Reciprocal Caregiving between Aging Parents and Adult Children with Disabilities

Background and Purpose

The number of older adult parents caring for adult children with disabilities has risen steadily since the 1970s (Rolf & Kelley-Gillespie, 2009). The health of these household members, reciprocal caregiving arrangements, and other household supports has important implications for policy makers who seek to support these households or provide alternative living arrangements in the community; for example, if the older adult requires an out of home placement, the adult child with a disability will requires a placement as well.

The sources of support, risks (Selzer & Krauss, 2002), and life course impacts (Selzer, Greenberg, Floyd et. Al, 2001) of the older adult caregivers in these households has been examined. These studies have provided an in-depth look at functioning of these families. This study adds to the current literature on older adult caregiving by using nationally representative data that contain detailed information on demographic information, health, household supports, and caregiving arrangements to explore the extent and nature of caregiving in households where older adults care for adult children with disabilities. Comparisons in caregiving arrangements, household supports, and reciprocal caregiving by race, region, and socio-economic status are made. These data also allow a comparison to households where adult children are present and report no disability.

Methods

Multiple panels (1988- 2004) from the Survey of Income and Program Participation (SIPP) were used to describe older adult caregiving by household characteristics, health characteristics of household members, utilization of healthcare, caregiving relationships, and reciprocal caregiving in these households. In order to control for state level effects on program participation, SIPP data were merged with state level poverty data. Regression analyses examined the relationship of household adult child disability characteristic to 1) older adult caregiving, and 2) reciprocal caregiving. The effect of race, region, and socio-economic status were also examined in these regressions.

Results

As caregivers age, the probability that an older adult child with a disability will be found in a caregiver's home significantly increases. Older adults are least likely to care for individuals with the most severe orthopedic limitations. Adult children with disabilities provided care for their parents' ADLs more often than in households where adult children did not have disabilities. Race, region, and position in the income distribution had significant effects on older adult caregiving and mediated reciprocal caregiving.

Conclusions and Implications

Households with older adults and adult children with disabilities can represent important resources in our communities. These households may also need support because they are more likely to contain an older adult child with a disability. The challenge for communities is to support these arrangements as long as possible while maintaining the health of the caregiver and the adult child. When these households dissolve (because of a community placement of the caregiver), two placements are often needed. Because these arrangements are found across racial and ethnic groups, researchers are challenged to find what is working about these situations in culturally sensitive ways and to support these unique caregiving families in the least restrictive settings.