Caregiving within and beyond the family is associated with lower mortality for the caregiver: A prospective study

Grandparenting has been proposed as an ultimate evolutionary mechanism that has contributed to the increase in human life expectancy (see the grandmother hypothesis). The neural and hormonal system – originally rooted in parenting and thus grandparenting – that is activated in the process of caregiving has been suggested as a potential proximate mechanism that promotes engagement in prosocial behavior towards kin and non-kin alike. Evidence and theory suggest that activating this caregiving system positively impacts health and may reduce the mortality of the helper. Although some studies have found grandparental care to have beneficial effects on grandparents' health outcomes, most studies have focused on the detrimental health consequences of providing custodial care for grandchildren. Little is known about how non-custodial grandparental and other forms of caregiving relate to mortality hazards for the care provider. Using an evolutionary framework, we examined whether caregiving within and beyond the family is related to mortality in older adults. Survival analyses based on data from the Berlin Aging Study revealed that mortality hazards for grandparents who provided non-custodial childcare were 37% lower than for grandparents who did not provide childcare and for non-grandparents. These associations held after controlling for physical health, age, socioeconomic status and various characteristics of the children and grandchildren. Furthermore, the effect of caregiving extended to non-grandparents and to childless older adults who helped beyond their families. Potential ultimate and proximate mechanisms underlying these effects are discussed.     

Family composition and the characteristics of parental care during the nursing phase of captive common marmosets (Callithrix jacchus)

Cooperative care of the young by the father, older siblings, and unrelated group members is observed in a number of species, but inCallithrix jacchus parental care by the father is considered to be part of the reproductive behavior of the species. Nevertheless, the way the presence of potential helpers influences the costs of caring for the parents is not well understood. In this study we describe the suckling phase of youngC. jacchus, in families with and without older siblings, assessing the effect of siblings on the amount of care given by the father and mother. Six family groups were observed: three consisting of the mated pair and two newborn infants, and three with one or two additional sub-adult siblings. Our results suggest that the presence of older siblings as helpers affects the parents' participation in caregiving by altering maternal investment through the control of nursing and by reducing the costs of carrying for the father.     

Zorgzame vrienden en buren als mantelzorgers van oudere volwassenen: een vergelijking met kinderen

This study compared informal care to older, non-coresiding adults provided by friends and neighbours and informal care by children or their partners. Using data from a Dutch representative survey among informal caregivers conducted by CBS and SCP, caregivers of friends (n=133), neighbours (n=108) and parents (n=1,008) were compared with one another to investigate care that friends and neighbours provide to the elderly non-coresiding adults (age 55 and over). Nine percent of those providing care to someone outside the household were friends and nine percent were neighbours. Friends, like children, usually provide long-lasting care, up to four or five years. Friends are similar to neighbours in the number of hours that they provide care. Friends and neighbours experience a lower caregiver burden than children. However, when fulfilling multiple caring tasks, both friends and children, have a greater chance of experiencing higher levels of burden. When there were other caregivers to help, friends experienced a small reduction in burden. Friends and neighbours deserve to be recognized as informal caregivers by policy makers and they deserve attention and support along with family caregivers.     

The impact of informal care-giving networks on adult children's care-giver burden

Previous research on the care-giver burden experienced by adult children has typically focused on the adult child and parent dyad. This study uses information on multiple informal care-givers and examines how characteristics of the informal care-giving network affect the adult child's care-giver burden. In 2007, 602 Dutch care-givers who were assisting their older parents reported on parental and personal characteristics, care activities, experienced burden and characteristics of other informal care-givers. A path model was applied to assess the relative impact of the informal care-giving network characteristics on the care-giver burden. An adult child experienced lower care-giver burden when the informal care-giving network size was larger, when more types of tasks were shared across the network, when care was shared for a longer period, and when the adult child had no disagreements with the other members of the network. Considering that the need for care of older parents is growing, being in an informal care-giving network will be of increasing benefit for adult children involved in long-term care. More care-givers will turn into managers of care, as they increasingly have to organise the sharing of care among informal helpers and cope with disagreements among the members of the network.     

