Intergenerational support structures and pathways

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DESCRIPTION (provided by applicant): With the aging of the population, the number of individuals requiring care is expected to increase dramatically during the next decades. Elder care puts considerable burden and strain on the caregiver. Many family caregivers thus require support by others, often other family members. Indeed, data from a recent national survey indicate that 73% of all family caregivers received assistance from other family members, suggesting that care is best understood as family system effort. Although past research provides a glimpse at the composition of family care systems, the coordination and shifting of responsibilities among family members and of changes in their involvement (e.g., care hours) remain poorly understood. One premise of our project is that the viability of family care systems is contingent on their flexibility, that is, their ability to restructure in response to the ever-changing needs and demands of caregivers and care recipients. A second premise is that caregiving must be understood as a career, of variable duration, with distinct transition points, and that the predictors of caregiver involvement at early stages may therefore differ from those of caregiver involvement at later stages of a relative's illness. Both the flexibility of care systems and changes in caregiver involvement over time are further expected to have consequences for caregivers, care recipients, and use of formal services or nursing home placement. The main aim of this project is to assess changes in family care systems over time, to examine the predictors of such changes both at the level of the caregiver and of the care system as a whole, and to investigate the impact of such changes on selected outcomes, including well-being of the caregivers and care recipients, the extent of unmet care needs, the use of formal services, and nursing home placement. Our analyses will rely on data from the Health and Retirement and Assets and Health Dynamics of the Oldest Old surveys and rely on statistical methods that are appropriate for multi-level data with endogenous and censored variables from complex surveys. Our results can inform policies and programs designed to enhance the care systems of frail and cognitively impaired elders as well as policies and programs targeting the well being of families and caregivers. They also speak to the future availability of family caregivers in response to changing family structures and caregiving requirements.