Middle generation roles and the well-being of men and women

[Employed persons caring simultaneously for children and care-dependent relatives - a scoping review]

Employed persons caring simultaneously for children and care-dependent relatives - a scoping review Abstract. Background: Due to the demographic changes with higher life expectancy, later childbirth, and an increasing number of working women, more middle-aged persons are confronted with the care needs of younger and older generations while they themselves are still employed. Aim: The objective of this manuscript is to review the body of knowledge about employed people caring simultaneously for underaged children and care-dependent relatives. Methods: The databases MEDLINE, CINAHL, Cochrane Library, GeroLit, CC Med, SOWIPORT Gesis, PsycINFO and BASE were searched without any time limitations. Publications in German and English were included into this scoping review regardless of the study design. Results: A total of 85 studies from Western countries were included. Research activity is centered in North America and there are only limited empirical findings from the German-speaking regions. Nearly 70 % of the studies used a quantitative design. Research questions address the consequences of adopting multiple roles and the compatibility of different areas of life. In total, role theoretical perspectives predominate. Conclusions: The findings show that little attention has been paid to this specific issue in German-speaking regions. The methodical limitations and inadequate theoretical differentiation of the studies led to partly contradictory results. Future research should take the complexity of this living situation into account while considering methodical approaches and theoretical foundations.

Types of Family Caregiving and Daily Experiences in Midlife and Late Adulthood: The Moderating Influences of Marital Status and Age

Guided by the life-course perspective, this study contributes to the family caregiving, aging, and disability literature by examining the daily experiences of three types of family caregivers in midlife and late adulthood. A sample of 162 caregivers from the National Survey of Midlife in the United States study completed interviews, questionnaires, and a Daily Diary Study. Multilevel models showed the patterns of daily time use did not differ by caregiver types. Caregivers of sons/daughters with developmental disabilities (DD) experienced more daily stressors than caregivers of parents with health conditions (HC) and caregivers of spouses with HC. Unmarried caregivers of sons/daughters with DD reported spending more time on daily leisure activities and exhibited greater daily stressor exposure than other family caregivers. Age did not moderate the associations between caregiver types and daily experiences. Findings highlight the important consideration of the caregivers' characteristics to better determine the quality of their daily experiences in midlife and late adulthood.

The Depressive Symptomatology of Parent Care Among the Near Elderly

This article investigates the independent additive and the interactive effects of being an informal caregiver of an elderly parent and three role commitments (being married, having a child or grandchild coreside, and being employed) on depressive symptomatology. For the respondents with a living mother, being a caregiver to their mother was not associated with the level of depressive symptoms. For the respondents with a living father, being a caregiver to their father was associated with higher levels of depressive symptoms. Respondents who were caregivers to their father reported lower depressive symptom scores due to being married and due to being employed. Being married and being employed may provide an alternative source of integration and thus buffer the detrimental effects that caregiving for a father has on depressive symptomatology. The findings are discussed in the context of role strain and role enhancement perspectives.

Gender’s Effect on the Relationships Linking Older Americans’ Resources and Financial Satisfaction

This article tests the assumptions that the effect of resources on the financial satisfaction of older Americans is consistent (1) for different measures of income and wealth and (2) for men and women. Data are from a weighted subsample of those 65 and older from Waves I (1986) and II (1989) of the Americans’ Changing Lives Panel Study. Multivariate analyses contradict both assumptions with the following statistically significant findings: (1) Financial satisfaction in 1986 and not receiving food stamps are stronger predictors of financial satisfaction for men, whereas having interest and retirement/pension incomes are more important for women; and (2) a lowered number of chronic ailments is more important for women, whereas having a surviving spouse is more important for men. Findings support both George’s ideas of “control” and “illusion of control” and Moen’s ideas about gender-specific patterns of status transitions.

