The Society for Social Work and Research

2013 Annual Conference

January 16-20, 2013 I Sheraton San Diego Hotel and Marina I San Diego, CA

Dual Roles: Employed Caregivers of Older Adults

Friday, January 18, 2013: 8:00 AM
Executive Center 2B (Sheraton San Diego Hotel & Marina)
* noted as presenting author
Abby Schwartz, MGS, MSW, Doctoral Student, Boston College, Chestnut Hill, MA

Male and female employed caregivers of older adults face challenges in managing the demands of being both caregiver and employee.  Many middle-aged caregivers, referred to as the “sandwich generation,” have a third role as a parent. These multiple demands can create a variety of stresses for caregivers.  Less is known about the extent to which differences in the age or sex of the caregiver impact their stress, and how stress may be moderated by a variety of circumstances.

The research questions for this study were:

  1. Does the caregiver’s age and sex predict physical strain, emotional stress, and financial hardship (outcomes)?
  2. Does the use of services (paid, unpaid, and internet use), co-residence with the care recipient, and caregiver race moderate the relationships between the predictors and outcomes?


This secondary analysis used the Caregiving in the U.S. Study, 2009, conducted by the National Alliance for Caregiving in collaboration with AARP. The current study sample included 460 employed caregivers (170 men, 290 women) aged 65 and over, sampled through random digit dialing and target sampling for minority groups. Fifty-nine percent were white, and the mean age was 51 (SD= 10.7). 

Caregiver age was recoded: 18 to 44 (younger), 45 to 55 (sandwich generation), and 56 to 99 (older). Physical strain, emotional stress, and financial hardship ranged from 1 (not at all) to 5 (a great deal). Ordered logistic regression was used to test the main effects models, and moderation analyses tested research question 2.


The odds of experiencing physical strain was 2.15 times greater for the older group of caregivers compared to the sandwich generation group (reference group).  Emotional stress was also 1.77 times more likely to be experienced by older caregivers than younger caregivers.  Being a male decreased the odds of emotional stress by 68%, compared to females.

The moderation analyses revealed two significant interactions. The odds of having higher physical strain was 3.04 for the older group who received paid help, and 3.20 for the older group not receiving paid help. The odds of having higher emotional stress was 70% less for male caregivers who lived within 20 miles of the care recipient, compared to females co-residing with the care recipient.

The older age group was found to experience more physical strain, however those receiving paid help had lower odds of physical strain. The care recipient’s age and impairment increases as the caregiver’s age increases.  Males having less emotional stress than females, particularly those not living with the care recipient may be related to providing less care due to not co-residing. Race was not a significant moderator.


The relationship between caregiving and employment is important. The caregiver's age is significant in understanding how paid help can assist in care provision.  Although the findings concern employed caregivers, the question remains whether these results are significantly different from caregivers who are unemployed. Future research warrants a closer examination of the circumstances that impact the experience of employed caregivers to understand the unique service needs of this group.