The transfer of resources from middle-aged children to functionally limited elderly parents: providing time, giving money, sharing space

Structural Inequities in the Kin Safety Net: Mapping the Three-Generational Network throughout Early Adulthood1

Research in the intergenerational transmission of socioeconomic status (SES) consistently shows that the SES of one generation benefits the next. Demographic processes shape the kin structures that serve as conduits for the transmission of SES. Few studies have examined these trends together to describe experiences in evolving kin structures throughout the life course and across generations. This article applies demographic techniques to fertility, marital, and mortality data from three generations in the Panel Survey of Income Dynamics to simulate the amount of time young adults would spend within consequential kin structures. High-SES adults spend more years of their young adulthood in advantageous kin structures with greater potential for kin support and capital accumulation, while low-SES adults spend a larger portion of their young adulthoods as single parents, sandwiched between widowed parents and children, and as adult orphans. The kin network inequities have grown since the 1980s, driven by lagging mortality improvements and increasing single parenthood among low-SES families.

A national profile of sandwich generation caregivers providing care to both older adults and children

BACKGROUND

Many U.S. caregivers provide care to the generation above and below simultaneously, described as "sandwich" generation caregivers. We seek to provide the first national estimates characterizing sandwich generation caregivers and the older adults for whom they care.

METHODS

We used the 2015 National Study of Caregiving (NSOC) and National Health and Aging Trends Study (NHATS) to compare individual (demographic, socio-economic, health, and caregiving characteristics) and caregiving-related experience (financial and emotional difficulties, caregiver role overload and gains, supportive services, employment and participation restrictions) between sandwich and non-sandwich generation caregivers. The analysis included adult child caregivers with or without any minor child under 18 years (n = 194 and 912 NSOC respondents, respectively) providing care to n = 436 and 1217 older adult NHATS respondents.

RESULTS

Of all adult child caregivers, 24.3% also cared for a minor child (i.e., sandwich generation caregivers), representing 2.5 million individuals. Sandwich generation caregivers provided similar care hours to older care recipients as non-sandwich caregivers (77.4 vs. 71.6 h a month, p = 0.60), though more of them worked for pay (69.4% vs. 53.9%, p = 0.002). Both sandwich generation caregivers (21.0% vs. 11.1%, p = 0.005) and their care recipients (30.1% vs. 20.9%, p = 0.006) were more likely to be Medicaid enrollees than their non-sandwich caregiving counterparts. More sandwich generation caregivers reported substantial financial (23.5% vs. 12.2%, p < 0.001) and emotional difficulties (44.1% vs. 32.2%, p = 0.02) than non-sandwich caregivers; they also reported higher caregiver role overload (score: 2.9 vs. 2.4, p = 0.04). Their supportive services use was similarly low as non-sandwich caregivers except for seeking financial help (24.8% vs. 14.7%, p = 0.008).

CONCLUSIONS

Besides caring for minor child(ren), sandwich generation caregivers provided similarly intense care to care recipients as non-sandwich caregivers and had higher labor force participation; they experienced more caregiving-related financial and emotional difficulties and role overload. Policymakers may consider supportive services that address their unique needs and roles.

Influencing Factors of Undermet Care Needs of the Chinese Disabled Oldest Old People When Their Children Are Both Caregivers and Older People: A Cross-Sectional Study

We examined the influencing factors of the undermet care needs of the Chinese disabled oldest old people when their children are both caregivers and are themselves older people. Data were obtained from a cross-sectional survey: the Chinese Longitudinal Healthy Longevity Survey (CLHLS) in 2018. The study participants included 1617 disabled oldest old people whose primary caregiver were their children or children-in-law and were aged 60 years and over. The results showed that the prevalence of undermet needs remained high, with 49.6% disabled oldest old people reporting undermet care needs. Binary logistic regression analysis revealed that living in a rural area (OR = 1.309, 95% CI = 1.133-1.513) and a higher frailty index (OR = 1.103, 95% CI = 1.075-1.131) were significantly positively associated with higher odds for undermet care needs, while a higher annual household income (OR = 0.856, 95% CI = 0.795-0.923), more financial support from children (OR = 0.969, 95% CI = 0.941-0.997), higher care expenditures (OR = 1.044, 95% CI = 1.002-1.088), better caregiver's performance (OR = 0.282, 95% CI = 0.196-0.407) and sufficient income to pay for daily expenses (OR = 0.710, 95% CI = 0.519-0.973) were significantly inversely associated with higher odds for undermet care needs. This evidence suggests the importance of policies to establish a community-based socialized long-term care system and supporting family caregivers of the disabled oldest old people.

