Primary Caregiver Characteristics and Transitions in Community-Based Care

To identify informal primary caregiver characteristics associated with care transitions of community-dwelling older persons with impairments in daily living activities. Data for this study were pooled to observe transitions from Wave 1-Wave 2 and Wave 2-Wave 3 of the Second Longitudinal Survey on Aging (LSOA II). The sample includes respondents with at least one impairment in daily living activities and with an informal caregiver at baseline of each transition period (n = 2,990). Primary caregiver transitions to another informal caregiver, to formal care, to a nursing home, or to no care were modeled using multinomial logistic regression. More than half (54%) of the surviving respondents experienced a care transition for a period of 2 years. Multivariate results indicate that husband and son primary caregivers are more likely to transfer care than wives and daughters, although children caring for same-gender parents were less likely to transfer out of the primary caregiver role than children caring for parents of the opposite sex. Respondents with primary caregivers who are "other" relatives or nonrelatives, who are not coresident with the care receiver, or who are assisted by secondary helpers were at elevated risk for care transitions over the 2-year study period. The results of this study suggest that older persons' care transitions result from complex informal network dynamics, with primary caregiver gender and relationship to the care receiver playing key roles.