Informal Caregiving to Older Adults:
Health Effects of Providing and Receiving Care
Lynn M. Martire
University of Pittsburgh
The provision of ongoing care to an impaired older friend or relative is often a stressful experience that impacts the mental and physical health of the caregiver. Because caregiving sometimes has severe consequences for the health of the caregiver, and because these individuals are an invaluable resource to the rapidly growing population of older adults, research on caregiving has burgeoned over the past two decades. The important role of health psychology in this area of research is demonstrated by the fact that many of the advances made in understanding the consequences of caregiving have resulted from the application of theoretical models and methodologies borrowed from this field.
This chapter first briefly describes the nature and prevalence of informal caregiving to impaired older adults. The second and third sections review the evidence for the effects of caregiving on the individual who provides care and the older adult who receives that care, respectively. The latter focus on the consequences of informal care for the older adult represents a relatively new direction in caregiving research that has important linkages to other literatures in social and health psychology. Because providing care to another person is not always bad for the caregiver, and receiving care is not always good for the care recipient, the second and third sections describe both the negative and positive consequences of providing care and receiving care. Finally, the chapter concludes by highlighting the interactive nature of helping and being helped and the need to address the perspectives of both the caregiver and care recipient in future descriptive and intervention research.
TO OLDER ADULTS
One unfortunate consequence of growing older is the increased difficulty in carrying out everyday activities such as driving, shopping, and preparing meals (instrumental activities of daily living, IADLs), or even personal care activities such as bathing and dressing (activities of daily living, ADLs). For many older adults, this difficulty stems from illnesses such as arthritis, heart disease, and diabetes, the most chronic health problems of older men and women (Benson & Marano, 1994). Such difficulty with everyday activities, often referred to as functional disability, eventually progresses to the point where the older adult needs assistance from others.
Although the likelihood of becoming disabled increases with age, the functional ability of the older adult population is actually characterized by much variability. Of the 95% of U.S. adults from age 65 to 74 who live in noninstitutionalized settings, only 11% are ADL or IADL impaired. This percentage rises to 27% for those from age 75 to 84, and 60% of those over age 85 experience some amount of disability (Manton, Corder, & Stallard, 1997). Investigations utilizing several different national data sets have shown that between 1982 and 1994, the proportion of the population age 65 and older that was disabled decreased slightly (Crimmins, Saito, & Reynolds, 1997; Manton et al., 1997). Despite the relatively low rates of disability before age 85 and the modest improvements in the physical functioning of older adults in general, the contrasting dramatic growth in the proportion of the population that is older will result