{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,19]],"date-time":"2026-06-19T11:44:05Z","timestamp":1781869445105,"version":"3.54.5"},"reference-count":80,"publisher":"SAGE Publications","issue":"7-8","license":[{"start":{"date-parts":[[2024,1,22]],"date-time":"2024-01-22T00:00:00Z","timestamp":1705881600000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"funder":[{"DOI":"10.13039\/100000049","name":"National Institute on Aging","doi-asserted-by":"publisher","award":["K99AG073473"],"award-info":[{"award-number":["K99AG073473"]}],"id":[{"id":"10.13039\/100000049","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Res Aging"],"published-print":{"date-parts":[[2024,8]]},"abstract":"<jats:p>We investigate how the type of caregiving arrangement is associated with older Americans\u2019 outcomes. We use the Health and Retirement Study (2004\u20132018) and discrete-time event history analysis to assess the odds of institutionalization or death over a 14-year period among older adults with limitations in Activities of Daily Living (ADLs; e.g., bathing). We consider caregiving arrangements as conventional (i.e., spouse or adult child), unconventional (e.g., extended family, employee, friend), or self-directed (i.e., no caregiver). We find a \u201ccare paradox\u201d in that self-directing one\u2019s own care was associated with a lower risk of institutionalization or death compared with having conventional care (spouse\/adult caregiver) and unconventional care (employee). Relative to conventional care, having an employee caregiver was associated with increased risk of institutionalization. Findings are still observed when controlling for level of impairment and various health-related factors. More research is needed to understand older adults who self-direct their own care.<\/jats:p>","DOI":"10.1177\/01640275241229416","type":"journal-article","created":{"date-parts":[[2024,1,22]],"date-time":"2024-01-22T19:23:20Z","timestamp":1705951400000},"page":"363-385","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":10,"title":["A Care Paradox: The Relationship Between Older Adults\u2019 Caregiving Arrangements and Institutionalization and Mortality"],"prefix":"10.1177","volume":"46","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-4712-6615","authenticated-orcid":false,"given":"Meggan","family":"Jordan","sequence":"first","affiliation":[{"name":"Department of Sociology, Gerontology, and Gender Studies, California State University Stanislaus, Turlock, CA, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1018-0693","authenticated-orcid":false,"given":"Kenzie","family":"Latham-Mintus","sequence":"additional","affiliation":[{"name":"Department of Sociology, Indiana University-Purdue University, Indianapolis, IN, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5040-7576","authenticated-orcid":false,"given":"Sarah E.","family":"Patterson","sequence":"additional","affiliation":[{"name":"Institute of Social Research, University of Michigan, Ann Arbor, MI, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2024,1,22]]},"reference":[{"key":"bibr1-01640275241229416","volume-title":"Caregiving in the U.S.: 2020 report","author":"AARP &amp; National Alliance for Caregiving","year":"2020"},{"key":"bibr2-01640275241229416","doi-asserted-by":"publisher","DOI":"10.1177\/0192513X11404335"},{"key":"bibr3-01640275241229416","doi-asserted-by":"publisher","DOI":"10.1093\/geronb\/gbs032"},{"key":"bibr4-01640275241229416","doi-asserted-by":"publisher","DOI":"10.4135\/9781452270029"},{"key":"bibr5-01640275241229416","doi-asserted-by":"publisher","DOI":"10.1093\/geronb\/57.3.S158"},{"key":"bibr6-01640275241229416","volume-title":"An assessment of available data and data needs for studying intra- and inter-generational family relationships and behavior","author":"Bianchi S.","year":"2007"},{"key":"bibr7-01640275241229416","doi-asserted-by":"publisher","DOI":"10.1093\/geront\/gny060"},{"issue":"5","key":"bibr8-01640275241229416","first-page":"e629","volume":"59","author":"Bom J.","year":"2019","journal-title":"The Gerontologist"},{"key":"bibr9-01640275241229416","doi-asserted-by":"publisher","DOI":"10.1177\/0898264310385930"},{"key":"bibr10-01640275241229416","doi-asserted-by":"publisher","DOI":"10.1177\/016402757914002"},{"key":"bibr11-01640275241229416","doi-asserted-by":"publisher","DOI":"10.1155\/2016\/4723250"},{"key":"bibr12-01640275241229416","doi-asserted-by":"publisher","DOI":"10.1177\/0164027519899576"},{"key":"bibr13-01640275241229416","doi-asserted-by":"publisher","DOI":"10.1017\/S0714980811000316"},{"key":"bibr14-01640275241229416","doi-asserted-by":"publisher","DOI":"10.1016\/j.jhealeco.2005.05.001"},{"key":"bibr15-01640275241229416","doi-asserted-by":"publisher","DOI":"10.1093\/geronb\/61.1.S18"},{"key":"bibr16-01640275241229416","doi-asserted-by":"publisher","DOI":"10.1177\/0192513X18783805"},{"key":"bibr17-01640275241229416","doi-asserted-by":"publisher","DOI":"10.1111\/jgs.14586"},{"key":"bibr18-01640275241229416","doi-asserted-by":"publisher","DOI":"10.1353\/cja.2004.0003"},{"key":"bibr19-01640275241229416","doi-asserted-by":"publisher","DOI":"10.1093\/geronb\/62.4.S209"},{"key":"bibr20-01640275241229416","doi-asserted-by":"publisher","DOI":"10.1111\/1468-0009.12076"},{"key":"bibr21-01640275241229416","volume-title":"Caregiving Leave","author":"Freedman V. 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