The Impact of Caregiving for Children with Special Needs on Later-Life Health of Parent Caregivers

Background and Purpose: Parent caregivers for a child with disabilities or chronic health problems often play a prolonged caregiving role that extends beyond typical parenting, requiring sustained emotional, physical, and financial investment. Although the short-term effects of caregiving for children with special needs are well documented, its long-term health consequences for parent caregivers remain underexplored. Guided by the life course perspective and the stress process model, this study examines: (1) Do parent caregivers of children with special needs report worse later-life health outcomes compared to non-caregivers and other types of caregivers (e.g., caregiving for parents or spouses)? (2) How do caregiving characteristics, such as caregiving start/end age, duration, multiple care roles, number of caregiving episodes, and concurrent caregiving, shape later-life health outcomes among parent caregivers?

Methods: The study used data from the Health and Retirement Study (HRS), a nationally representative longitudinal survey of U.S. adults aged 50 and older. The Life History Mail Survey (LHMS) was an off-year supplement of HRS, collects retrospective data on earlier life experiences. Our sample included participants who completed the LHMS in 2017 or 2019 and reported physical, mental, and cognitive health in the 2020 core interview. Participants included parent caregivers of children with special needs (n = 178), other types of caregivers (n = 1,462), and non-caregivers (n = 5,452). We used descriptive statistics and multinomial logistic regression to examine caregiving group characteristics. Multivariate regression models assessed the associations between earlier-life caring for children with special needs experiences and later-life physical, mental, and cognitive health. Additional models within the parent caregivers examined how caregiving characteristics influence later-life health outcomes. All models included sociodemographic characteristics measured in 2020.

Results: Compared to non-caregivers, parent caregivers of children with special needs were more likely to be female, unmarried, and well-educated. Compared to other types of caregivers, parent caregivers were more likely to be younger, better educated, to begin caregiving at an earlier age, end caregiving at a later age, and have a longer duration of caregiving. Additionally, parent caregivers reported significantly worse later-life mental health compared to other caregivers (b = 0.315, p = 0.036), with no significant differences in physical or cognitive health. Among parent caregivers, a later caregiving end age was associated with increased physical limitations (b = 0.059, p = 0.019).

Conclusions and Implications: Parent caregivers of children with special needs represent a unique and vulnerable caregiving population that requires support during and beyond the caregiving tasks. Caregiving for children with special needs is associated with parent caregivers’ increased risk of later-life depression. Additionally, the timing and transitions of caregiving affect long-term health. Future studies should further explore the mechanisms linking earlier-life caregiving experiences to later-life mental health by examining factors such as coping strategies, marital strain, and social isolation. Our study also underscores the need for targeted interventions to address the psychological burden faced by parent caregivers across their life course.