Carolyn A. Mendez-Luck

​Low-income older adults with disabilities in California depend on a variety of public programs to help them remain in their own homes. The availability of those services has been in flux since 2009 because of cuts caused by the recession. This article in Home Health Care Services Quarterly reports on the Center's qualitative study of 33 California seniors who depend on these fragile arrangements of paid and unpaid assistance. The research stems from the Center's ongoing "HOME Project," which follows and conducts in-depth interviews with these older adults and their caregivers in order to paint a comprehensive picture of their needs, physical and mental health status, and the role that public services serve as a crucial link in the support networks of these individuals.

• Kathryn G. Kietzman, PhD, MSW
• Steven P. Wallace, PhD
• Eva M. Durazo, MPH
• Jacqueline Torres, MPH, MA
• Anne Soon Choi, Ph.D.
• Carolyn A. Mendez-Luck, PhD, MPH

This study examines health-risk behaviors among "Baby Boomer" caregivers and non-caregivers and uses data from the 2009 California Health Interview Survey of the state's non-institutionalized population provided individual-level, caregiving, and health behavior characteristics for 5,688 informal caregivers and 12,941 non-caregivers. Logistic regression models were estimated separately for four individual health-risk behaviors — smoking, sedentary behavior, and regular soda and fast-food consumption — as well as a global health-risk measure.

Controlling for psychological distress and personal characteristics and social resources such as age, gender, income and education, work and marital status, and neighborhood safety, caregivers had greater odds than non-caregivers of overall negative health behavior and of smoking and regular soda and fast-food consumption. We did not observe significant differences in odds of negative behavior related to stress for spousal caregivers and caregivers in the role for longer periods of time or those providing more hours of weekly care compared with other caregivers.

This study found evidence that Baby Boomer caregivers engage in poor health behaviors that are associated with exposure to caregiving. Baby Boomer caregivers may be at risk for certain behavioral factors that are associated with disability and chronic illness.

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• Geoffrey J. Hoffman
• Jihey Lee
• Carolyn A. Mendez-Luck, PhD, MPH

This policy brief profiles California's informal caregivers -- adults who provide care to a family member or friend coping with an illness or disability. Although caregivers appear to be as healthy as noncaregivers of the same age, they report higher levels of psychological distress and engagement in poor health-related behaviors, such as smoking. Middle-aged caregivers may be at greatest risk for poor health outcomes such as high blood pressure, diabetes and heart disease. Few caregivers are paid for their work or use state services that might help alleviate both financial and psychological burdens. Caregivers should foresee difficult times ahead, given recent state budget cuts to programs that support caregivers, and older and disabled adults.

Low-income older Californians with disabilities depend on a variety of public programs to remain in their own homes. This policy note provides the first findings from a project that is following a group of seniors who depend on a fragile arrangement of paid and unpaid help to maintain their independence. The analysis finds that the disability needs of these older adults are often unstable, with both their physical and mental health status sometimes changing day to day. Public services are a crucial component of these individuals’ support networks, even if they sometimes fall short of addressing all their complex needs. Many of these disabled older adults have nowhere else to turn for assistance should their public services be cut. Interviews reveal that these people are typically in poor physical and psychological condition and are just managing to live safely in their homes. At the same time, they share a common goal of staying at home and maintaining their independence.