Symposium De toekomst van de informele zorg

Due to the reform of long term care in 2015, there is growing concern about whether groups at risk receive the care they need. People in need of care have to rely more on help from their social network. The increased need for informal care requires resilience and organizational skills of families, but also of volunteers, professionals and employers. What does this mean for the provision of informal care in the next decennia? The symposium ‘The future of informal care’, organized on January 26 2017 by the National Institute for Social Research and the Institute for Societal Resilience of the Vrije Universiteit, addressed possible answers to this question. In her inaugural speech Alice de Boer discussed social inequality as possible determinant and outcome of informal care. Some conclusions:Until 2050 the absolute number of 75-plus doubled to about 3 million persons, but the number of informal caregivers will decrease. In addition to the importance of social and economic resources (the ‘have & have-nots’), the ability to arrange care (the ‘can & can-nots’) gains importance.Almost half of the older employers provides informal care just before retirement. Flexibility in working hours and work location facilitates combining work and care, but about half of the employers indicates that partial retirement and working at home are no options.Informal caregivers and professionals often provide care from comparable perspectives and identities. Addressing similarities rather than differences improves their chances for collaboration.The number of adult children providing household care to older parents increased between 2002 and 2014. This suggests an increase in family solidarity, but current reform policies may increase the gender inequality in caregiving families.Spouses and children remain primary caregivers in the future, preferably supported by many different types of caregivers. Not everybody has the capabilities to organize and direct such a large care network.Providing informal care increases the risk for overburden and absence at work or education. Informal caregivers at risk remain, also in the future, women, spouses, migrants, and younger carers.     

Children aged 7–9 prefer cuteness in baby faces,and femininity in women's faces

Infant facial features are typically perceived as “cute,” provoking caretaking behaviours. Previous research has focused on adults' perceptions of baby cuteness, and examined how these perceptions are influenced by events of the adult reproductive lifespan, such as ovulation and menopause. However, globally, individuals of all ages, including pre-pubertal children, provide notable proportions of infant care. In this study, we recruited participants in and around northern England, and tested 330 adults and 65 children aged 7–9 using a forced-choice paradigm to assess preferences for infant facial cuteness in two stimulus sets and (as a control task) preferences for femininity in women's faces. We analysed the data with Hierarchical Bayesian Regression Models. The adults and children successfully identified infants who had been manipulated to appear cuter, although children's performance was poorer than adults' performance, and children reliably identified infant cuteness in only one of the two infant stimuli sets. Children chose the feminised over masculinised women's faces as more attractive, although again their performance was poorer than adults' performance. There was evidence for a female advantage in the tasks: girls performed better than boys when assessing the woman stimuli and one of the infant stimulus sets, and women performed better than men when assessing one of the infant stimulus sets. There was no evidence that cuteness judgements differed depending upon exposure to infants (children with siblings aged 0–2; adults with a baby caregiving role), or depending upon being just younger or older than the average age of menopause. Children and grandparents provide notable portions of infant caretaking globally, and cuteness perceptions could direct appropriate caregiving behaviour in these age groups, as well as in adults of reproductive age.     

Social development during the first twenty weeks in the cotton-top tamarin (Saguinus o. oedipus)

Fourteen infant cotton-top tamarins from five captive family groups were studied during the first 20 weeks of life. We examined the roles of parents and of siblings of different ages as caregivers and as social companions for the infants, as well as the effects of group composition and group size on these roles. Parents and adult siblings played similar active roles in infant caregiving during the first few weeks after birth, with males showing a greater involvement than females. In groups without other offspring the two parents showed equal infant caregiving behaviour, whreas fathers carried more than mothers did in groups with offspring present. Although infants received more caregiving from males, they showed a preference for contact and proximity with their mothers. No sex differences were found in infant behaviour or in the direction of behaviour by caregivers toward infants. Twins showed greater amounts of both social and solitary play in weeks 15–20 than did singletons, and there was no effect of the number of older siblings on the amount of play shown by an infant.     

Allomaternal Investment and Relational Uncertainty among Ngandu Farmers of the Central African Republic

Several studies have suggested a matrilateral bias in allomaternal (non-maternal) infant and child caregiving. The bias has been associated with the allomother’s certainty of genetic relatedness, where allomothers with high certainty of genetic relatedness will invest more in children because of potential fitness benefits. Using quantitative behavioral observations collected on Ngandu 8- to 12-month-old infants from the Central African Republic, I examine who is caring for infants and test whether certainty of genetic relatedness may influence investment by allomothers. Results indicate a matrilateral bias in caregiving by extended kin members, but this does not affect the total level of care infants receive when fathers and siblings are included in the analysis. These results replicate a previous study done among an adjacent foraging population and emphasize the importance of examining children’s complete social environments when addressing caregiving and child development.     

