Exploring the Relationship between Caregiver's Perception of Stress, Living Arrangement, and Respite Care Utilization: Insights from the 2017 National Poll on Healthy Aging (NPHA)

Background and Purpose:

By 2030, it is estimated that one out of every five Americans will reach the age of 65 or older, many of whom will require some level of care to maintain their overall well-being. Informal caregivers of individuals with dementia often face challenges in balancing caregiving responsibilities with other obligations. Respite care, however, offers temporary relief to primary caregivers by providing myriad services tailored to the family's needs. This study seeks to investigate whether caregivers' perceived stress levels and their living arrangements (whether they reside with the person with dementia or not) are associated with their likelihood of utilizing respite care services.

Methods:

This study uses publicly available data from the 2017 National Poll on Healthy Aging (NPHA). The NPHA targets non-institutionalized US adults aged 50-80 years. The current study utilizes a subsample consisting of 148 people who self-identify as caregivers for an adult 65 years and above with a memory problem such as dementia, Alzheimer’s or other cognitive impairment. The nominal dependent variable of interest was patronage/use of respite care (have used; interested in using; not interested in using). The independent variables examined were perception of stress (not stressful, somewhat stressful, very stressful) and living arrangement (caregiver lives with or does not live with the care-recipient). Multinomial logistic regressions were constructed to examine the relationship between the dependent and independent variables.

Results:

Caregivers were predominantly female (61.5%), White non-Hispanic (75%) and aged 50-64 years (54.1%). Most of the care-recipients were either parents/in-laws (53.4%) or spouses (23.6%) of the caregivers. Additionally, the majority (58.1%) reported that caregiving was somewhat stressful yet, only 6.1% of the study population reported ever using respite care. Multinomial logistic regressions demonstrated that comparing those who have used respite care to the reference category of those who were not interested, perceiving caregiving as “very stressful”, is significantly associated with the likelihood of having used respite (OR= 7.7248, β = 1.981, p < 0.05; 95% CI=1.195-43.943). Similarly, when comparing those who are interested in using respite care to the reference category of those who are not interested, perceiving caregiving as “very stressful” was once again significantly associated with the likelihood of one expressing interest in using respite care (OR = 10.414, β = 2.343, p<0.05; 95% CI=2.393-45.323). Living arrangement however did not emerge as a significant predictor on the likelihood of using or being interested in respite care in the context of this study.

Conclusions and Implications:

In summary, the perception of caregiving as very stressful appears to be an important factor in both the utilization and interest in respite care; however, the role of living arrangement was not supported in the findings. Interestingly, most caregivers in this study were not interested in respite care. Although the sample is small, these findings call upon social workers and policymakers to delve into the factors deterring individuals from using respite care. It is crucial to tackle these barriers and expand efforts to promote respite care usage given the reported benefits.