The potential of informal care for self-perceptions of aging among older community-dwelling adults: Longitudinal findings from the Health and Retirement Study

Abstract Objectives This is the first study to analyze, whether receipt of (informal) care with (instrumental) activities of daily living (IADL/ADL) is associated with (positive and negative) self-perceptions of aging among community-dwelling older adults; and whether chronological age moderates these associations, using a longitudinal design. Method Longitudinal data of the Health and Retirement Study (HRS) in the United States was used. The sample comprised up to 9,198 observations of community-dwelling adults aged ≥50 years pooled over six waves (2008-2018). Receiving care at all and the amount of care received with (I)ADL was analyzed in association with positive and negative attitudes towards own aging (ATOA; 8-item modified Philadelphia Geriatric Center Morale Scale, positive and negative subscore). Adjusted fixed effects regression analyses with robust standard errors were calculated. Results Transitioning into receipt of care with any (I)ADL was associated with lower positive ATOA but not with any change in negative ATOA. Chronological age moderated the association between receipt of informal care, primarily with IADL, and negative ATOA. More negative ATOA was found among care recipients between 50 and 64 years but less among care recipients aged ≥80 years. Discussion Receiving any form of informal care was associated with an increase of internalized ageism, in particular among adults aged 50 to 64 years, but a decrease among those aged ≥80 years. Psycho-educative measures are recommended for adults with care needs to prevent a loss of positive self-perceptions of aging, and reduce the danger to their healthy aging, with the receipt of care.