Variability in spousal perceptions of caregiving and its relationship to older caregiver health outcomes.

BACKGROUND: The transition to later-life caregiving roles, especially for couples caring for each other, can be rife with ambiguity. The incident discordance in spousal perceptions of one another's role and its relationship to mental health outcomes have not been well-described. OBJECTIVES: (1) To describe the range of daily agreement between older adult spouses' perceptions of care given and care received; (2) to explore associations between caregiving agreement and daily caregiver depression, anxiety, and marital satisfaction; and (3) to evaluate differential effects for male and female caregivers. DESIGN: Cross-sectional, ecological assessment (daily diary). PARTICIPANTS: Sample of 191 couples aged 60-64 (total 5196 daily surveys) drawn from the longitudinal Life and Family Legacies study. MAIN MEASURES: During 2011-2012, spouses independently completed 14 consecutive daily surveys about their mood, marital interactions, and support exchanges. Caregiving agreement was defined as the daily ratio of spouse-reported care received to self-reported care given. Using generalized linear mixed effect modeling, we examined associations between spousal care agreement and outcomes of depression, anxiety, and marital satisfaction. KEY RESULTS: Sample data demonstrated broad variability in spousal agreement, with couples exhibiting substantial disagreement on nearly one-third of couple days (780/2598 days). On days where care was exchanged, higher caregiving agreement was associated with lower caregiver depression (p < 0.01) and anxiety (p < 0.01) in male caregivers, and higher marital satisfaction (p = 0.03) in female caregivers. When care recipients reported receiving more support than their spouse reported giving, these associations did not persist. CONCLUSIONS: Findings suggest that spousal agreement about the amount of care given and received varies broadly and is an important consideration for primary care providers who counsel these patients day-to-day. Furthermore, agreement appears to predict mental health and relationship outcomes and should be further evaluated in this growing population of mid-to-late life adults emerging into caregiving.

Daily Sleep Predicting Marital Interactions as Mediated Through Mood.

Objectives: Sleep problems increase in later life. Studies have linked sleep with marital satisfaction, yet mechanisms, such as mood, have not been explored. The current study is innovative in examining sleep and marital interactions among older couples in a daily context, exploring mood as a potential mediator. Method: Data were taken from the Life and Family Legacies Daily Experiences Study, involving 191 older couples surveyed across 14 days. Multivariate (dyadic) multilevel models were used to address our research questions. Results: Findings indicated significant associations between daily sleep hours, sleep quality, and feeling rested with daily marital interactions. These associations were most consistent for wives. Mediation analyses indicated that positive mood was a common mechanism linking sleep with marital interactions. Also, in some cases, spouse sleep and mood reports were associated with partner marital interactions. Discussion: Improving sleep quality among older couples could lead to better daily marital interactions through changes in mood.