Relationship, Choice, Health, and Typologies of Unpaid Care Labor for Older Adults

Robin Tarter, Exu Anton Mates, Allison Lindauer, Dena Hassouneh

Research output: Contribution to journalArticlepeer-review

1 Scopus citations


Providing unpaid care labor to older adult friends and relatives is associated with deleterious health outcomes, especially among persons who feel they have no choice when taking on care responsibilities. We used hierarchical cluster analysis and structural equation modeling of data from the National Alliance for Caregiving’s Caregiving in the U.S. 2015 Survey to explore choice—outcome relationships. We identified three distinct care typologies, hands-on, household, and managerial care. Perceived lack of choice predicted emotional stress directly and indirectly through household and managerial care; predicted physical strain directly and indirectly through all care typologies; but only predicted negative health impact indirectly through mediation. Lack of choice had greater direct effects on emotional stress and negative health impact for adult–descendants compared to participants with other relationships with recipients, for whom the effects of lack of choice on outcomes were mediated through household and managerial care.

Original languageEnglish (US)
Pages (from-to)436-445
Number of pages10
JournalWestern journal of nursing research
Issue number5
StatePublished - May 2022


  • caregivers
  • family nursing
  • older adults
  • structural equation modeling

ASJC Scopus subject areas

  • Nursing(all)


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