Informal Care Receiving Among Older Adults: The Role of Multimorbidity and Intersectional Social Position

Older adults with distinct multimorbidity combinations may require varying intensities of informal care and these needs may vary in important ways by race/ethnicity and sex. This study aims to examine informal care-receiving characteristics among older adults with varying multimorbidity patterns and race/ethnicity-sex characteristics.

A total of 4,875 participants from the National Health and Aging Trends Study were included. Five clinically informed multimorbidity categories (no condition(s), somatic-only, depression without cognitive impairment, cognitive impairment without depression, both depression, and cognitive impairment) and 6 intersectional groups (non-Hispanic White female, non-Hispanic White male, non-Hispanic Black female, non-Hispanic Black male, Hispanic female, and Hispanic male) were assessed. Negative binomial regression was applied to explore the associations among multimorbidity groups, race/ethnicity and sex combinations, and informal care-receiving characteristics.

Compared with the somatic-only multimorbidity group, individuals with no condition(s) received assistance with fewer ADL/IADL activities, whereas the cognitive impairment multimorbidity group received assistance with more ADL/IADL activities. Across race/ethnicity-sex groups, non-Hispanic White and Black males received assistance with fewer ADL/IADL activities, and no statistical significance was found for non-Hispanic Black females or Hispanics compared with non-Hispanic White female counterparts. Sensitivity analysis examining assistance with only ADL activities revealed the same pattern.

The study highlighted the complexities of informal care-receiving characteristics among older adults, particularly among those with cognitive difficulties, and the ways in which race/ethnicity and sex are associated with care-receiving patterns. The findings highlight a need for person- and family-centered interventions sensitive to the diverse needs of care-recipients and caregivers.