Skip to main content

Fit for caring: factors associated with informal care provision by older caregivers with and without multimorbidity

Abstract

Due to an increased prevalence of chronic diseases, older individuals may experience a deterioration of their health condition in older ages, limiting their capacity for social engagement and in turn their well-being in later life. Focusing on care provision to grandchildren and (older) relatives (‘informal care’) as forms of engagement, this paper aims to identify which individual characteristics may compensate for health deficits and enable individuals with multimorbidity to provide informal care. We use data from the SHARE survey (2004–2012) for individuals aged 60 years and above in 10 European countries. Logistic regression estimates for the impact of different sets of characteristics on the decision to provide care are presented separately for people with and without multimorbidity. Adapting Arber and Ginn’s resource theory, we expected that older caregivers’ resources (e.g., income or having a spouse) would facilitate informal care provision to a greater extent for people with multimorbidity compared to those without multimorbidity, but this result was not confirmed. While care provision rates are lower among individuals suffering from chronic conditions, the factors associated with caregiving for the most part do not differ significantly between the two groups. Results, however, hint at reciprocal intergenerational support patterns within families, as the very old with multimorbidity are more likely to provide care than those without multimorbidity. Also, traditional gender roles for women are likely to be weakened in the presence of health problems, as highlighted by a lack of gender differences in care provision among people with multimorbidity.

This is a preview of subscription content, access via your institution.

Fig. 1

Notes

  1. As in SHARE wave 4 only one member of the household is presented with the question on grandparenting and is instructed to refer to the entire household when answering, we have imputed positive values for the partner of a respondent who has reported to have provided care to grandchildren.

  2. We report virtually no changes in statistical significance and coefficient sign, with changes in coefficient values to the first or to the second decimal. The authors, upon request, can provide detailed results.

References

  • Albertini M, Kohli M, Vogel C (2007) Intergenerational transfers of time and money in European families: common patterns different regimes? J Eur Soc Policy 17:319–334

    Article  Google Scholar 

  • Arber S, Ginn J (1991) Gender and later life. Sage Publications, London

    Google Scholar 

  • Atchley RC (1989) A continuity theory of normal aging. Gerontologist 29:183–190

    Article  Google Scholar 

  • Auspurg K, Hinz T (2011) Gruppenvergleiche bei Regressionen mit binären abhängigen Variablen—Probleme und Fehleinschätzungen am Beispiel von Bildungschancen im Kohortenverlauf. ZfS 40:62–73. http://zfs-online.org/index.php/zfs/article/view/3058

  • Baltes PB, Baltes MM (1990) Selective optimization with compensation. In: Baltes PB, Baltes MM (eds) Successful aging: perspectives from the behavioral sciences. Cambridge University Press, New York, pp 1–34

    Chapter  Google Scholar 

  • Barnett S, Molinuevo D, Leichsenring K, Rodrigues R (2010) Contracting for quality—an ESN research study on the relationships between the financer, regulator, planner, case manager, provider and user in long-term care in Europe. European Social Network, Brighton. http://www.esn-eu.org/userfiles/Documents/Publications/Thematic_Reports/2010_Contracting_for_Quality_EN.pdf

  • Baydar N, Brooks-Gunn J (1998) Profiles of grandmothers who help care for their grandchildren in the United States. Fam Relat 47:385–393

    Article  Google Scholar 

  • Börsch-Supan A, Brugiavini A, Jürges H, Kapteyn A, Mackenbach J, Siegrist J, Weber G (eds) (2008) First results from the survey of health, ageing and retirement in Europe (2004–2007). Mannheim Research Institute for the Economics of Aging, Mannheim. http://www.share-project.org/fileadmin/pdf_documentation/FRB2/FRB2_all_chapters.pdf

  • Brandt M, Haberkern K, Szydlik M (2009) Intergenerational help and care in Europe. Eur Sociol Rev 25:585–601

