvantages, and as a solution through its advantages. The gaps in both themes were bridged by the account: ‘as long as it's good’. Findings are discussed in the context of modernisation theory, the lifecourse and the family lifecycle perspectives relating to changes in family structure and ambivalence and how to deal with them on the macro, mezzo and micro levels.

Who provides care? A prospective study of caregiving among adult siblings

PURPOSE

We use data from a longitudinal, within-family study to identify factors that predict which adult siblings assumed caregiving responsibilities to older mothers over a 7-year period.

DESIGN AND METHODS

Data for the study were collected from 139 older mothers at 2 points 7 years apart regarding their expectations and experiences of care from 537 adult children.

RESULTS

Children whom mothers identified at T1 as their expected future caregivers were much more likely to provide care when a serious illness occurred. Caregiving offspring were also more likely at T1 to have shared their mothers' values, lived in proximity, and to be daughters.

IMPLICATIONS

The findings indicate the degree to which a mother's expectations for care predict actual caregiving by that child. Practitioners working with older adults should explore parents' expectations for future care that involves their adult children.

[Use of family resources in future need of care. Care preferences and expected willingness of providing care among relatives: a population-based study]

The family is an important resource in elderly care. It is of great interest if persons who might be in need of care in the future would use this resource. Our study assessed wishes and expectations regarding family care in a representative sample of the general population (≥ 45 years, N = 1,445) using questionnaires. Logistic regressions were performed to analyze the potential impact on the willingness to use or provide family care. One quarter of the participants reported experience in family care. In case of own need 62.9% of participants would prefer care provided by relatives and 56.7% would prefer professional care. Participants are more likely to use family care if they report having relatives, are experienced in care of relatives or do not associate old age with being a burden, e.g. report low values in the image of age "being a burden/demanding". Perceived willingness of the relatives to provide care is more likely if there is little regional distance to the relatives, in male participants and if participants talked about future care with their relatives. Besides structural factors, negative images of old age might have a negative influence on the willingness to use family care. Talking about care in old age seems to have a positive impact.

Exploring causal effects of combining work and intergenerational support on depressive symptoms among middle-aged women

In debates about ageing western societies it is often assumed that many middle-aged women struggle to combine paid employment and intergenerational support, and that the subsequent stress leads them to experience an increase in depressive symptoms. Cross-sectional studies have supported this notion, but the question remains whether combining work and intergenerational support actually causes an increase in depressive symptoms. In order to fill a gap in the literature, this study examines the proportion of middle-aged women combining paid work and support to an adult child and/or parent, and the extent to which combining these roles affects women's depressive symptoms over time. For this purpose, we make use of the Survey of Health, Ageing, and Retirement in Europe (SHARE) data set which includes longitudinal data collected on European women aged 50+. Descriptive analyses indicated that 14 per cent of middle-aged women combine the roles of employee, support provider to an adult child, and/or support provider to a parent. Results from semi-dynamic and full-dynamic regression analyses indicate that combining roles can take away some, of the positive mental health effects of fulfilling a role. These findings support the role combination stress hypothesis.

Adult children and parental care-giving: making sense of participation patterns among siblings

The aim of this article is to analyse 20 Finnish working carers' perceptions of their sibling relations and the sharing of the responsibility for parental care. The main focus is on the interviewees' rationales for the participation or non-participation of their siblings in the parents' care. Almost all the interviewed carers stated that the division of care responsibilities is unequal and that they are the primary carers, but the majority did not convey any clear intention to try to persuade their siblings to increase their participation in parental care. In many cases, the siblings were described either as entirely absent or as providing occasional backup, but some interviewees reported that caring for the parent(s) was shared with their other siblings. Consequently, three participation patterns were identified: ‘absence’, ‘backup’ and ‘togetherness’. All the interviewees offered rationales for the unequal division of care tasks and responsibilities among the siblings. The discussion focuses on these rationales and their variations by participation patterns, and considers the similarity of the findings to those from previous American and British studies. The study concludes that social-care services should take the primary carer's siblings into consideration, although not always as a ‘resource’. It should not be taken for granted or assumed that the primary care-giver receives help from her or his siblings, even if their relationship is otherwise close and unproblematic.