Mental health effects of caregiving for older parents in the United Kingdom: the roles of social support, neighborhood cohesion, and neighborhood deprivation.

OBJECTIVES: We investigate whether changes in the mental health of adult children providing care for an older parent or parent-in-law are mediated by perceived social support from relatives and friends and perceived neighborhood social cohesion. We also investigate whether neighborhood deprivation modifies the effects of neighborhood social cohesion or independently influences mental health.

METHODS: We fit dynamic panel models to analyze changes in the mental health of caregivers using data from 4 annual waves of a nationally representative UK longitudinal study. We distinguish between intensive caregivers providing 20 or more hours of care per week and those providing fewer hours. We controlled for sociodemographic factors associated with mental health and with caregiving. In some analyses, we distinguished between positive aspects of perceived social support and negative effects of social strain.

RESULTS: Higher perceived neighborhood social cohesion was associated with improved mental health for caregivers providing lesser amounts of care and less mental health deterioration for intensive caregivers, irrespective of neighborhood deprivation. Although less intensive caregiving had no direct effect on caregivers' mental health, their mental health improved because of the association between less intensive caregiving and perceptions of increased support from family, friends, and the neighborhood. However, intensive caregivers reported increased social strain, exacerbating the negative effects of caregiving on mental health.

DISCUSSION: The mental health impacts of caregiving vary by the extent of perceived neighborhood social cohesion and support from family and friends. Stresses and supports of less and more intensive caregivers need separate attention.