Institute for Social Research, University of Michigan, Ann Arbor, Michigan, USA.
Gerontologist. 2023 Jun 15;63(5):840-850. doi: 10.1093/geront/gnac155.
Caregiving research often assumes older adults receiving care have a primary caregiver who provides the bulk of care. Consequently, little is known about the extent to which care responsibilities are shared more evenly within a care network, the characteristics associated with sharing, or the consequences for meeting older adults' care needs.
We analyze a sample of U.S. older adults receiving care from the 2011 National Health and Aging Trends Study (n = 2,398). Based on variables reflecting differences in care hours, activities, and care provided by the whole network, we create network typologies for those with two or more caregivers (n = 1,309) using K-means cluster analysis. We estimate multinomial and logistic regression models to identify factors associated with network type and the association between type and unmet needs. We conduct analyses overall and for older adults living with and without dementia.
Analyses reveal four network types: Small, low-intensity shared care network (SCN); large, moderate-intensity SCN; small, low-intensity primary caregiver network (PCN); and moderate-sized, high-intensity PCN. Among all older adults receiving care, 51% have a sole caregiver, 20% have an SCN with no primary caregiver, and 29% have a PCN. Among older adults with dementia receiving intense care, unmet needs are lower among those with an SCN (vs. PCN).
Findings underscore that the primary caregiver construct, although common, does not apply to a substantial share of care networks. Moreover, having an SCN when needs are high may be beneficial to meeting older adult's needs.
照护研究通常假设接受照护的老年人有一个主要照护者,该照护者提供大部分的照护。因此,对于照护责任在照护网络内更平均分担的程度、与分担相关的特征,以及满足老年人照护需求的后果,知之甚少。
我们分析了 2011 年国家健康老龄化趋势研究(n = 2398)中接受照护的美国老年人样本。基于反映整个网络中照护时间、活动和照护提供者差异的变量,我们使用 K 均值聚类分析为有两个或更多照护者的人(n = 1309)创建网络类型。我们估计多项和逻辑回归模型,以确定与网络类型相关的因素以及类型与未满足需求之间的关联。我们总体进行分析,并针对患有和不患有痴呆症的老年人进行分析。
分析显示出四种网络类型:小型、低强度共享照护网络(SCN);大型、中强度 SCN;小型、低强度主要照护者网络(PCN);和中等规模、高强度 PCN。在所有接受照护的老年人中,51%有单一照护者,20%有无主要照护者的 SCN,29%有 PCN。在接受高强度照护的患有痴呆症的老年人中,SCN(与 PCN 相比)的未满足需求较低。
研究结果强调,尽管主要照护者的概念很常见,但它不适用于相当一部分的照护网络。此外,当需求较高时,拥有 SCN 可能有利于满足老年人的需求。