    Article  Google Scholar 

  • Burr JA, Choi NG, Mutchler JE, Caro FG (2005) Caregiving and volunteering: are private and public helping behaviors linked? J Gerontol B Psychol Sci Soc Sci 60:S247–S256

    Article  Google Scholar 

  • Cameron AC, Trivedi PK (2010) Microeconometrics using STATA. STATA Press, College Station

    Google Scholar 

  • Carmichael F, Charles S (1998) The labour market costs of community care. J Health Econ 17:747–765. http://www.ncbi.nlm.nih.gov/pubmed/10339251

  • Carmichael F, Charles S, Hulme C (2010) Who will care? Employment participation and willingness to supply informal care. J Health Econ 29:182–190

    Article  Google Scholar 

  • Clarke LH, Bennett E (2013) “You learn to live with all the things that are wrong with you”: gender and the experience of multiple chronic conditions in later life. Ageing Soc 33:342–360

    Article  Google Scholar 

  • Coe NB, Van Houtven C (2009) Caring for mom and neglecting yourself? The health effects of caring for an elderly parent. Health Econ 18:991–1010

    Article  Google Scholar 

  • Colombo F, Llena-Nozal A, Mercier J, Tjadens F (2011) Help wanted? Providing and paying for long-term care. OECD Publishing, Paris

    Google Scholar 

  • England P, Folbre N (2003) Contracting for care. In: Ferber M, Nelson J (eds) Feminist economics today. University of Chicago Press, Chicago, pp 61–80

    Google Scholar 

  • Ettner SL (1996) The opportunity costs of elder care. J Hum Resour 21:189–205

    Article  Google Scholar 

  • EUROFAMCARE (2006) Services for supporting family carers of older dependent people in Europe: characteristics, coverage and usage (The Trans-European Survey Report, Deliverable Nr. 19), EUROFAMCARE Consortium, European Union

  • European Commission (2015) Which priorities for a European policy on multimorbidity? Booklet from the conference held on 27th October 2015 in Brussels. http://ec.europa.eu/health/ageing/docs/ev_20151007_frep_en.pdf

  • Finley NJ, Roberts MD, Banahan BF (1988) Motivators and inhibitors of attitudes of filial obligation toward aging parents. Gerontologist 28:73–78

    Article  Google Scholar 

  • Glaser K, Ribé Montserrat E, Waginger U, Price D, Stuchbury R, Tinker A (2010) Grandparenting in Europe. London, UK: Grandparents Plus. http://www.grandparentsplus.org.uk/wp-content/uploads/2011/03/Grandparenting-in-Europe-Report.pdf

  • Gray A (2005) The changing availability of grandparents as carers and its implications for childcare policy in the UK. J Soc Policy 34:557–577

    Article  Google Scholar 

  • Greene WH (2009) Econometric analysis, 5th edn. Pearson Education India, Delhi

    Google Scholar 

  • Grundy E (2005) Reciprocity in relationships: socio-economic and health influences on intergenerational exchanges between third age parents and their adult children in Great Britain. Br J Sociol 56:233–255

    Article  Google Scholar 

  • Guzman L (1999) The use of grandparents as child care providers. University of Wisconsin-Madison, Madison. https://www.ssc.wisc.edu/cde/nsfhwp/nsfh84.pdf

  • Hank K (2005) Spatial proximity and contacts between elderly parents and their adult children : a European comparison. Mannheim Research Institute for the Economics of Aging, Mannheim. http://ub-madoc.bib.uni-mannheim.de/1291/1/098_05.pdf

  • Hank K (2011) Societal determinants of productive aging: a multilevel analysis across 11 European countries. Eur Sociol Rev 27:526–541

    Article  Google Scholar 

  • Hank K, Buber I (2009) Grandparents caring for their grandchildren: findings from the 2004 Survey of Health, Ageing, and Retirement in Europe. J Fam Issues 30:53–73

