Respite Services and Self-Rated Health Among Older Family Caregivers: Differences between Young-Old and Old-Old Caregivers

Background and Purpose: Respite services, including in-home respite, day care respite, and overnight respite, have been found helpful to relieve caregivers’ burden and promote their well-being. However, the health benefits of three respite services can vary among older caregivers, which needs separate examination. In addition, the differences of health impacts of three types of respite services on young-old (65-74) and old-old (75+) caregivers have been neglected. Therefore, this study aimed to address such research gaps by examining the influence of three types of respite on self-rated health (SRH) among young-old and old-old caregivers respectively.

Methods: The data used in this study was extracted from 13th National Survey of Older Americans Act Participants (n = 1,028). The dependent variable was SRH of older caregivers which was measured by a 5-point Likert scale from 1 = poor to 5 = excellent. Independent variables included in-home respite use, day care respite use, and overnight respite use, which were dichotomous variables (0 = no, 1 = yes). Control variables consisted of caregiver’s social demographics (gender, race, marital status, educational level, and income), health problem of caregiver, physical health of care recipient (# of medical conditions, # of ADL and IADL needs), and caregiving-related stress (emotional stress, physical strain, and financial hardship). Two multiple linear regression models in SPSS 15.0 were conducted separately among young-old and old-old caregivers, to identify whether and how three types of respite services influenced their SRH. A multiple imputation procedure was adopted to estimate missing values.

Results: For young-old caregivers (n = 570), the average SRH score was 3.07 (SD = 1.10). 35.05% of them used in-home respite, 10.70% used day care respite, and 5.09% used overnight respite. Coefficients of regression in imputation 5 were used due to a lack of pooled overall model. Therefore, the overall regression model was significant, F(15, 554) = 14.53, p < .001, adjusted R² = 26.3%. Overnight respite tended to increase SRH of young-old caregivers (B = 0.36, p = .053); and race, educational level, income, health problem of caregiver, and care recipients were significant predictors of SRH. Among old-old caregivers (n = 458), the mean SRH score was 2.85 (SD = 1.05). 48.47% of them used in-home respite, 7.86% used day care respite, and 4.15% used overnight respite. Similar to the previous model, regression coefficients in imputation 5 were also used. The overall regression model was also significant, F(15, 442) = 10.95, p < .001, adjusted R² =24.6%. Day care respite was found to positively affect SRH of old-old caregivers (B = 0.53, p = .002); and income and financial hardship were significant control variables.

Conclusions and Implications: These findings suggested that overnight respite positively influenced SRH of young-old caregivers, and day care respite was significantly beneficial for SRH of old-old caregivers. Therefore, respite services can be designed according to the characteristics of older caregivers in different age groups; and such age differences can also be considered in policy making for promoting respite services use among older caregivers.