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

Abstract

Background and Objectives: 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. Research Design and Methods: 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. Results: 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. Discussion and Implications: 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.