Until Death Do Us Part: Careers of Caregiving Wives

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DESCRIPTION (provided by applicant): This application has been revised based on useful suggestions made by 3 reviewers. Caregiving is the provision of support or assistance by one family member to another in basic or instrumental activities of daily living. Informal caregivers provide a large proportion of the long-term care services that elderly persons receive. Wives caring for husbands is the focus of the proposed project since that is the most common caregiving arrangement and wives may be particularly vulnerable to negative outcomes. The goal of our project is to better understand how caregiving affects caregiving wives. The key outcomes are quality of life and health care use of the caregiving wife, with a focus on the use of preventive health services. We use a simplified model of caregiving to conceptually guide our analyses of two national, longitudinal surveys: the National Longitudinal Caregiver Study (NLCS; 4 waves of data) and the Asset and Health Dynamics Among the Oldest Old study (AHEAD; 6 waves of data). Our primary contribution is to test this simplified model and corresponding hypotheses longitudinally. A major benefit of AHEAD is the presence of a "control group" of couples in which the husband has no apparent need for caregiving that will enable us to more precisely measure the effect of caregiving on wives. We will also test whether the type of caregiving employed by the wife moderates the effect of stressors such as the husband having dementia on wife outcomes. We will complete analyses in both NLCS and AHEAD and compare our findings. We will use both traditional longitudinal analysis methods as well as state of the art latent class trajectory analysis (LCTA) techniques. The specific aims of the project are to: (1) Describe the longitudinal caregiving trajectories (caregiving career) of wives; (2) Determine longitudinally the extent to which caregiving influences caregiving wives' quality of life and health care use; and (3) Determine longitudinally the extent to which caregiving wives' quality of life, and use of preventive care increase following the institutionalization or death of the care receiving husband.