Associations between caregiving intensity and caregiver burden in "sandwiched" caregivers: Results from the new National Study of Caregiving

Over 50 million informal caregivers provide care to an aging adult, saving the national economy hundreds of billions of dollars annually from hospitalization or institutionalization. Informal caregiving often negatively impacts caregiver quality-of-life.  Further, increased longevity and intergenerational age have induced an increase in “sandwiched” caregivers: those who provide care both to an aging relative and a child.  However, how the established associations between caregiver intensity and burden differ by whether a caregiver also cares for a child is unknown.  Using a new, comprehensive, nationally representative database of 1014 informal caregivers (National Study of Caregiving-NSOC), we used generalized linear models to assess the association between caregiver intensity and four domains of caregiver burden identified through factor analyses-social, financial, positive emotional, and negative emotional, stratified by presence or absence of a child at home.  Social burden from caregiving was significantly associated with an increasing number of ADLs (OR 1.20, p=0.004), number of IADLs (OR 1.28, p<0.001), and hours spent caregiving per month (OR 1.02 per 10 hour increase, p=0.001).  Similar results were found for those not caring for a child at home, but for those also caring for a child at home, only hours per month remained significant (OR 1.08, p=0.010).  There were also other notable differences by presence or absence of a child at home, in the associations between caregiver intensity and the other burden domains.  Therefore, programs designed to promote caregiver health should take into account these important sociodemographic considerations, and address the specific types of burden resulting from caregiving.