Birth order, sibship size, and status in modern Canada

This paper investigates the possibility that birth order affects the degree to which individuals attain higher status. Humans give birth to a variable number of (usually) single offspring spaced one to many years apart, and continue to maintain contact with them for extended periods of time. The continued presence of older siblings, and arrival of younger ones, means that each child is reared in a different family environment. Research findings from the field of behavior genetics suggest that these differences have a significant impact on the development of individual differences between children in the same family. Although no two families are likely to be exactly the same, factors such as birth order remain constant across them, and may have similar influences. The present study examines the relationships between birth order, sibship size, and several variables thought to index future status attainment (status striving) in a random sample of Canadians. Firstborn children appear to be more status oriented than lastborns, and this effect is mediated by sibship size. While firstborn children are unaffected by the number of younger siblings they have, the status ambitions of youngest children decrease the more older siblings they have. Birth order effects on status attainment are not as strong as they are on status ambitions.     

Older Adults' Preferences for Future Care: Formal Plans and Familial Support

A total of 45 adults, ranging in age from 56 to 88, were asked whom they expected to provide care for them if they became frail. Past experiences, family structure, and current relationships with children and grandchildren influenced their perceptions of how they would manage in the future. For some individuals, evidence of family conflict was linked with plans not to rely on family members. Others with formal plans, and those who identified family members as being responsible for their future care, did so regardless of the nature of their relationships. The findings point to a potential transformation in family caregiving and challenge the notion that families are always the preferred provider of care in the later years.     

Hip joint replacement surgery for idiopathic osteoarthritis aggregates in families

In order to determine whether there is a genetic component to hip or knee joint failure due to idiopathic osteoarthritis (OA), we invited patients (probands) undergoing hip or knee arthroplasty for management of idiopathic OA to provide detailed family histories regarding the prevalence of idiopathic OA requiring joint replacement in their siblings. We also invited their spouses to provide detailed family histories about their siblings to serve as a control group. In the probands, we confirmed the diagnosis of idiopathic OA using American College of Rheumatology criteria. The cohorts included the siblings of 635 probands undergoing total hip replacement, the siblings of 486 probands undergoing total knee replacement, and the siblings of 787 spouses. We compared the prevalence of arthroplasty for idiopathic OA among the siblings of the probands with that among the siblings of the spouses, and we used logistic regression to identify independent risk factors for hip and knee arthroplasty in the siblings. Familial aggregation for hip arthroplasty, but not for knee arthroplasty, was observed after controlling for age and sex, suggesting a genetic contribution to end-stage hip OA but not to end-stage knee OA. We conclude that attempts to identify genes that predispose to idiopathic OA resulting in joint failure are more likely to be successful in patients with hip OA than in those with knee OA.     

Relationships and burden: An empirical‐ethical investigation of lived experience in home nursing arrangements

Quantitative research has called attention to the burden associated with informal caregiving in home nursing arrangements. Less emphasis has been placed, however, on care recipients’ subjective feelings of being a burden and on caregivers’ willingness to carry the burden in home care. This article uses empirical material from semi‐structured interviews conducted with older people affected by multiple chronic conditions and in need of long‐term home care, and with informal and professional caregivers, as two groups of relevant others. The high burden of home‐care arrangements is unanimously stressed by all three groups involved in the triangle of care. An empirical‐ethical investigation of what can be legitimately expected from family members and informal caregivers, informed by Frith's symbiotic empirical ethics approach, was undertaken. Key tenets from the special goods theory and nursing professionalism are used as analytical tools. The study concludes that the current situation may hinder professional development and can reinforce feelings of being a burden to relevant others.     

Hip joint replacement surgery for idiopathic osteoarthritis aggregates in families

In order to determine whether there is a genetic component to hip or knee joint failure due to idiopathic osteoarthritis (OA), we invited patients (probands) undergoing hip or knee arthroplasty for management of idiopathic OA to provide detailed family histories regarding the prevalence of idiopathic OA requiring joint replacement in their siblings. We also invited their spouses to provide detailed family histories about their siblings to serve as a control group. In the probands, we confirmed the diagnosis of idiopathic OA using American College of Rheumatology criteria. The cohorts included the siblings of 635 probands undergoing total hip replacement, the siblings of 486 probands undergoing total knee replacement, and the siblings of 787 spouses. We compared the prevalence of arthroplasty for idiopathic OA among the siblings of the probands with that among the siblings of the spouses, and we used logistic regression to identify independent risk factors for hip and knee arthroplasty in the siblings. Familial aggregation for hip arthroplasty, but not for knee arthroplasty, was observed after controlling for age and sex, suggesting a genetic contribution to end-stage hip OA but not to end-stage knee OA. We conclude that attempts to identify genes that predispose to idiopathic OA resulting in joint failure are more likely to be successful in patients with hip OA than in those with knee OA.     