    Article  Google Scholar 

  • Hank K, Stuck S (2008) Volunteer work, informal help, and care among the 50+ in Europe: further evidence for “linked” productive activities at older ages. Soc Sci Res 37:1280–1291

    Article  Google Scholar 

  • Heitmueller A (2007) The chicken or the egg? Endogeneity in labour market participation of informal carers in England. J Health Econ 26:536–559

    Article  Google Scholar 

  • Hochman O, Lewin-Epstein N (2013) Determinants of early retirement preferences in Europe: the role of grandparenthood. Int J Comp Sociol 54:29–47

    Article  Google Scholar 

  • Huber M, Rodrigues R, Hoffmann F, Gasior K, Marin B (2009) Facts and figures on long-term care—Europe and North America. European Centre for Social Welfare Policy and Research, Vienna

    Google Scholar 

  • Igel C, Szydlik M (2011) Grandchild care and welfare state arrangements in Europe. J Eur Soc Policy 21:210–224

    Article  Google Scholar 

  • King D, Pickard L (2013) When is a carer’s employment at risk? Longitudinal analysis of unpaid care and employment in midlife in England. Health Soc Care Community 21:303–314

    Article  Google Scholar 

  • Knijn T, Martin C, Le Bihan B (2013) Introduction: workers under pressure and social care arrangements—a research framework. In: Le Bihan B, Martin C, Knijn T (eds) Work and care under pressure: care arrangements across Europe. Amsterdam University Press, Amsterdam, pp 7–32

    Google Scholar 

  • Kyung Y, Norton EC, Stearns SC, Van Houtven CH (2015) Informal care and caregiver’s health. Health Econ 24:224–237

    Article  Google Scholar 

  • Rodrigues R, Huber M, Lamura, G (eds) (2012) Facts and figures on healthy ageing and long-term care. European Centre for Social Welfare Policy and Research, Vienna. http://www.euro.centre.org/data/LTC_Final.pdf

  • Löffler C, Kaduszkiewicz H, Stolzenbach C, Streich W et al (2012) Coping with multimorbidity in old age: a qualitative study. BMC Fam Pract 13:45

    Article  Google Scholar 

  • Lowenstein A, Daatland SO (2006) Filial norms and family support in a comparative cross-national context: evidence from the OASIS study. Ageing Soc 26:203–223

    Article  Google Scholar 

  • Malter F, Börsch-Supan A (2013) SHARE Wave 4: innovations and methodology. Munich Centre for the Economics of Ageing, Munich

    Google Scholar 

  • Mentzakis E, McNamee P, Ryan M (2008) Who cares and how much: exploring the determinants of co-residential informal care. Rev Econ Househ 7:283–303

    Article  Google Scholar 

  • Mood C (2010) Logistic regression: why we cannot do what we think we can do, and what we can do about it. Eur Sociol Rev 26:67–82

    Article  Google Scholar 

  • Mooney A, Statham J, Simon A (2002) The pivot generation: informal care and work after fifty. The Policy Press, Bristol

    Google Scholar 

  • O’Brien R, Wyke S, Guthrie B, Watt G, Mercer SW (2014) The ‘everyday work’ of living with multimorbidity in socioeconomically deprived areas of Scotland. JOC 4:1–10

    Article  Google Scholar 

  • Pfau-Effinger B, Rostgaard T (eds) (2011) Care between work and welfare in European societies. Palgrave Macmillan, Basingstoke

    Google Scholar 

  • Principi A, Chiatti C, Lamura G, Frerichs F (2012) The engagement of older people in civil society organizations. Educ Gerontol 38:83–106

    Article  Google Scholar 

  • Reid M (1934) Economics of household production. Wiley, New York

    Google Scholar 

  • Sadiraj K, Oudijk D, Van Kempen H, Stevens J (2011) Summary and discussion: the rise of the personal budget. Sociaal en Cultureel Planbureau, The Hague. http://www.scp.nl/english/Publications/Summaries_by_year/Summaries_2011/The_rise_of_the_personal_budget

