The mental health implications of informal care receipt stability among older adults with persistent care needs

Despite growing scholarship on the mental health consequences of informal care receipt, little is known about how longitudinal dynamics of informal care-specifically, the stability of informal care-shape older adults' psychological well-being. This study introduces a measure of informal care receipt stability and investigates 1) how the stability of informal care receipt predicts depressive symptoms among older adults with persistent care needs, and 2) how it moderates the associations between functional limitations, i.e., activities of daily living (ADL) and instrumental activities of daily living (IADL) limitations, and depressive symptoms.

We used data from the 2010-2018 waves of the Health and Retirement Study (n = 4,160 respondents; 8,332 person-year observations). The analysis employed mixed-effect models to predict depressive symptoms.

Receiving stable informal care is associated with significantly fewer depressive symptoms than not receiving informal care. Stable informal care also weakens the negative association between IADL limitations and depressive symptoms, though it does not play a similar role for ADL limitations. Additional analyses demonstrate that informal care stability is particularly important for the mental health of older adults who receive care from close family members, i.e., spouses and children.

These findings imply that informal care stability serves as a measure of care quality through a longitudinal lens, especially for older adults receiving care from their closest kin. Policies encouraging caregiving commitments from core family members and those facilitating care coordination among extended family and nonrelative caregivers are crucial for the mental health of long-term care recipients.