Until Death Do Us Part: Careers of Caregiving Wives

描述(由申请人提供)：本申请已根据3位评审员提出的有用建议进行了修改。照料是指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。在老年人接受的长期护理服务中，有很大一部分是由非正式护理人员提供的。妻子照顾丈夫是拟议项目的重点，因为这是最常见的照料安排，妻子可能特别容易受到负面结果的影响。 我们项目的目标是更好地了解照顾如何影响照顾妻子。关键成果是照顾妻子的生活质量和保健利用，重点是预防性保健服务的利用。我们使用一个简化的护理模型来从概念上指导我们对两项全国性纵向调查的分析：国家纵向护理人员研究(NLCS；4波数据)和最古老的旧研究中的资产和健康动态(AHEAD；6波数据)。我们的主要贡献是对这一简化模型和相应的假设进行纵向检验。AHEAD的一个主要好处是出现了一组夫妇，其中丈夫没有明显的照看需要，这将使我们能够更准确地衡量照看对妻子的影响。我们还将测试妻子从事的照料类型是否缓和了压力因素(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，并比较我们的结果。我们将使用传统的纵向分析方法以及最新的潜在类轨迹分析(LCTA)技术。 该项目的具体目标是：(1)描述妻子的纵向照料轨迹(照料职业)；(2)纵向确定照料对照料妻子的生活质量和保健使用的影响程度；(3)纵向确定照料妻子的生活质量和预防性护理的使用在接受照料的丈夫被收容或死亡后增加的程度。

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.