The Moderating Role of Formal Support in the Relationship between Caregiving Stressors and Positive Aspects of Caregiving Among Caregivers of Older Adults

Background and Purpose:

Informal family caregivers of older adults experience significant stressors associated with caregiving, which may diminish the positive aspects of fulfilling their caregiver roles. Formal support, which involves organized services aimed at assisting caregivers in managing the care for older adults, can enhance caregivers’ mental health. Despite the positive effect of formal support on caregivers’ mental well-being, few studies have examined the relationships between caregiving stressors, formal support, and positive aspects of caregiving. This study aims to address this research gap by examining the moderating effect of formal support on the association between caregiving stressors and positive aspects of caregiving among caregivers of older adults.

Methods:

This study used a cross-sectional research design. Data were drawn from the 2021 National Survey of Older Americans Act Participants (NSOAAP), which included caregivers (N = 1878) enrolled in the National Family Caregiver Support Program (NFCSP) across the United States. Positive aspects of caregiving were evaluated using five self-report items from the four-dimensional Scale for Positive Aspects of Caregiving Experience. Example items include feelings of joy, a sense of accomplishment from caregiving, and more. Caregiving stressors encompass caregivers’ assistance with older adults’ activities of daily living and instrumental activities of daily living (ADLs-IADLs assistance), and caregivers’ subjective feeling of caregiving intensity. Formal support refers to various types of assistance provided by the NFCSP, such as providing home-delivered meals, housekeeping services, and assistance in obtaining food stamps or Medicaid. Caregivers’ socio-demographic characteristics were included in the analysis as covariates. Multiple linear regression models were used to examine the study's aim.

Results:

Analysis shows that formal support significantly moderated the relationship between ADLs-IADLs assistance and positive aspects of caregiving (B = .18, p < .05). For caregivers with higher levels of formal support, the negative association between ADLs-IADLs assistance and positive aspects of caregiving was attenuated. Results also indicated that (1) lower levels of ADLs-IADLs assistance were associated with higher levels of positive aspects of caregiving (B = -3.26, p < .05) and (2) higher levels of formal support were associated lower levels of positive aspects of caregiving (B = -1.25, p < .05). Additionally, African-American caregivers (B = -.66, p < .05) and caregivers with lower levels of education (B = .78, p < .001) experienced lower levels of positive aspects of caregiving.

Conclusion:

This study identified formal support as a moderator that can mitigate the negative effect of caregiving stressors on positive aspects of caregiving among caregivers of older adults. Findings highlight the importance of formal support in increasing caregivers’ gains and rewards from caregiving. The results also inform social service agencies to provide organized services aimed at reducing caregiving stressors as means to enhance positive aspects of caregiving. In addition, by identifying the factors contributing to positive aspects of caregiving, this study helps social work practitioners establish a risk and protective profile for positive aspects of caregiving. Social workers can then integrate this profile into clinical assessments and direct resources to caregivers less likely to experience positive aspects of caregiving.