The Effects of Caregiving Resources On the Perceived Physical Health Among National Caregivers

Background and Purpose: Family caregivers play a major role in providing long-term care for older adults. Given the demands of caregiving, caregivers experience various negative caregiving outcomes and eventually worse health.  Despite extensive research, prior research reveals limited knowledge about health of caregivers because of a lack of attention toward the role of resources and inconsistent findings on the relationships between caregiving related variables. Thus, this study aims to test a comprehensive health model built upon the Conservation of Resources (COR) theory with a sample drawn from the 2004 National Long-term Caregiver Survey (NLTCS). According to the COR theory, individuals seek resources when they experience a chronic stress defined as “resource loss”. This theory implies that caregivers with more difficult situations seek more resources to offset their resources, which eventually affect the health of caregivers. Based on the COR theory, caregiving resources are conceptualized as psychological (i.e. mastery), financial (i.e., financial hardship), informal (i.e., social support and family harmony), and formal (i.e., use of formal services) resources, and the following hypotheses were developed: a. direct effects of caregiving conditions (i.e. functional limitations and cognitive problems of older adults and longer caregiving time) on resources and burden and health of caregivers: b. direct effects of resources on burden and health of caregivers: c. Indirect effects of caregiving conditions on health of caregivers.

Methods: A total of 1,837 unpaid informal caregivers who completed the survey were included in this. Structural equation modeling (SEM) was conducted to examine the model fit and the hypothesized relationships between variables in the model using Mplus Version 6.0.

Results:  The majority of caregivers were female (65%), married (70%), and White (87%). Less than half of caregivers were adult children caregivers (48%) followed by spousal caregivers (34%). The model yielded an overall good model fit, χ² (32) = 127.61, TLI=.941. CFI = .958, RMSEA = .040. Standardized factor loadings for all indicators were significant at p <.001, ranging from .11 to .77.  The hypothesis a is partially supported, and the hypotheses b and c are fully supported by the data. More negative caregiving conditions (e.g., caregiving for the older adults with more cognitive impairment, and more IADL and ADL limitations) was associated only with higher burden. However, having more resources (e.g., higher perceived mastery, and more financial resources, social support, and family harmony) were associated with lower burden and better physical health of caregivers. In addition, a small indirect effect of caregiving conditions to physical health of caregiver was found through resources.

Conclusion and implication: This study suggests that perceived resources are the most important component to maintain the physical health of caregivers.  Among multiple indicators of resources, caregiver mastery and financial hardship are identified as critical factors. Given the fact that caregiving conditions are likely to deteriorate as time goes by, these findings could be promising, underlying the necessity of financial support and intervention programs to improve caregiver mastery.