The Prevalence of Older Couples With ADL Limitations and Factors Associated With ADL Help Receipt

Abstract

Using the Andersen-Newman model, we investigated the prevalence of Activities of Daily Living (ADLs) limitations in married couples, and couple characteristics associated with ADL help receipt. In this sample of 3,235 couples age 65+ in the 2004 Health and Retirement Study, 74.3%, 22.1% and 3.6% were couples in which neither, one or two partners had limitations, respectively. Logistic regression results indicate help receipt was associated with certain health needs in the couple, but not with their predisposing characteristics or enabling resources. Social workers could target couples most in need of assistance by assessing both partners’ health problems.

Assessment of Activities of Daily Living, Self-Care, and Independence

“…Caregiver burden is critical to assess, as it can be predictive of costly institutionalization. The physical and mental burden of providing ADL care can be heavy for informal caregivers (Shen, Feld, Dunkle, Schroepfer, & Lehning, 2015;Vaingankar et al, 2016). For example, caregiving often interferes with time that could be spent on self-care and social activities (Savundranayagam, Montgomery, & Kosloski, 2010).…”

Spousal care-giving arrangements in Europe. The role of gender, socio-economic status and the welfare state

“…Disability as well as mobility and ADL limitations have been found to determine the degree of care needed (Balia and Brau, 2014). On the other hand, the health of the care-giver plays a role, too (Corden and Hirst, 2011; Shen et al , 2015). Our models thus contain indicators on the functional health of both respondent and spouse.…”

Within‐couple dissimilarities in functional impairment as determinants of spousal care arrangement among older married couples

“…Here, the question could be raised as to why spouses holding similarly low level of IADL impairments were unlikely to report mutual care. One explanation might be relevant to the multidimensional nature of functional needs (Johnson & Wolinsky, 1993; Shen et al, 2015). Some items included in IADL (i.e., managing money) require more advanced capacities than those household‐related items (e.g., shopping, cooking), in which one's need for help was often more invisible.…”

“…If there was a considerable within‐couple dissimilarity in functioning (i.e., one spouse was seriously impaired while the other reported only a few of impairments), the spousal complementarity may still happen (Bauer & Sousa‐Poza, 2015). According to the task‐specific model, the less impaired spouse would provide ADL/IADL assistance for the more impaired one, and such assistance is typically not reciprocated because the more impaired one has insufficient capacities (e.g., time, energy, skills) to provide assistance for the other (Shen et al, 2015). Thus, we expect that when both spouses are functionally impaired, a greater spousal dissimilarity in IADL impairment would be positively associated with the likelihood of the arrangement of one‐way spousal care; that is, the more impaired spouse receives care from the less impaired one but not vice versa.…”

“…Of note, there is evidence that ADL and IADL impairment might have different implications for spousal care arrangements. Unlike the situations when spouses collaborate to manage IADL tasks for each other, it seems to be rare for both spouses with ADL impairments to report mutual assistance (Shen et al, 2015). Such ADL impairments might have restricted their abilities to provide help for the other, and spouses may become reluctant to ask for help from the other because of concerns about the partner's own care needs (Roth, 2020).…”