SHAPE OF CARE: PATTERNS OF FAMILY CAREGIVING ACTIVITIES AMONG OLDER ADULTS FROM MIDLIFE TO LATER AGES IN CHINA AND THE U.S.

Abstract

This dissertation consists of three papers that investigate the long-term family caregiving patterns among Chinese and American older adults. Family caregiving has long been an essential fabric of long-term care services. Due to the prolonged life expectancy and the declined family size, older adults today are more likely to care for multiple family members for longer years than the previous cohorts. However, studies on caregiving predominately focus on singular care experiences over a short period time. As older adults transition into and out of multiple care roles, the overall caregiving patterns are overlooked. Leveraging two rich longitudinal datasets (the China Health and Retirement Study and the Health and Retirement Study), this dissertation aims to fill this current research gap by developing long-term family caregiving typologies. The first paper develops a care typology for Chinese older adults, and thoroughly assesses how gender, hukou status, living arrangement, and significant life transitions are associated with the long-term caregiving patterns. In the second paper, using linear mixed-effects models, I continue exploring the positive and negative health consequences of each caregiving pattern among Chinese older adults. The third paper focuses on developing a long-term family caregiving pattern for American older adults. In addition to prolonged life expectancies and the decline in family size, the U.S. has experienced complex transitions in family structures over the past few decades, leading to more diverse family networks and international relations in later life. After establishing the long-term care typology, the third paper pays closer attention to the variations of family caregiving patterns across the War Babies cohort, Early Baby Boomer, and the Middle/Late Baby Boomer cohort. Moreover, I explore how gender, race, and socioeconomic status are linked with these patterns. In the context of global aging, this dissertation highlights the heterogeneity in the family caregiving experiences and identifies the most vulnerable demographic groups who shoulder the heaviest care burden over time. In the end, the findings from the dissertation provide guidance for the investment and design of long-term care services in rapidly aging contexts.