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Previous research has identified that unmet needs are associated with adverse mental health outcomes in older adults. However, the unmet needs of older adults' spousal caregivers are unknown. The present study examined the association between unmet needs and depression among spousal caregivers, and whether marital satisfaction mediated this association. We included 1,856 participants who provided care to their spouses with difficulties in activities of daily living (ADL) and instrumental activities of daily living (IADL) from the 2018 China Health and Retirement Longitudinal Survey. Unmet needs of spousal caregivers were assessed as the total number of ADL/IADL tasks with which respondents had unmet needs. Path models were conducted to evaluate the associations between unmet needs, marital satisfaction, and depression. Subgroup analyses by sex were conducted to examine the sex differences regarding the associations. Spousal caregivers with more unmet ADL/IADL needs reported higher levels of depression (p < 0.001). Additionally, for wife caregivers, unmet ADL/IADL needs were associated with lower marital satisfaction, and lower marital satisfaction was associated with higher degrees of depression, indicating that marital satisfaction partially mediated the association between unmet needs and depression (p < 0.01). However, marital satisfaction did not mediate the association between unmet needs and depression among husband caregivers. The mediating effect of marital satisfaction on the association between unmet needs and depression only existed in wife caregivers. Social services should be provided to meet the needs of caregivers with ADL/IADL difficulties, and interventions should be implemented to promote the marital satisfaction of wife caregivers. [ABSTRACT FROM AUTHOR]

With sociodemographic changes, men are increasingly taking responsibility for spousal caregiving. Previous studies have described gender differences in the psychological outcomes of caregiving; however, few have focused exclusively on husband caregivers. This study investigates the influence of starting spousal caregiving on the psychological well-being of older husbands in rural areas and examines whether living arrangements can moderate this relationship. A total of 1,167 baseline non-caregiver husbands aged 60 and above in rural areas were taken from the 2011–2015 China Health and Retirement Longitudinal Study (CHARLS). The generalized estimating equation (GEE) was employed to examine the effects of spousal caregiving transitions and living arrangement changes on depressive symptoms over four years. Compared with rural husbands who remained non-caregivers, those transitioning into activities of daily living (ADL) caregiving reported higher depressive symptoms at follow-up (B = 1.67, p < 0.05). Moreover, the increase in depressive symptoms when transitioning into ADL caregiving was significantly lower among participants who changed from living with spouse alone to living with spouse and other family members together (B = − 5.37, p < 0.05). There was an association between transitioning into ADL caregiving and an elevated level of depression over four years among older husbands, which could be alleviated by living with family members. Co-residence with family members could serve as a natural support resource, buffering adverse mental health outcomes when older husbands start a demanding caregiving role. [ABSTRACT FROM AUTHOR]

Previous studies documented that caregiving affects the mental health of spousal caregivers, and social participation is a favorable contributor to late-life well-being. However, it remains unclear whether changing social participation influences caregivers' mental health during their transition into spousal caregiving. The present study investigated the influence of transitioning into spousal caregiving, continuity and changes in social participation, and their interactions on older adults' depressive symptoms over time. Information on caregiving transitions and social participation for 2,436 baseline noncaregivers was drawn from the 2011‒2015 China Health and Retirement Longitudinal Survey. Generalized estimating equations were used for estimating the effects of caregiving transitions (transition into low-intensity caregiving, transition into high-intensity caregiving versus no caregiving) and changing social participation (increased participation, decreased participation, continuous participation versus no participation) on follow-up depressive symptoms. Individuals who transitioned into spousal care provision over a four-year period reported more elevated depressive symptoms than those who remained noncaregivers. Individuals who continued or increased social participation reported fewer depressive symptoms than those who reported no participation over the four-year period. Increases in depressive symptoms were less severe among individuals who maintained continuous or increased social participation when transitioning into high-intensity care provision than among their counterparts who were not continuously involved in social participation during the transition. Continuous social participation protected against adverse psychological consequences during the transition into high-intensity spousal caregiving. Clinical attention should be directed at supporting spousal caregivers who meet difficulties in maintaining social participation when starting a demanding caregiving role. [ABSTRACT FROM AUTHOR]