Caregivers serving as confidants: relationship correlates and well-being by care-recipients' dementia status

Family and unpaid caregivers are mainstays of help with daily activities when older adults experience health problems; caregivers can also be relied on as confidants for discussing important matters. It remains unclear what characteristics of caregiving relationships may underlie caregivers' confidant status, how serving this additional role affects their psychological well-being, and whether these associations vary by the presence of dementia in older adults.

We used data from the 2017 National Health and Aging Trends Study and the National Study of Caregiving. Participants included 1,694 family or other unpaid caregivers of 1,126 older adults receiving self-care, mobility, or household help due to health and functioning. We estimated logistic regression models for being nominated as a confidant and linear regression models for caregivers' psychological well-being.

Caregivers who were spouses or children and who reported more positive relationships with the older adults they provided care for were more likely to be nominated as confidants; yet the association involving relationship quality was moderated by older adults' dementia status. Being a confidant was associated with better well-being among caregivers of older adults without dementia, but not for caregivers of older adults with dementia.

Caregivers of older adults with dementia tend to also be a confidant, but serving these multiple roles is only associated with positive psychological well-being for those caring for older adults without dementia. We call for more research to better understand the unique stressors that caregivers experience when serving as confidants for older adults with dementia.