The caregiving role: dimensions of burden and benefits

Rapidly increasing public expenditures for nursing home care raise the policy question of how to support community care of disabled elderly persons and postpone admissions to nursing homes. It is crucial that research clearly identify the burdens of community caregivers in order to devise appropriate support programs. Data from the Caregiver Survey of the 1982 Long Term Care Survey are used here to understand dimensions of caregiver burdens and benefits, to develop reliable scales, and to identify sources of variation in burden and benefits. Using factor analysis, two dimensions of caregiver burden were identified, including role strain and role conflicts indicated by items comprising Guttman scales. Caregiver characteristics associated with variations in total perceived caregiver burdens, role strain and role conflict include the extent of caregiving work (disabled person's ADL, IADL scores), caregiver resources (age, health status, employment), latent social characteristics (gender), and the need to make adjustments in living (e.g. among employed caregivers, having to change work schedule to care for the disabled person). Caregiver benefits of two types - help with tasks and socio-emotional support - related inversely to objective burden as well as to relationship to the caregiver (spouse/nonspouse, primary caregiver/other).