  • Sassi F, Hurst J (2008) The prevention of lifestyle-related chronic diseases: an economic framework. OECD Health Working Paper 32. http://www.oecd.org/els/health-systems/40324263.pdf

  • Satariano W, Haight T, Tager I (2002) Living arrangements and participation in leisure-time physical activities in an older population. J Aging Health 14:427–451

    Article  Google Scholar 

  • Schmid T, Brandt M, Haberkern K (2011) Gendered support to older parents: Do welfare states matter? Eur J Ageing 9:39–50

    Article  Google Scholar 

  • Schulz R, Beach SR (1999) Caregiving as a risk factor for mortality: the caregiver health effects study. J Am Med Assoc 282:2215–2219

    Article  Google Scholar 

  • StataCorp (2011) Stata Statistical Software: Release 12. STATA Press, College Station

    Google Scholar 

  • Strain L, Grabusic CC, Searle MS, Dunn NJ (2002) Continuing and ceasing leisure activities in later life: a longitudinal study. Gerontologist 42:217–223

    Article  Google Scholar 

  • Van Bavel J, De Winter T (2013) Becoming a grandparent and early retirement in Europe. Eur Sociol Rev 29:1295–1308

    Article  Google Scholar 

  • Wilcox S, Castro C, King AC, Housemann R, Brownson RC (2000) Determinants of leisure time physical activity in rural compared with urban older and ethnically diverse women in the United States. J Epidemiol Community Health 54:667–672

    Article  Google Scholar 

  • Withnall A (2000) The debate continues: integrating educational gerontology with lifelong learning. In: Glendenning F (ed) Teaching and learning in later life: critical implications. Ashgate, Aldershot, pp 87–97

    Google Scholar 

  • Zaidi A, Gasior K, Zólyomi E, Schmidt A, Rodrigues R, Marin B (forthcoming) Measuring active and healthy ageing in Europe. J Eur Soc Policy (accepted for publication)

Download references

Acknowledgments

This paper uses data from SHARE wave 4 release 1.1.1, as of March 28th 2013 (DOI: 10.6103/SHARE.w4.111) or SHARE waves 1 and 2 release 2.6.0, as of November 29th 2013 (DOIs: 10.6103/SHARE.w1.260 and 10.6103/SHARE.w2.260) or SHARELIFE release 1.0.0, as of November 24th 2010 (DOI: 10.6103/SHARE.w3.100). The SHARE data collection has been primarily funded by the European Commission through the 5th Framework Programme (project QLK6-CT-2001-00360 in the thematic programme Quality of Life), through the 6th Framework Programme (projects SHARE-I3, RII-CT-2006-062193, COMPARE, CIT5- CT-2005-028857, and SHARELIFE, CIT4-CT-2006-028812) and through the 7th Framework Programme (SHARE-PREP, No 211909, SHARE-LEAP, No 227822 and SHARE M4, No 261982). Additional funding from the U.S. National Institute on Aging (U01 AG09740-13S2, P01 AG005842, P01 AG08291, P30 AG12815, R21 AG025169, Y1-AG-4553-01, IAG BSR06-11, and OGHA 04-064) and the German Ministry of Education and Research as well as from various national sources is gratefully acknowledged (see www.share-project.org for a full list of funding institutions).

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Stefania Ilinca.

Additional information

Responsible editor: H. Litwin.

Rights and permissions

Reprints and Permissions

About this article

Verify currency and authenticity via CrossMark

Cite this article

Schmidt, A.E., Ilinca, S., Schulmann, K. et al. Fit for caring: factors associated with informal care provision by older caregivers with and without multimorbidity. Eur J Ageing 13, 103–113 (2016). https://doi.org/10.1007/s10433-016-0373-4

Download citation

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s10433-016-0373-4

Keywords

  • (Multi)morbidity
  • Extra-residential care
  • Grandchild care
  • Older people
  • Europe
  • SHARE