The Effect of a Reduced Statutory Workweek on Familial Long-Term Care in Korea

Objectives: We examine how statutory workweeks affect workers’ provision of long-term care for their non-coresident elderly parents. Method: The Korean government reduced its statutory workweek from 44 to 40 hr, gradually from larger to smaller establishments, between 2004 and 2011. Using multiple regressions, we assess how the reduction affected visits, financial transfers, and in-kind transfers to parents. Annual longitudinal data come from the 2005 to 2013 waves of the Korea Labor and Income Panel Study. Results: The reduction caused an increase in the frequency of visits and in-kind transfers among male workers, with no significant impact on their financial transfers. Among female workers, we found no impact on any outcomes. Discussion: We interpret the findings within the context of developed Asian countries with long work hours and Confucian traditions, and suggest regulating workweeks as a policy tool to encourage familial long-term care in the rapidly aging societies.

His and Her Retirement: Effects of Gender and Familial Caregiving Profiles on Retirement Timing

Objectives

Retirement timing has been linked to a host of outcomes for individuals, families, and societies. The present study predicted retirement timing using profiles of preretirement family caregiving and gender.

Method

Using longitudinal data from the Health and Retirement Study, cluster analysis was used to create profiles of preretirement family caregiving (operationalized as time and financial transfers to aging parents and adult children). These profiles, as well as gender, were used to predict later retirement timing.

Results

Four distinct preretirement caregiving profiles were evident. All profiles retired, on average, earlier than their full eligibility for Social Security benefits. A main effect of caregiving profile, but not gender, was evident. The Eldercare profile, which was characterized by high levels of time and financial transfers to aging parents, retired the earliest. There was not a significant interaction between caregiving profile and gender.

Discussion

When men enacted female-typical caregiving roles, their retirement timing resembled women’s. Eldercare, in particular, was associated with earlier retirement timing. Implications for individual retirement decision-making and policy are discussed.

Bargaining Power, Parental Caregiving, and Intergenerational Coresidence

OBJECTIVE

To examine the effect of changes in parent-child coresidence on caregiving decisions of non-resident siblings over a 5-year period while controlling for characteristics of the elderly parent and adult children in the family network.

METHOD

We use difference-in-difference models applied to Health and Retirement Study-Assets and Health Dynamics of the Elderly data to test the hypothesis that the formation of a joint household between a parent and one of her children raises the bargaining power of non-resident siblings, who then reduce their care to the parent. Similarly, the dissolution of a parent-child household is expected to increase the bargaining power of the child who no longer coresides with the parent relative to her siblings.

RESULTS

We find that children whose parent and sibling begin coresiding during the study period are less likely to provide care and provide fewer hours of care than children whose parents never coresided with a child. Adult children whose parent cease coresiding with a sibling, on the other hand, have a higher likelihood of providing care and provide significantly more hours of care relative to children whose parents either coresided with a sibling in both time periods or never coresided with a child.

DISCUSSION

Meeting the needs of the growing elderly population while maintaining them in the community is a particular focus of long-term care policy. To the extent that shared living is an important component of such care, the observed sensitivity of non-resident children's caregiving efforts has implications for the well-being of both disabled parents and their coresiding adult children.

Stability and change in financial transfers from adult children to older parents

We sought to identify the extent and predictors of longitudinal changes in adult children's financial assistance to parents and in transfer networks over a two-year period. Analyses rely on pooled data from 1994 to 2000 of the Health and Retirement Study, using families in which adult children with no more than four siblings financially supported parents over two years. Change in the help network occurred in about 40 per cent of these families over the two-year period. When change occurred, it most commonly involved cessation of support by a child, followed by addition of another child to the network, whereas exchange of supporting children was relatively rare. Change reflected children's ability to provide care and the burden created by parents' needs. However, the size and composition of the adult-child network and of the initial support group also played an important role. Results highlight the dynamic and systemic nature of intergenerational financial networks.