Formación de cuidadores en un programa de estimulación cognitiva: efectos diferenciales según el tipo de cuidador

Background and objectivesThe ageing population and the increasing dependency associated with it, makes the caregiver a highly relevant figure nowadays. The present study analyzes the socio-demographic differences between family and professional caregivers and their satisfaction and implication in a training program for caregivers.MethodsThe sample consisted of 59 caregivers of older people (37 were family caregivers and 22 professional caregivers) which received and implemented a caregivers training program in their daily care functions. These caregivers were trained in communication skills and cognitive stimulation strategies so they could use them in their daily care activities with the older adults under their care during a period of 3 months. All the participants were assessed with a socio-demographic questionnaire, 2 questionnaires to analyze their satisfaction with their work and the training received and one questionnaire to analyze their ability to detect and react to memory and behavior problems in the older adults they attended.ResultsThe results showed socio-demographic differences, improvements in satisfaction in family caregivers and a greater commitment in their daily work after the treatment in both groups although these effects could be due to different reasons.ConclusionsThe research shows the benefits of carrying out training programs for caregivers as they significantly increase the quality and satisfaction with caregiving. The study also displays the need to adjust such programs taking into account that the socio-demographic characteristics and training needs are different depending on whether de caregiver is a family member or a professional.     

Does Gender Moderate Factors Associated with Whether Spouses Are the Sole Providers of IADL Care to Their Partners?

We explored whether gender moderated the influence of other factors on solo spousal caregiving. The subsample (N = 452) from the AHEAD study included elderly care recipients (CRs) receiving IADL assistance and their spouses. Logistic regression modeled the likelihood of solo spousal IADL care. Gender moderation was tested by product terms between CRs' gender and measures of partners' health, potential helpers, and sociodemographic characteristics. As numbers of CRs' IADLs and couples' proximate daughters increased, wives less often received care solely from their husbands, but husbands' receipt of care from their wives was unaffected. Age differences between spouses and CRs affected solo spousal caregiving to wives and husbands in opposite ways. Regardless of gender, CRs' number of ADL limitations and spouses with IADL or ADL limitations reduced the likelihood of solo spouse care. Identifying circumstances influencing solo spouse caregiving differently among couples with frail wives and husbands facilitates gender sensitive services.     

The effectiveness of a group psycho-educational program on family caregiver burden of patients with mental disorders

ABSTRACT: BACKGROUND: Brief family intervention may have a positive impact on family caregivers to patients with mental disorders. We aimed to assess the effectiveness of a group psycho-educational program on family caregivers to patients with schizophrenia and mood disorders. METHOD: This randomized controlled trial was performed on 100 caregivers to patients with mental disorders attending Isfahan Behavioral Sciences Research Center, Isfahan, Iran. 100 family caregivers of patients with schizophrenia (n=50) and mood disorders (n=50) were selected and assigned randomly to either a psycho-educational group intervention or routine care in each diagnosis category. The caregivers were followed up for a period of 3 months. Caregiver burden was assessed using the Zarit Burden Interview. RESULTS: The burden decreased significantly in the group that participated in the psycho-educational program. The mean scores of the Zarit caregiver burden scale decreased, while scores in the control group did not change significantly. CONCLUSION: This group intervention program was effective for the Iranian studied population to reduce the caregiver burden in both categories of mental disorder. It may potentially improve the quality of life of both patients and caregivers by improving the standards of care giving.     

E-mental health interventies voor mantelzorgers van ouderen: een overzicht

E-mental health interventions for family caregivers of older adults: a review Purpose: To present a systematic overview of the different e-mental health interventions for caregivers of older adults. Methods: Systematic literature research of implemented and evaluated e-mental interventions for caregivers of older adults. Results: Thirteen e-mental health interventions are included: six telephone, one camera and six internet interventions. In general, research on user friendliness and client satisfaction shows positive results. The effectiveness of three e-mental health interventions have been studied. The family-based structural in-home intervention with the computer telephone integrated system shows a decrease in depressive symptoms after six and eighteen month. The telephone linked computer system did not show positive mental health effects for the total group of family caregivers. After online lessons, caregivers were more capable to organize respite care and to manage disruptive and challenging behaviours of the care recipient. Their ability to solve their own problems increased and their subjective burden decreased. A cost analysis of an internet intervention shows a reduction in costs in comparison to regular care. Conclusion: E-mental health interventions for caregivers of older adults are encouraging, although research in this field is still in its infancy. Research on the effectiveness and cost-effectiveness of these type of interventions is needed. In addition, the opportunities of internet interventions could be used more extensively. Tijdschr Gerontol Geriatr 2007; 38: 274-287     

Adaptation of children to a chronically ill or mentally handicapped sibling.