Elder Care, Multiple Role Involvement, and Well-Being Among Middle-Aged Men and Women in Japan

Japan's population is aging at an unprecedented rate. Combined with the tradition of family responsibility for elder care, this rapid population aging has resulted in middle-aged Japanese people being much more likely today than in past decades to face the responsibility of caring for their elderly parents alongside their other major roles. Using nationally representative Japanese data, this study assessed the individual and combined implications of caregiving and other role involvements for the well-being of middle-aged men and women. Some evidence was found for deleterious psychological consequences of the caregiver role. However, in contrast to expectations, the interaction between the roles of caregiver and worker was positively associated with well-being among both men and women. The results suggest the importance of middle-aged adults being able to keep working when they have to care for their aging parents. Another important finding was significant gender differences in the psychological consequences of holding multiple family- and work-related roles and in combining these with the caregiver role. Further analysis showed that the spousal role was also negatively associated with depressive symptoms and positively associated with satisfaction for men but not for women. Gender differences in the findings appear to reflect the significant gender asymmetry in role experiences in Japan.

Caregiving for parents and in-laws: commonalities and differences

This study examined support, stress, and well-being between adults who provide care for an aging and disabled parent and those who care for an aging and disabled parent-in-law. The study utilized a sample of individuals caring for a parent (n = 77), individuals caring for an in-law (n = 26) and a comparison group of noncaregivers (n = 1,939) from the Midlife Development in the United States study. In-law caregivers provided more financial assistance but adult child caregivers provided more emotional support and unpaid work. Adult child caregivers reported poorer mental health and family strain; in-law caregivers reported more spouse support and less family strain.

Evaluative Organization of the Self-Concept in Younger, Midlife, and Older Adults

Showers’s model of evaluative organization is a fruitful way to conceptualize the self-concept and is related to self-esteem, depressive symptoms, and emotion regulation. In this study, the authors developed and piloted a card-sort measure to compare the evaluative organization of the self-concept in healthy older, midlife, and younger adults (approximately two thirds of participants were women). The results support the primary hypothesis that older adults would exhibit greater compartmentalization of the self-concept than younger and middle-aged persons. Older adults may think about their positive and negative self-aspects in a more differentiated fashion (i.e., categorize positive and negative self-aspects into separate roles) than younger and midlife persons, who are more integrative (i.e., categorize positive and negative self-aspects under the same role heading) in their self-concepts. The results are consistent with cognitive priming, memory, and emotion regulation studies, which suggest that the way persons organize information about themselves may be different in younger, midlife, and older adults.

Norwegian sandwiches: On the prevalence and consequences of family and work role squeezes over the life course

Population ageing changes profoundly the current balance between generations. Governments are responding with policies to promote later retirement and family care, but these ideals may come in conflict in mid-life when family obligations can be hard to reconcile with employment. Yet we know little about the prevalence of being "sandwiched", and even less about the consequences. This article maps out the prevalence of different forms of family and work sandwiching for the Norwegian population, and explores adaptive strategies and psycho-social outcomes. The analyses are based on data from the NorLAG and LOGG studies (n = 15 109, age 18-84). Preliminary findings indicate that 75-80% of the population are located in-between younger and older family generations in mid-life, the great majority are at the same time in paid work, but comparatively few (8-9% aged 35-45) have both children and parents in need at the same time, and fewer still (3%) are then also caregivers to older parents. Although few in proportion of their age group, they add up to a considerable number of persons. Women are more likely to reduce work in response to family needs than men. Implications of family and work sandwiching for health and well-being are analysed.

The inter-relationship between formal and informal care: a study in France and Israel

This study examined whether formal care services delivered to frail older people's homes in France and Israel substitute for or complement informal support. The two countries have comparable family welfare systems but many historical, cultural and religious differences. Data for the respondents aged 75 or more years at the first wave of the Survey of Health, Ageing and Retirement in Europe (SHARE) were analysed. Regressions were examined of three patterns of care from outside the household: informal support only, formal support only and both formal and informal care, with the predictor variables including whether informal help was provided by a family member living in the household. The results revealed that about one-half of the respondents received no help at all (France 51%, Israel 55%), about one-tenth received care from a household member (France 8%, Israel 10%), and one-third were helped by informal carers from outside the household (France 34%, Israel 33%). More French respondents (35%) received formal care services at home than Israelis (27%). Most predictors of the care patterns were similar in the two countries. The analysis showed that complementarity is a common outcome of the co-existence of formal and informal care, and that mixed provision occurs more frequently in situations of greater need. It is also shown that spouse care-givers had less formal home-care supports than either co-resident children or other family care-givers. Even so, spouses, children and other family care-givers all had considerable support from formal home-delivered care.

