title: Predictors and consequences of perceived lack of choice in becoming an informal caregiver.
abstract: OBJECTIVE
  Using data from a national sample of informal caregivers to older adults, we identify predictors of lack of choice and the consequences of lack of choice in taking on the caregiving role.
  
  
  METHODS
  A national telephone survey with 1397 caregivers was carried out to assess whether respondents had a choice in taking on the caregiving role, their demographic characteristics, the nature and duration of their caregiving experience, and its impact on their physical and psychological well-being. We compare caregivers who felt they had no choice in taking on the caregiving role to those who did.
  
  
  RESULTS
  In total, 44% of caregivers reported a lack of choice in taking on the caregiving role. Highly educated, older caregivers caring for a younger care recipient with emotional or behavioral problems were most likely to report that they had no choice in taking on the caregiving role. Lack of choice is associated with higher levels of emotional stress, physical strain, and negative health impacts, after controlling for multiple confounds including level of care provided, relationship type, primary health condition of the care recipient, and demographic characteristics.
  
  
  CONCLUSIONS
  Lack of choice is an independent risk factor for the negative effects of caregiving, and clinicians should be vigilant to lack of choice as a marker of caregiver distress.
authors.affiliation: Department of Psychiatry, University of Pittsburgh, PA, USA. schulz@pitt.edu
authors.forename: Richard
authors.initials: R
authors.lastname: Schulz
authors.forename: Scott R
authors.initials: SR
authors.lastname: Beach
authors.forename: Thomas B
authors.initials: TB
authors.lastname: Cook
authors.forename: Lynn M
authors.initials: LM
authors.lastname: Martire
authors.forename: Jennifer M
authors.initials: JM
authors.lastname: Tomlinson
authors.forename: Joan K
authors.initials: JK
authors.lastname: Monin
mesh_terms: D000293:Adolescent; D000328:Adult; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D017028:Caregivers / Q000523:psychology*; D002755:Choice Behavior; D003625:Data Collection; D003657:Decision Making; D004522:Educational Status; D005260:Female; D005544:Forecasting; D006801:Humans; D007389:Internal-External Control; D008297:Male; D008875:Middle Aged; D012307:Risk Factors; D012737:Sex Factors; D013315:Stress, Psychological; D014481:United States; D055815:Young Adult