Intergenerational support structures and pathways

描述（由申请人提供）：随着人口老龄化，预计未来几十年需要护理的人数将急剧增加。照顾老人给照顾者带来了相当大的负担和压力。因此，许多家庭照顾者需要他人的支持，通常是其他家庭成员的支持。事实上，最近一项全国调查的数据表明，73%的家庭照护者得到了其他家庭成员的帮助，这表明最好将照护理解为家庭系统的努力。虽然过去的研究提供了对家庭护理系统组成的一瞥，但家庭成员之间责任的协调和转移以及他们参与的变化（例如，护理时间）仍然知之甚少。我们项目的一个前提是，家庭护理系统的可行性取决于它们的灵活性，也就是说，它们能够根据照顾者和被照顾者不断变化的需求和要求进行重组。第二个前提是，护理必须被理解为一种职业，有不同的持续时间，有不同的过渡点，因此，早期阶段护理人员参与的预测因素可能与亲属疾病后期护理人员参与的预测因素不同。随着时间的推移，护理系统的灵活性和护理人员参与的变化预计会对护理人员、护理接受者以及使用正规服务或养老院安置产生影响。该项目的主要目的是评估家庭护理系统随时间的变化，检查护理者和整个护理系统水平上这种变化的预测因素，并调查这种变化对选定结果的影响，包括护理者和护理接受者的福祉、未满足的护理需求的程度、正式服务的使用和养老院安置。我们的分析将依赖于来自健康和退休以及最老老人的资产和健康动态调查的数据，并依赖于适用于复杂调查中具有内生变量和审查变量的多层次数据的统计方法。我们的研究结果可以为旨在加强体弱多病和认知障碍老年人护理系统的政策和计划以及针对家庭和照顾者福祉的政策和计划提供信息。他们还谈到未来家庭照顾者的可用性，以应对不断变化的家庭结构和照顾需求。

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.