Huei-Wern Shen

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

The authors explored whether gender moderated the influence of other factors on solo spousal caregiving. The subsample (n = 452) from the Asset and Health Dynamics Among the Oldest Old study included elderly care recipients (CRs) receiving assistance with instrumental activities of daily living (IADLs) and their spouses. Logistic regression was used to model 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’ numbers of limitations in activities of daily living and spouses with limitations in IADLs or activities of daily living 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.

Does Becoming an ADL Spousal Caregiver Increase the Caregiver’s Depressive Symptoms?

This study investigated whether transitioning into the role of activities of daily living (ADL) spousal caregiver is associated with increased depressive symptoms for older husbands and wives among a sample of coresiding community-dwelling older couples. Using data from the Health and Retirement Study, we estimated a two-level linear model to examine the association between change in caregiver status and respondents’ depressive symptoms at follow-up, controlling for other factors identified in Pearlin’s stress process model (PSPM). Results indicate that both husbands and wives who become ADL caregivers have more follow-up depressive symptoms than noncaregivers. Furthermore, wives continuing as caregivers have more follow-up depressive symptoms than wives who do not provide care. Finally, the physical health of the spousal caregiver is related to depressive symptoms at follow-up. We conclude with policy and practice implications of these three main findings.

Self-Esteem Mediates the Relationship Between Volunteering and Depression for African American Caregivers

Research on the influence of volunteering on mental health outcomes has not placed enough focus on African American female caregivers who are at risk for adverse outcomes such as depression. This study addresses this gap by examining the mechanism through which volunteering might influence depressive symptoms using data collected from 521 African American female caregivers of older adults. Regression results indicate that although volunteering is inversely associated with depressive symptoms, self-esteem mediates this relationship. Findings suggest inclusion in volunteering for African American female caregivers may be relevant to promotion of their mental well-being.

Giving Back and Staying Put: Volunteering as a Stabilizing Force in Relocation

Relocation in older adulthood has been shown to have health-related and environmental triggering factors. This study explores the relationship between volunteering in a community and relocation. Using data from the 2008 and 2010 Health and Retirement Study, which included 9,220 community-dwelling older individuals who were aged 65 years and older, our findings show that volunteering significantly reduces the likelihood of relocating out of the area, and such a relationship is partially mediated by having friends nearby. This study is innovative because it identifies a stabilizing mechanism important for understanding protective factors, such as volunteering, as a way communities can retain older adults.

The Prevalence of Older Couples With ADL Limitations and Factors Associated With ADL Help Receipt

Using the Andersen-Newman model, we investigated the prevalence of activities of daily living (ADLs) limitations in married couples, and couple characteristics associated with ADL help-receipt. In this sample of 3,235 couples age 65+ in the 2004 Health and Retirement Study, 74.3%, 22.1%, and 3.6% were couples in which neither partner, one partner, or both partners had limitations, respectively. Logistic regression results indicate that help-receipt was associated with certain health needs in the couple, but not with their predisposing characteristics or enabling resources. Social workers could target couples most in need of assistance by assessing both partners’ health problems.

Race and Place: Exploring the Intersection of Inequity and Volunteerism Among Older Black and White Adults

ABSTRACT Although the historical impact of racial segregation and ongoing health and economic inequities between older Black and White adults is well documented, little is known about the relationships among race, individual- and neighborhood-resources, and formal volunteering in later life. This study explores this intersection. Individual-level data from 268 respondents aged 55+ were collected in the St. Louis metropolitan area through paper-based mail surveys. Objective neighborhood data were obtained at the zip code level from secondary sources and matched with respondents. Using exploratory factor analysis, we constructed a 14-item environmental scale with 3 neighborhood dimensions (economic, social, and built environment). Older Black adults had lower levels of education; had fewer financial assets; lived in neighborhoods with less economic resources and lower built environment scores; and fewer formally volunteered when compared to older White adults. Individual resources (financial assets, health) and neighborhood resources (social and built environment) were positively associated with formal volunteering among older Black adults. Only individual resources (age, marital status, financial assets, health) were associated with formal volunteering among older White adults. A coherent set of policies that bolsters individual and environmental capacities may increase the rate of volunteerism among older black adults.