Changes in adult children's participation in parent care

Care-giving research has focused on primary care-givers and relied on cross-sectional data. This approach neglects the dynamic and systemic character of care-giver networks. Our analyses address changes in care-givers and care networks over a two-year period using pooled data from the US Health and Retirement Study, 1992–2000. Based on a matrix of specific adult-child care-givers across two consecutive time-points, we assess changes in any adult-child care-giver and examine the predictors of change. A change in care-giver occurred in about two-fifths of care-giving networks. Ability to provide care based on geographical proximity, availability of alternative care-givers, and gender play primary roles in the stability of care networks. Results underline the need to shift care-giving research toward a dynamic and systemic perspective.

Help to Family and Friends: Are There Gender Differences at Older Ages?

This paper uses recent data from the Wisconsin Longitudinal Study (N = 5,220) to explore gender differences in the extent to which adults in their 50s and 60s provide informal help to their adult children, elderly parents and friends We find that both men and women report very high levels of helping kin and nonkin alike, though women do more to assist elderly parents and women provide much more emotional support to others than do men. Men provide more assistance than do women with "housework, yard work and repairs." As they retire from the workforce, married men become significantly more involved in the care of their grandchildren, virtually eliminating any gender difference by the time they are in their 60s.

Application of the five-factor model of personality to intergenerational perception

The perception held by respondents in a full range of age groups (young, middle-aged, and old) toward a full range of target age groups (young, middle-aged, and old) was studied in a multidimensional way. The five-factor model of personality was chosen as the model of intergenerational perception and the Gough Adjective Checklist was chosen as the measurement device. A total of 867 participants rated the degree to which they thought 300 different adjectives described people of various ages. Responses were factor analyzed, and the five expected factors were found. For Conscientiousness, the factor scores showed a linearly increasing pattern, with young children and children scoring lower, and the middle-aged, adults, elderly people, and the very old scoring higher. For Openness, the reverse trend was observed, but the real decrease started at the young adult age. For Neuroticism, factor scores were very low when the targets were children, very high when the targets were adolescents, and neither high nor low when the targets were middle-aged, elderly, or very old. For Introversion, the pattern of scores appeared U shaped, with adolescents and young and middle-aged adults on one side and the other targets on the opposite side. Finally, for Agreeableness, the middle-aged adults scored much lower than all the other targets. Overall, the age of the target effect explained on the average more than two thirds of the explained variance, whereas the age of the respondent variable explained less than one tenth of the explained variance. It appears that, in the population, a strong consensus is held concerning the attribution of personality characteristics to various age groups.

Moving into a care home: the role of adult children in the placement process

Admission of an older person to a care home is widely recognised as a very stressful period for the family and one which, despite community care policy, is likely to be an increasingly common experience. Although there is a growing research base in this area, there have been few studies on the role of adult children in supporting their parents during this difficult transition. This paper reports on the third stage of a grounded theory study conducted in Sweden which explored the part played by adult children in the placement process. Data were collected from 13 adult children using in-depth semi-structured interviews and the results are compared with themes previously derived from interviews with 26 spouse carers. The analysis reveals important overlaps and differences and suggests the need for further research exploring the dynamics of the placement process.

Caregiving: challenges and implications for women's health

Informal and unpaid care is an integral feature of the U.S. health care system for the nation's sick, disabled, frail, and terminally ill. Much of what we know about caregiving is based on interviews with caregivers and, in some cases, care recipients. Prior studies have either not been based on a nationally representative sample or have collected very little information about non-caregivers. This study, using the Commonwealth Fund 1998 Survey of Women's Health, uses a nationally representative sample of caregivers and non-caregivers to examine the health impact of providing informal and unpaid care, focusing primarily on women. Our findings indicate that caregivers experience double jeopardy. They are significantly more likely to be in poor health and to have experienced problems getting needed care. These findings suggest that it is time to explore alternative or complements to informal caregiving. They underscore the need to find more equitable ways to share caregiving costs and risk, and provide support to assist those who currently provide care.