Intergenerational Antecedents of Care to Older Adults Approaching the End of Life With and Without Dementia

对患有或不患有痴呆症的临终老年人的护理的代际背景

• 批准号: 9808440
• 负责人: Merril D. Silverstein
• 金额: $ 20.96万
• 依托单位: SYRACUSE UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 2019
• 资助国家: 美国
• 起止时间: 2019-08-15 至 2021-05-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/9808440
• 关键词: 19 year old; Acute; Adolescent and Young Adult; Adopted; Adult Children; Age; Aging; Alzheimer' s Disease; Baby Booms; Biological; Biological Aging; Caring; Cause of Death; Cessation of life; Child; Chronic; Cognitive; Cognitive deficits; Data; Dementia; Diagnosis; Disabled Persons; Elderly; Emotions; Family; Family Life Cycle; Fathers; Financial Support; Generations; Goals; Health; Impaired cognition; Insurance; Investigation; Investments; Knowledge; Life; Life Cycle Stages; Light; Link; Long-Term Care; Longitudinal Studies; Longitudinal Surveys; Marriage; Measurement; Measures; Methodology; Methods; Modeling; Mothers; Parents; Patient Self-Report; Phase; Process; Proxy; Public Policy; Reporting; Research; Research Personnel; Resources; Rewards; Running; Source; Testing; Time; Uncertainty; Update; base; care delivery; career; caregiving; disability; end of life; experience; family structure; frailty; functional disability; improved; indexing; innovation; interest; intergenerational; intimate behavior; middle age; mortality; novel; public health relevance; rate of change; response; social; social deficits; theories; time use

ABSTRACT Based on the framework of social exchange, we hypothesize that early investments made in children will later be reciprocated in the form of instrumental care as parental needs increase. We will examine time-to-death as either an alternative or complementary approach to the use of proxy and self-reports about functional and cognitive impairment to assess vulnerability in older adults in relation to the care-careers of their adult children. The models tested will inform theory about how children serve as conditional resources—responding to their parents’ early investments when triggered by parental need—rendering an improved depiction of intergenerational relationships over the family life cycle. The goals of the research are to: (1) link early transfers of valued resources of time, money, and emotion to rates of change in the amount of care adult children provide to their vulnerable older parents; (2) test a novel methodological approach—the “countdown model”—that uses time-to-death to represent a global form of vulnerability that triggers the delivery of care to older parents; and (3) identify whether care to older parents is more strongly associated with time-to-death from Alzheimer's disease and other dementia-related causes compared to other causes. The countdown model uses time-to-death as an alternative, objectively derived metric of biological vulnerability to represent the need for care by aging parents. Our application of this model provides a unique marriage of theory and method that enhances understanding of long-term intergenerational exchange dynamics that unfold over many decades in families, and represents progressive vulnerability of parents using knowledge about the timing and (dementia and non-dementia) causes of their death. Data for this project are derived from the Longitudinal Study of Generations (LSOG), a multi-panel and multi- generational study that has collected data on three-generation families from 1971 to 2016. Focusing on the middle-generation, which averaged 19 years of age in 1971, we examine trajectories of care provided by these children to older mothers and fathers between 1985 and 2016 as a function of accelerating parental vulnerabilities, and their interaction with early investments of time (shared activities), money (financial support), and emotion (intimacy) made in them by their parents in 1971. Using previously collected mortality information about parents from the National Death Index in 2016—combined with an updated NDI search to 2019—we test the utility of time-to-death as a representation of growing cognitive and physical frailty that stimulates children to provide increasing amounts of care. This research is timely in light of growing uncertainty about the family as a reliable source of extended care in later life.

抽象的 基于社会交流的框架，我们假设，随着父母需求的增加，对儿童进行的早期投资将以工具护理的形式得到回报。我们将审查死亡时间是使用代理和自我报告的替代方法或完全的方法，以评估老年人与成年子女的照顾者有关的脆弱性。经过测试的模型将为儿童如何作为有条件资源提供介绍 - 在父母需求触发时向父母的早期投资辩护 - 在家庭生命周期中改善了代际关系的部署。研究的目标是：（1）将有价值的时间，金钱和情感的早期转移与成年子女为其脆弱的年长父母提供的护理量的变化率联系起来； （2）测试一种新颖的方法论方法（“倒计时模型”），该方法使用时间为死亡代表全球脆弱性形式，从而触发了向年长父母的护理触发； （3）与其他原因相比，确定对年长父母的护理是否与阿尔茨海默氏病和其他与痴呆症相关的其他原因更为密切。倒计时模型将死亡时间用作生物学脆弱性的替代，客观地得出的指标，以代表老年父母的护理需求。我们对该模型的应用提供了理论和方法的独特婚姻，该婚姻增强了对家庭数十年来在家庭中发展的长期代际交流动态的理解，并使用有关时间安排的知识和（痴呆症和非痴呆症）死亡的原因代表了父母的渐进脆弱性。该项目的数据源自世代的纵向研究（LSOG），这是一项多板和多代研究，从1971年到2016年收集了有关三代家庭的数据。着重于1971年的中等生物，该中期为1971年的19岁时，我们研究了这些孩子为这些儿童提供的范围，这些孩子为年龄较大的母亲和20185年的范围和20195年的一名功能和fathers Acterab and Acterab and acker and acker and and and octer and Fathers and Fatterer and a的功能范围，并研究了1985年的一名功能。与父母在1971年对他们进行的时间（共享活动），金钱（财务支持）和情感（亲密关系）的早期投资的互动。使用先前收集到的关于父母在2016年国家死亡指数的死亡率信息 - 与2019年的NDI搜索进行了更新的搜索 - 我们测试了随着时间的努力的效用，以表现为增长的认知能力和身体富有量化的量，以增加照顾的量。这项研究及时鉴于对家庭的不确定性越来越大，作为后来的扩展护理来源。