Jeremy Lim-Soh

As more countries transition to aging societies, widowhood is emerging as a broader social policy issue that heightens tensions between family and the state as key sources of support for older wido...

Following the loss of a spouse, older adults often experience changes in their social networks across various dimensions, which may affect their mental health. Guided by continuity, disengagement, and activity theories, which posit diverse trajectories of social network adaptation to spousal loss, this study adopted a typological approach to investigate the stability and change in social network profiles before and after widowhood and their associations with depressive symptoms among older adults. This person‐centered approach reconceptualizes how social networks evolve in later life, moving beyond single indicators to capture the multidimensionality and heterogeneity of older adults’ social worlds as they navigate significant life transitions within their specific socio‐spatial contexts. This study analyzed data from 727 older adults who were married at Time 1, experienced widowhood at Time 2, and responded to questions on depressive symptoms at Time 3 in three consecutive waves of the Korean Longitudinal Study of Aging. A latent transition analysis identified five distinct social network profiles—“diverse,” “child‐focused,” “restricted,” “coresident, diverse,” and “coresident, restricted”—before and after widowhood, along with their transition patterns. Multivariable regression, controlling for baseline depressive symptoms, showed that older adults who (1) transitioned from the diverse to child‐focused profile, (2) transitioned from the diverse to coresident, diverse profile, or (3) maintained the coresident, restricted profile were more likely to report higher levels of depressive symptoms after widowhood than those who maintained the diverse profile. These findings highlight the complexity and dynamics of social networks and intergenerational coresidence among older Koreans following widowhood, calling for interventions to promote diverse social networks among widowed older adults. Ultimately, this study resonates with recent scholarship calling for a shift from a focus on “aging in place” toward “aging in networks,” emphasizing that healthy aging depends on social embeddedness across various spatial and relational contexts.

The psychological health and quality of life (QoL) of family caregivers, who are central to care provision for older adults, may be impacted by the diagnosis of dementia in their care-recipients. However, the relevant literature is largely limited to qualitative studies or Western contexts. Using longitudinal quantitative data from Singapore, a rapidly ageing Asian nation, we assess the change in family caregivers’ depressive symptoms and QoL following the diagnosis of dementia in their older care-recipients. Data of 263 caregivers and their care-recipients (≥75 years with functional limitations) was extracted from a four-wave longitudinal study. Based on caregivers’ report if the care-recipient had been ‘ever diagnosed’ (at baseline interview) or ‘diagnosed since previous interview’ (in follow-up interviews) with dementia, the sample was grouped into: (1) new diagnosis ( n = 22), (2) existing diagnosis ( n = 57) and (3) not diagnosed ( n = 184). Caregiver depressive symptoms (Center for Epidemiologic Studies-Depression scale) and QoL (World Health Organization QoL scale; four domains: physical health, psychological health, social relationships, and environmental health) were measured at each wave. Across the three dementia diagnosis groups, caregivers in the ‘new diagnosis’ group had the highest depressive symptoms and lowest QoL (physical and psychological health domains) at their last available follow-up interview. Multivariable fixed-effect regression showed that caregivers exhibited a significant decline in QoL (psychological and environmental domains) following their care-recipients’ diagnosis of dementia. The detrimental psychological impact of the diagnosis of dementia in their care-recipients on family caregivers is also observed in Asian settings. Our findings emphasize the importance of support mechanisms for caregivers adapting to the diagnosis of dementia in their loved ones.

Little is known about whether and why social networks protect mental health among informal caregivers. This study examined the association between informal caregiver social network types and depressive symptoms and the mediatory mechanism of psychological resilience. Latent class analysis, applied to cross-sectional data on 278 Singaporean caregivers, identified four social network types: restricted (42%), friend (16%), family (21%), and diverse (21%). Path analysis showed that the diverse social network type, compared to the restricted social network type, was associated with a lower level of depressive symptoms, and psychological resilience fully mediated this association. Interventions should help caregivers to maintain social networks with their family and friends. KEY POINT Informal caregiver social network typologies were explored using data from Singapore. Diverse, friend, family, and restricted social network types were identified. Diverse social network type was negatively associated with depressive symptoms. Psychological resilience fully mediated the association.

Background and Objectives: Informal caregiving for older adults can be both burdensome and beneficial. Given that the informal caregiving situation may evolve over time, and care needs of older adults can result from diverse health conditions, it is valuable to understand the trajectories of burden or benefits of caregiving and how these trajectories vary across health conditions common among older care-recipients. This review is the first to summarize the literature on trajectories of burden or benefits of caregiving, including caregiver and care-recipient characteristics associated with the trajectories. Research Design and Methods: We reviewed longitudinal observational quantitative studies, from 5 bibliographic databases, that assessed burden or benefits of caregiving at 3 or more time points among informal caregivers of older adults (60 years or above). Results: The narrative synthesis included 41 studies, with only 7 (17%) considering trajectories of benefits. A stable average trajectory of burden or benefits of caregiving was the most common pattern over time across various care-recipient health conditions. However, an increasing burden over time was primarily observed among caregivers of persons with dementia, while a decreasing burden was noted among caregivers of persons discharged from the hospital after an acute health event. Only 6 (10%) studies, which reported heterogeneity in the progression of burden or benefits separately or jointly, identified distinctive trajectories within the same set of caregivers. Risk factors consistently identified to be associated with trajectories indicating persistently higher burden or persistently lower benefits included more care-recipient functional limitations and behavioral problems, being a non-spousal caregiver, being a solo caregiver, and perceiving less self-efficacy or competence. Discussion and Implications: Future studies should focus on the trajectories of benefits of caregiving, untangle heterogeneity in trajectories of burden or benefits of caregiving, and consider both burden and benefits concurrently to identify factors that both enhance benefits and alleviate burden over time.