Neighborhood and Depressive Symptoms: A Comparison of Rural and Urban Chinese Older Adults

Background and Objectives Individual stressors of depressive symptoms in old age are well identified, yet little is known about the neighborhood stressors of depressive symptoms. Guided by the ecological extension of the Pearlins Stress Process Model, this study explores the rural and urban differences in neighborhood stressors of depressive symptoms among older adults in China. Research Design and Methods Data came from two waves of the China Health and Retirement Longitudinal Study, a nationally representative survey. The study included 6,548 older adults ages 60 and above in 2011, with follow-up in 2013. Predictors (individual and neighborhood characteristics) were drawn from the 2011 baseline, and outcome, depressive symptoms, was extracted from the 2013 wave. Results Multilevel modeling results showed that after controlling for depressive symptoms at the baseline, symptoms decreased in neighborhoods where physical environment and social environment were better. Among rural respondents, neighborhood stressors stemmed mainly from the physical environment, whereas among urban residents, the stressors came from the social environment. Discussion and Implications This study demonstrated and discussed the role that neighborhoods may play in reducing depressive symptoms in later life. Community organizers and policy makers are encouraged to ameliorate community environments to improve mental health among older adults in China.

Caregiver stressors and depressive symptoms among older husbands and wives in the United States.

ABSTRACT Framed by Pearlin’s Stress Process Model, this study prospectively examines the effects of primary stress factors reflecting the duration, amount, and type of care on the depressive symptoms of spousal caregivers over a2-year period, and whether the effects of stressors differ between husbands and wives. Data are from the 2004 and 2006 waves of the Health and Retirement Study and we included community-dwelling respondents providing activities of daily life (ADL) and/or instrumental activities of daily life (IADL) help to their spouses/partners (N = 774). Results from multivariate regression models indicate that none of the primary stressors were associated with depressive symptoms. However, wives providing only personal care had significantly more depressive symptoms than wives providing only instrumental care, while husbands providing different types of care showed no such differences. To illuminate strategies for reducing the higher distress experienced by wife caregivers engaged in personal care assistance, further studies are needed incorporating couples’ relational dynamics and gendered experiences in personal care.

Does Volunteering Experience Influence Advance Care Planning in Old Age

ABSTRACT Advance care planning (ACP) increases the likelihood patients will receive end-of-life care that is congruent with their preferences and lowers stress among both patients and caregivers. Previous efforts to increase ACP have mainly focused on information provision in the very late stage of life. This study examines whether a relationship exists between volunteering and ACP, and whether this relationship is associated with social support. The sample comprises 877 individuals who were aged 55+ in 2008, and were deceased before 2010. The sample is derived from seven waves (1998–2010) of data from the Health and Retirement Study. Logistic regression results showed that overall ACP and durable power of attorney for health care (DPAHC) were both higher (OR = 1.61 and 1.71, respectively) for older adults with volunteering experience in the past 10 years than those without such experience. Available social support (relatives and friends living nearby) was not associated with the relationship between volunteering and ACP. Other factors related to ACP included poorer health, death being expected, death due to cancer, older age, and being a racial minority. Involving older people in volunteer work may help to increase ACP. Future research is encouraged to identify reasons for the association between volunteering and ACP.

Intersections of Home, Health, and Social Engagement in Old Age: Formal Volunteering as a Protective Factor to Health After Relocation

This study aims to further our understanding of formal volunteering as a protective mechanism for health in the context of housing relocation and to explore race, gender, and education as moderators. A quasi-experimental design evaluated the effects of volunteering on older adults’ health (self-report health, number of instrumental activities of daily living [IADLs], and depressive symptoms) among individuals who relocated but did not volunteer at Time 1 (N = 682) in the Health and Retirement Study (2008–2010). Propensity score weighting examined health differences at Time 2 between 166 volunteers (treated) and 516 nonvolunteers (controlled). Interaction terms tested moderation. Individuals who moved and engaged in volunteering reported higher levels of self-rated health and fewer IADL difficulties compared to the control group. Race moderated the relationship between volunteering and depressive symptoms, while gender moderated the relationship between volunteering and self-assessed health. Formal volunteering protects different dimensions of health after relocation. Volunteering was particularly beneficial for females and older Whites.