Virtue is its own reward? Support-giving in the family and loneliness in middle and old age

Gerontologists have emphasised that older adults are not only recipients of support but also important support providers. Using data from the first wave of the Netherlands Kinship Panel Study of 727 middle-generation adults aged 45 to 79 years, we examined the associations between loneliness and giving support up, across and down family lineages. Overall, the findings were consistent more with an altruism perspective, that giving brings rewards, than with an exchange perspective, which emphasises the costs of giving support. The results showed an inverse relationship between the number of generations supported and loneliness, and that those engaged in balanced exchanges with family members in three generations (parents, siblings and children) were generally the least lonely. As regards the direction of support giving, the findings showed that the association between giving support and loneliness was insignificant if the support was for parents, negative for support to siblings, and positive for support to children. Imbalanced support exchanges were differentially associated with loneliness, and depended on the type of family relationship involved. Non-reciprocated support made parents more vulnerable to loneliness, whereas non-reciprocated giving in sibling ties was associated with low levels of loneliness. Imbalanced support giving in relationships with parents was not associated with loneliness.

Parent Caregiving Choices of Middle-Generation Blacks and Whites in the United States

Objective: This study compares how middle-generation caregivers and non-caregivers differ by race and explores racial differences in activities of daily living (ADL), instrumental activities of daily living (IADL), and financial assistance that middle-generation caregivers provide for their parents. Method: Using 2000 Health and Retirement Study data, racially stratified descriptive analyses and logistic regression models for ADL, IADL, and financial assistance are presented. Results: Parental need and race influence support, with similar patterns of Black and White ADL support, but racial differences in IADL and financial support. Having more children motivates Whites to increase IADL support and reduce financial support; more children decreases Blacks' IADL support. Sibling caregiver networks influence IADL and financial support in ways that vary by race. The number employed is a key determinant for Blacks for all support, but only influences White ADL support. Discussion : The findings of this article indicate the importance of sample stratification by race and that employment or other subsidies may aid the expansion of caregiving by middle-generation adults.

Psychosocial Moderators the Effects of Transitioning Into Filial Caregiving on Mental and Physical Health

A life-course theoretical perspective guided this study to examine how effects on mental and physical health (depressive symptoms, hostility, global happiness, self-esteem, personal mastery, psychological wellness, self-rated physical health) of transitioning into filial caregiving for a sole surviving parent are moderated by prior relationship quality, filial obligation, race or ethnicity, education, income, employment status, marital status, and parental status. Results from models estimated using longitudinal data from 1,060 adults aged 25 to 65 years at baseline (National Survey of Families and Households, 1987 to 1994) suggested that life-course and contextual factors do contribute to patterning health risks of caregiving, often in different ways for men and women: For example, low income puts daughter caregivers at greater risk for decline in physical health, combining employment with filial caregiving is more problematic for daughters' mental health, and being an unmarried filial caregiver is more problematic for men. Heterogeneity in the experience of filial care needs further attention in future research.

Grandfathers Raising Grandchildren

<i>Objectives</i>. The purpose of this study was to more fully understand the factors that motivate and influence kinship care provided by African American grandfathers who raise their grandchildren. <br><i>Methods</i>. Data were gathered from a community sample of older men, age 65+, who were responsible for the care of at least one grandchild in a rural community in southeastern North Carolina. Fifty-four percent of the grandfathers were African American men who are the focus of the present analysis. Responses were analyzed using a qualitative content analysis mode and descriptive statistics. <br><i>Results</i>. Five factors (obligation, lack of availability of other caregivers, family tradition, role modeling, care and concern) that influence their decision to assume the parenting role emerged and three areas (lack of resources, feelings of powerlessness, religious beliefs and spirituality) that impact their ability to continue providing care were identified. <br><i>Discussion</i>. Findings indicate that practitioners seeking to understand kinship care and assist grandparents who are raising grandchildren must take into account the hardships these families face due to a lack of concrete services and the implications for mental health. Results affirm the need for special attention to grandfathers who provide kinship care. doi:10.1300/J045v22n03_12.