Objectives: Research on family caregiving for older adults has largely focused on primary caregivers. We identify caregiving task-sharing patterns among multiple caregivers, including family members and live-in hired workers. In addition, we investigate caregiver and care-recipient characteristics associated with these patterns. Methods: We interviewed 278 primary family caregivers of home-dwelling older adults in Singapore about who provides what assistance across 3 domains: activities of daily living, health and social services use, and socioemotional and other needs. Latent class analysis was used to identify caregiving task-sharing patterns. Results: Three patterns were identified: (a) “Shared-Diverse” (39%)—multiple caregivers assisting in all 3 domains, (b) “Shared-Domestic” (32%)—multiple caregivers assisting with activities of daily living and socioemotional and other needs, and (c) “Solo-Diverse” (29%)—a sole caregiver assisting in all 3 domains. “Solo-Diverse” caregivers were less likely to be employed and had higher depressive symptoms relative to “Shared-Diverse” primary family caregivers. Discussion: The predominance of caregiving task-sharing patterns involving multiple caregivers calls for expansion of research, policies, and programs beyond primary caregivers. Greater attention should be given to how families and live-in hired workers share caregiving tasks for older adults, and how this varies across cultural settings, especially in familial Asian societies. The findings further highlight the vulnerabilities of solo caregivers, whose employment capacity and mental health may be adversely affected by their caregiving duties. Policy-makers should ensure that solo caregivers have access to support programs that address their financial and mental health needs.

Objective: To identify changes over time in gendered patterns of intergenerational contact between older adults and their adult children in an Asian context.Background: Patterns of contact between older adults and their adult children have strong implications for older adults' health in societies with strong family values and gendered expectations for old age care.Methods: The authors utilized data from two waves of the Korean Longitudinal Study of Ageing (2006 and 2016); 1,311 Korean older adults reported their frequency of contact (in‐person contact and mediated communication) with their 5,663 mixed‐gender adult children when they were aged 65–74 years and when they were aged 75–84 years, respectively. Latent transition analysis was applied to identify gendered patterns of contact among multiple children and examine transitions between waves.Results: More frequent contact with sons was twice as common as more frequent contact with daughters in 2006. However, these gender‐unequal patterns of contact were likely to transition to gender‐equal patterns in 2016. The onset of functional limitations was associated with transitions into equally frequent in‐person contact with sons and daughters, whereas the onset of clinically significant depressive symptoms was associated with transitions into more frequent mediated communication with daughters.Conclusion: The findings show a decline in traditional son‐preferential patterns of contact, in favor of gender‐equal contact among Korean older adults. Furthermore, mental health issues emerging in the transition from young‐old to middle‐old emphasize the role of daughters as kin‐keepers who support their parents emotionally.

Little is known about whether and why social networks protect mental health among informal caregivers. This study examined the association between informal caregiver social network types and depressive symptoms and the mediatory mechanism of psychological resilience. Latent class analysis, applied to cross-sectional data on 278 Singaporean caregivers, identified four social network types: restricted (42%), friend (16%), family (21%), and diverse (21%). Path analysis showed that the diverse social network type, compared to the restricted social network type, was associated with a lower level of depressive symptoms, and psychological resilience fully mediated this association. Interventions should help caregivers to maintain social networks with their family and friends.

Introduction: Loneliness in older persons with cognitive impairment (PCI) may beget loneliness in their family caregivers, depending on buffering resources caregivers possess. This study examined the association between loneliness in older PCI and loneliness experienced by their family caregivers, and the moderating role of caregiver mastery in this association. Methods: Dyadic data from 135 PCI and their family caregivers in Singapore were analyzed using multivariable regression. Loneliness was measured using a three-item UCLA loneliness scale. Mastery was assessed using a seven-item Pearlin instrument. Results: Multivariable regression showed that PCI loneliness and caregiver loneliness were weakly associated, taking other covariates into account. Notably, a significant interaction between PCI loneliness and caregiver mastery was observed, indicating that PCI loneliness was associated with caregiver loneliness only when caregivers had low mastery. Conclusion: Lonely PCI may share their feelings of loneliness with their caregivers, and this can lead to loneliness among caregivers if they have low mastery. Promoting caregiver mastery may help reduce caregiver loneliness, directly and indirectly as a buffer against PCI loneliness.

Intergenerational contact is important to older adults’ quality of life, but less is known about within-family differences in older parents’ contact between sons and daughters, especially in countries with patrilineal traditions. Applying latent profile analysis to data on 3,228 Korean older adults’ frequency of meeting and communication with each of their children, this study identified within-family patterns of intergenerational contact. Nearly half of parents exhibited gender-balanced patterns of meeting across children, while 13% reported “more frequent contact with daughters” and 39% reported “more frequent contact with sons.” On the other hand, “equally high contact” (77%) was the most common pattern for communication. Multinomial regression results showed that the derived patterns were differentiated by parents’ education, marital status, region, economic satisfaction, health, and depressive symptoms. The results highlighted the enduring nature of patrilineal traditions as well as the differing patterns of contact that Korean older adults have with their children.