The presence of a chronically ill or mentally handicapped child in a family can be a stress for the child''s siblings, who often are ill informed about the nature and prognosis of the illness, may be uncertain what is expected of them in the caregiving role, may feel their own identities threatened, and may experience ostracism by their friends and misunderstanding at school. Although individual reactions vary widely, feelings of anger, guilt, resentment and shame are commonly reported. Excessive responsibility and concern about one''s identity may add to these feelings and culminate in psychologic problems in the sibling. The physician caring for the family must be alert for symptoms of emotional disturbance or social maladjustment among the siblings of chronically ill or mentally handicapped children and should be prepared to counsel the family or refer them to a counsellor experienced in this area. In general, the first step is to be sure that the sibling is fully informed about the condition and to encourage frank discussion between the parents and the handicapped child''s siblings.     

Early-Life Factors and Risk of Parkinson’s Disease: A Register-Based Cohort Study

Parkinson’s disease (PD) may take decades to develop and early life exposures such as infection may be important. However, few epidemiological studies have evaluated early life risk factors in relation to PD risk. We therefore examined such associations in a prospective analysis of 3 545 612 individuals born in Sweden between 1932 and 1970 without PD on January 1, 2002. Incident PD cases were identified using the Swedish Patient Register during 2002–2010. Information on sibship size, number of older and younger siblings, multiple births, parental age, birth month and season was obtained from the Swedish Multi-Generation Register. Monthly data on national burden of influenza-like illness during 1932–1970 were obtained from the Swedish Public Health Agency. Hazard ratios with 95% confidence intervals (CI) were estimated using Cox proportional hazards regression. During the follow-up, 8779 incident PD cases were identified. As expected, older age, male sex, parental occupation as farmers, and family history of PD were associated with higher PD risk. Overall, early life factors, including flu burden in the year of birth, were not associated with PD risk, although we did find a lower PD risk among participants with older siblings than those without (HR = 0.93, 95%CI: 0.89, 0.98). Our study therefore provided little support for important etiological contributions of early life factors to the PD risk late in life. The finding of a lower PD risk among individuals with older siblings will need confirmation and further investigation.     

Characteristics and Quality of Child Care for Toddlers and Preschoolers

In this article, we use data from the National Institute of Child Health and Human Development (NICHD) Study of Early Child Care (NICHD Early Child Care Research Network, 1996, 1997, 1998, 1999) to answer 3 questions. The first question is: What structural features and caregiver characteristics predict more positive caregiver behavior in child care for 1- to 3-year-old children? Positive caregiving was assessed in 5 types of care (centers, child-care homes, and care provided by in-home sitters, grandparents, and fathers) when children in the NICHD study were 15, 24, and 36 months of age (Ns = 612, 630, and 674). Across ages and types of care, positive caregiving was more likely when child-adult ratios and group sizes were smaller, caregivers were more educated, held more child-centered beliefs about childrearing, and had more experience in child care, and environments were safer and more stimulating. The second question is: What differences in caregiving are associated with the type of child care and the child's age? The highest level of positive caregiving was provided by in-home caregivers, including fathers and grandparents, caring for only 1 child, closely followed by home-based arrangements with relatively few children per adult. The least positive caregiving was found in center-based care with higher ratios of children to adults. By 36 months of age, the significance of child-adult ratio decreased, and in-home arrangements became less positive. The third question is: What is the overall quality of child care for 1- to 3-year-olds in the United States? Observed positive caregiving was determined to be "very uncharacteristic" for 6% of the children in the NICHD sample, "somewhat uncharacteristic" for 51%, "somewhat characteristic" for 32%, and "highly characteristic" for 12%. An extrapolation to the quality of care in the United States was derived by applying NICHD observational parameters, stratified by maternal education, child age, and care type, to the distribution of American families documented in the National Household Education Survey (Hofferth, Shauman, Henke, & West, 1998). Positive caregiving was extrapolated to be "very uncharacteristic" for 8% of children in the United States ages 1 to 3 years, "somewhat uncharacteristic" for 53%, "somewhat characteristic" for 30%, and "highly characteristic" for 9%.