Caregiving outside of the home: the effects of race on depression

OBJECTIVE

This research examines the conditions that determine whether Blacks experience lower or higher levels of depression while caregiving outside of the home, as compared to Whites. Some prior literature has found that African Americans report a lesser caregiver burden despite an increased likelihood that they will acquire this role, and decreased resources to do so. Others have found that African Americans experience the same caregiver burden and distress as Whites. Given these mixed findings, we use the stress process model to examine whether African American caregivers experience lower or higher levels of depression when they provide care outside of the home.

DESIGN

A sample of care workers who provide care to others outside of the home was drawn from the 1992-4 National Survey of Families and Households. The final sample included 275 (11%) Blacks, and 2,218 (89%) Whites (not of Hispanic origin). The primary statistical method for predicting differences in caregivers' depressive symptomatology was OLS regression analysis with progressive adjustment.

RESULTS

We examined sociodemographics, family structure, resources, and stressors and found that African Americans, those with lower socioeconomic status, the unmarried, spending more weeks caregiving, having a physical impairment, and surprisingly receiving more help from parents are associated with higher depressive symptomatology. Stronger religious beliefs decreased depressive symptomatology for Blacks. The race effect was, in part, explained by family structure, amount of caregiving, and impairment of care worker.

CONCLUSION

Contrary to prior literature, we found that Blacks are more depressed than White caregivers in large part because of lower socioeconomic status and greater stressors, and higher levels of physical impairment. Yet, strength in religious belief has a stress-buffering effect for African Americans. We suggest that policies that attempt to eliminate racial disparities in socioeconomic status and health could benefit these caregivers.

Gender Disparities in Health: Strategic Selection, Careers, and Cycles of Control

This article proposes a dynamic model of the intersections between gender, health, and the life course incorporating processes of strategic selection--of roles, relationships, and behavior. Men and women make decisions within a tangled web of multilayered, often contradictory, and frequently outdated institutional contexts of opportunity and constraint. Both their decisions and the institutions shaping them reflect prior as well as ongoing socialization and allocation mechanisms. These institutionalized scripts and regimes tend to reproduce gendered biographical paths around two central life foci: paid work (or careers) and unpaid family work (or careers). The gendered nature of occupational and family-care paths, in turn, produces patterned disparities in a constellation of health-related resources, relationships, and risks, as well as feelings of mastery and control. We call for research charting alternative constellations of these gendered health careers, their antecedents, temporal patterning, and consequences.

The health consequences of multiple roles at older ages in the UK

Increasing proportions of men and women are combining family (including care-giving) and work responsibilities in later life; however, the relationship between multiple role commitments and health at older ages remains unclear. Employing data from the longitudinal Retirement Survey (1988-1989 and 1994), the present authors applied logistic regression models to investigate the relationship between multiple role occupancy (1) cross-sectionally in 1988-1989 and health status in 1994; (2) retrospectively over the respondent's lifetime up to 1988-1989 and health outcomes in 1988-1989; and (3) retrospectively between 1988-1989 and 1994, and health status in 1994. The health outcomes considered were (1) general health status, (2) functional ability and (3) severity of disability category. Overall, simultaneous role occupancy (e.g. care-giving and employment) at older ages does not appear to be associated with poor health. The authors report a positive association between employment and health, as expected. There were mixed results concerning the association between care-giving and health. Where adverse health outcomes were found, the parental role, alone or in combination with other roles, was most frequently related to poor health. Thus, for a nationally representative sample of mid-life men and women, the combination of care-giving with other family and work roles appears to have few negative health consequences. Further research is needed on whether continued parental demands in mid-life have a negative impact on health.

Multiple role occupancy in midlife: balancing work and family life in Britain

PURPOSE

This article investigates the extent of multiple-role occupancy among midlife individuals in Britain in cross-section and over the life course, focusing on work and family commitments. The association between demographic and social factors and multiple-role obligations is also investigated.

DESIGN AND METHODS

The research is based on secondary analysis of the British Family and Working Lives Survey, which contains retrospective paid work, caregiving, and child coresidence histories.

