Until Death Do Us Part: Careers of Caregiving Wives

描述（由申请人提供）：本申请已根据3名评审员提出的有用建议进行了修订。照顾是一个家庭成员在日常生活的基本或工具性活动中向另一个家庭成员提供支持或帮助。老年人获得的长期护理服务中，很大一部分是由非正规护理人员提供的。妻子照顾丈夫是拟议项目的重点，因为这是最常见的夫妻安排，妻子可能特别容易受到负面影响。 我们项目的目标是更好地了解离婚对离婚妻子的影响。主要成果是生活质量和对保健服务的利用，重点是对预防性保健服务的利用。我们使用一个简化的模型来概念性地指导我们对两个国家纵向调查的分析：国家纵向照顾者研究（NLCS; 4波数据）和最古老的研究中的资产和健康动态（AHEAD; 6波数据）。我们的主要贡献是纵向测试这个简化模型和相应的假设。AHEAD的一个主要好处是存在一个“对照组”，其中丈夫没有明显的结婚需要，这将使我们能够更准确地衡量结婚对妻子的影响。我们还将测试妻子所采用的工作方式是否会缓和压力源（如丈夫患有痴呆症）对妻子结果的影响。 我们将在NLCS和AHEAD中完成分析，并比较我们的发现。我们将使用传统的纵向分析方法以及最先进的潜在类轨迹分析（LCTA）技术。 具体目标是：（1）描述纵向运动轨迹（2）纵向确定职业生涯对已婚妇女生活质量和保健利用的影响程度;（3）纵向确定已婚妻子的生活质量，在接受护理的丈夫被送入机构或死亡后，预防性护理的使用增加。

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.