title: Transitions in spousal caregiving.
abstract: OBJECTIVE
  This study describes transitions over 5 years among community-dwelling elderly spouses into and within caregiving roles and associated health outcomes.
  
  
  METHODS
  Participants in the Caregiver Health Effects Study (n = 818) were interviewed four times over 5 years with changes in their caregiving status described. Analyses of the effect on health outcomes of transitions were performed on those for whom four observations were available (n = 428).
  
  
  RESULTS
  Only half (49.5%) of noncaregivers at baseline remained noncaregivers at 5-year follow-up. The remainder experienced one or more transitions, including moving into the caregiving role, their own or their spouse's death, or placement of their spouse in a long-term care facility. The trajectory of health outcomes associated with caregiving was generally downward. Those who transitioned to heavy caregiving had more symptoms of depression, and poorer self-reported health and health behaviors.
  
  
  CONCLUSIONS
  Transitions into and within the caregiving role should be monitored for adverse health effects on the caregiver, with interventions tailored to the individual's location in the caregiving trajectory.
authors.affiliation: Health Services Research and Development Center, Johns Hopkins University, Bloomberg School of Public Health, Baltimore, MD 21205, USA. lburton@jhsph.edu
authors.forename: Lynda C
authors.initials: LC
authors.lastname: Burton
authors.forename: Bozena
authors.initials: B
authors.lastname: Zdaniuk
authors.forename: Richard
authors.initials: R
authors.lastname: Schulz
authors.forename: Sharon
authors.initials: S
authors.lastname: Jackson
authors.forename: Calvin
authors.initials: C
authors.lastname: Hirsch
mesh_terms: D000223:Adaptation, Psychological; D000368:Aged; D000369:Aged, 80 and over; D017028:Caregivers / Q000523:psychology*; D005260:Female; D015438:Health Behavior; D006304:Health Status; D006801:Humans; D008134:Long-Term Care; D008297:Male; D012111:Residence Characteristics; D018454:Spouses / Q000523:psychology*; D013315:Stress, Psychological / Q000523:psychology*; D013997:Time Factors