RESULTS

The proportion of individuals in midlife (women aged 45-59 and men aged 45-64) who have multiple roles, in terms of paid work and consistent family care, at any one point in time is low (2%). This is primarily due to the relatively small proportion (7%) of people in this age group who are caring for a dependent. Being older, unmarried, and in poor health significantly reduces the number of roles held among men and women. Although the frequency of multiple role occupancy, and intensive multiple role occupancy, is low on a cross-sectional basis, a much higher proportion of individuals have ever occupied multiple roles over their life course (14%).

IMPLICATIONS

The findings will inform debate on how policy can best aid those endeavouring to balance paid work, family life, and caring responsibilities.

Daughters-in-law in Korean caregiving families

AIM

The aim of this study was to examine the emotional and physical health and experiences of daughter-in-law (DIL) caregivers compared with daughter caregivers who care for cognitively and/or functionally impaired older people in Korea.

BACKGROUND

In Korea, DILs are the predominant caregivers of impaired older people, but little is known about DIL caregivers. A study which explores the emotional and physical health outcomes of DIL caregivers who care for impaired parents-in-law in the sociocultural context of Korea is necessary.

METHOD

A cross-sectional descriptive correlational study was conducted to examine the emotional and physical health of 93 DIL caregivers compared with 27 daughter caregivers who care for the cognitively and/or functionally impaired older people in Korea. This study hypothesized that DIL caregivers would have poorer emotional and physical health than daughter caregivers and that the type of relationship with the care-recipient is an important predictor of caregivers' health outcomes. t-tests, chi-square and hierarchical regression analyses were used for hypotheses testing.

RESULTS

Contrary to expectations, this study found that caregivers' health outcomes were very similar for DILs and daughters in Korean families. The type of relationship was not an important predictor of caregivers' health outcomes, and neither was the quality of intergenerational relationship. However, Korean DIL and daughter caregivers reported relatively poor emotional and physical health compared to those of Western caregivers in previous studies.

CONCLUSIONS

Daughter-in-laws caregivers were not at greater risk group of negative health outcomes than daughter caregivers. However, DIL and daughter caregivers in Korea were a vulnerable group regardless of their relationship with the care-recipient. The cultural norms and social expectations regarding family-centred caregiving in Korea may cause negative health outcomes for Korean caregivers. Further family caregiving studies in the Korean context are recommended.

Multigenerational caregiving and well-being: distress of middle-aged daughters providing assistance to elderly parents

This article investigates whether being a caregiver of an elderly parent and the caregiver's involvement in multiple roles increases distress in middle-aged women. Previous studies assumed that providing care to frail parents causes distress in women, in particular when they have other social roles as well. Longitudinal data were collected within a cohort of middle-aged women (n = 934; n = 743). The acquisition or loss of the caregiver role did not appear to affect levels of distress of middle-aged women, nor did additional roles of caregivers increase distress levels or caregiver role strain. Most distressed were women not performing any major social role, suggesting that the lack of social roles rather than the multiplicity of roles is associated with distress. The caregiver role might even reduce distress when women have very few other roles. Findings are explained in terms of the role scarcity, the role expansion and role accumulation hypotheses of role theory.

Life satisfaction and health-related quality of life (SF-36) of middle-aged men and women

OBJECTIVES

To investigate life satisfaction and health-related quality of life (SF-36) in a general population sample of middle-aged women and men. The effects of menopausal status and hormone replacement therapy (HRT) use upon life satisfaction and health-related quality of life (HrQOL) were also examined for the female sample.

DESIGN

All men and women aged 49-55 years from the age/sex register of a large general practice in London were contacted and asked to complete a questionnaire about their health.

SUBJECTS

A total of 103 women (55%) and 86 men (40%) participated; of the women, 15% were premenopausal, 68% peri- or postmenopausal and 17% taking HRT.

RESULTS

Women and men reported similar levels of HrQOL, life satisfaction and general health, although women reported more physical problems (SF-36). The significant predictors of HrQOL were serious illness, employment and marital status, but HRT use and menopausal status were not significantly associated with life satisfaction nor HrQOL (for women).

CONCLUSIONS

Gender differences in health and HrQOL may be less apparent during mid-life, although there were some subtle differences between men and women in reported health concerns and reasons given for (dis)satisfaction with their lives.