Family Caregiving for Older Adults

Abstract

Family members are the primary source of support for older adults with chronic illness and disability. Thousands of published empirical studies and dozens of reviews have documented the psychological and physical health effects of caregiving, identified caregivers at risk for adverse outcomes, and evaluated a wide range of intervention strategies to support caregivers. Caregiving as chronic stress exposure is the conceptual driver for much of this research. We review and synthesize the literature on the impact of caregiving and intervention strategies for supporting caregivers. The impact of caregiving is highly variable, driven largely by the intensity of care provided and the suffering of the care recipient. The intervention literature is littered with many failures and some successes. Successful interventions address both the pragmatics of care and the emotional toll of caregiving. We conclude with both research and policy recommendations that address a national agenda for caregiving.

Keywords: caregiving; health effects; interventions; prevalence; risk factors; roles.

Figure 1:

Chronic disease care trajectory: caregiver tasks and health effects. Note that caregiver tasks are additive over time from the early to the late stages of a caregiving career. Figure adapted with permission from Schulz & Tompkins (2010).

Figure 2:

A unified model of the stress–health process applied to caregiving. Solid lines represent direct effects and dashed lines represent feedback loops. Figure adapted with permission from Cohen et al. (1995).