Department of Health Policy and Management, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland.
Center on Aging and Health, Division of Geriatric Medicine and Gerontology, Johns Hopkins University School of Medicine, Baltimore, Maryland.
Gerontologist. 2018 Nov 3;58(6):1021-1032. doi: 10.1093/geront/gnx093.
To assess trends in family caregiving between 1999 and 2015.
We construct nationally representative profiles of community-dwelling older adults receiving help with self-care or indoor mobility and their "primary" family or unpaid caregiver using the 1999 and 2004 National Long Term Care Survey, 2011 and 2015 National Health and Aging Trends Study, and linked caregiver surveys. Trends are examined.
Older adults receiving help were incrementally younger, more racially diverse, and better educated in 2015. Primary caregivers overwhelmingly continued to be spouses and adult children. Arrangements were increasingly 4 years or longer in duration (shifting from 44.8% in 1999 to 60.5% by 2015). On average, primary caregivers provided about or in excess of 30 hr per week at all four time points. Spouses provided fewer hours of care, were twice as likely to work, and half as likely to report substantial emotional, physical, and financial difficulty due to caregiving in 2015 than 1999. Adult children provided comparable hours of care to a more impaired population; a similar proportion reported substantial caregiving-related difficulty at each time. Use of respite care nearly doubled from 8.5% in 1999 to 15.7% in 2015. Dementia caregivers were less likely to report substantial physical and financial difficulty and more likely to use respite care in 2015 than 1999.
Family caregivers' circumstances generally improved during the 16-year period. Results diverge from prevailing concerns regarding the state of family caregiving and demonstrate the importance of longitudinally monitoring trends in late-life family caregiving.
评估 1999 年至 2015 年期间家庭护理的趋势。
我们利用 1999 年和 2004 年全国长期护理调查、2011 年和 2015 年国家健康与老龄化趋势研究以及相关的护理人员调查,构建了具有全国代表性的接受自我护理或室内活动帮助的社区居住老年人及其“主要”家庭或无薪护理人员的档案。研究检查了趋势。
2015 年,接受帮助的老年人年龄逐渐变小,种族更加多样化,受教育程度更高。主要护理人员仍然是配偶和成年子女。护理安排的持续时间越来越长(从 1999 年的 44.8%增加到 2015 年的 60.5%)。在所有四个时间点,主要护理人员平均每周提供约 30 小时或更多的护理。配偶提供的护理时间更少,工作的可能性是配偶的两倍,由于护理而感到身体、情绪和经济困难的可能性是配偶的一半。成年子女为更需要护理的人群提供了相当数量的护理时间;在每个时间点,报告存在大量护理相关困难的比例相似。从 1999 年的 8.5%到 2015 年的 15.7%,临时护理的使用几乎翻了一番。2015 年痴呆症护理人员报告身体和经济困难的可能性较小,使用临时护理的可能性较大。
在 16 年期间,家庭护理人员的情况总体上有所改善。结果与普遍关注的家庭护理状况不符,表明有必要对晚年家庭护理趋势进行纵向监测。