Determinants of primary caregiver stress and burden: area of residence and the caregiving networks of frail elders.

This research examines the association among characteristics of the caregiving network, primary caregiver stress and burden, and area of residence. The purpose is two-fold: to determine whether the structure of the relationship between the caregiving network, and stress and burden is uniform across rural, small city, and urban samples; and, to assess whether stress and burden are explained by a similar set of variables within area of residence categories. The data are drawn from a matched sample of 1,388 impaired elders and their primary caregivers from the 1982 National Long-Term Care Survey and the National Survey of Informal Caregivers. In general, the analysis shows that several characteristics of the care-receiver and the primary caregiver have a differential effect on stress and burden across residential categories, and that, within rural, small city, and urban samples, the determinants of stress and burden are not homogeneous. When the frail elder is able to reciprocate by doing chores, babysitting, or providing some other type of assistance for the primary caregiver, however, both stress and burden are reduced in all three residential categories. Similarly, the increased provision of assistance with instrumental activities of daily living by the primary caregiver uniformly increases stress and burden. These findings suggest that interventions designed to alleviate primary caregiver stress and burden may be able to have some common components, but may also need to be tailored in some ways to specific residential environments.