title: Combining Formal and Informal Caregiving Roles: The Psychosocial Implications of Double- and Triple-Duty Care.
abstract: OBJECTIVE
  Women who combine formal and informal caregiving roles represent a unique, understudied population. In the literature, healthcare employees who simultaneously provide unpaid elder care at home have been referred to as double-duty caregivers. The present study broadens this perspective by examining the psychosocial implications of double-duty child care (child care only), double-duty elder care (elder care only), and triple-duty care (both child care and elder care or "sandwiched" care).
  
  
  METHODS
  Drawing from the Work, Family, and Health Study, we focus on a large sample of women working in nursing homes in the United States (n = 1,399). We use multiple regression analysis and analysis of covariance tests to examine a range of psychosocial implications associated with double- and triple-duty care.
  
  
  RESULTS
  Compared with nonfamily caregivers, double-duty child caregivers indicated greater family-to-work conflict and poorer partner relationship quality. Double-duty elder caregivers reported more family-to-work conflict, perceived stress, and psychological distress, whereas triple-duty caregivers indicated poorer psychosocial functioning overall.
  
  
  CONCLUSIONS
  Relative to their counterparts without family caregiving roles, women with combined caregiving roles reported poorer psychosocial well-being. Additional research on women with combined caregiving roles, especially triple-duty caregivers, should be a priority amidst an aging population, older workforce, and growing number of working caregivers.
authors.affiliation: Department of Human Development & Family Studies, The Pennsylvania State University, University Park. nzd117@psu.edu.
authors.forename: Nicole
authors.initials: N
authors.lastname: DePasquale
authors.affiliation: Department of Human Development & Family Studies, The Pennsylvania State University, University Park.
authors.forename: Kelly D
authors.initials: KD
authors.lastname: Davis
authors.affiliation: Department of Human Development & Family Studies, The Pennsylvania State University, University Park.
authors.forename: Steven H
authors.initials: SH
authors.lastname: Zarit
authors.affiliation: Department of Sociology, University of Minnesota, Minneapolis.
authors.forename: Phyllis
authors.initials: P
authors.lastname: Moen
authors.affiliation: Department of Psychology, Portland State University, Oregon.
authors.forename: Leslie B
authors.initials: LB
authors.lastname: Hammer
authors.affiliation: Department of Human Development & Family Studies, The Pennsylvania State University, University Park.
authors.forename: David M
authors.initials: DM
authors.lastname: Almeida
mesh_terms: D000328:Adult; D017028:Caregivers / Q000523:psychology*; D003430:Cross-Sectional Studies; D003695:Delivery of Health Care; D005192:Family Health; D005260:Female; D006282:Health Personnel / Q000523:psychology*; D006801:Humans; D009784:Occupational Diseases / Q000209:etiology*; D005791:Patient Care / Q000523:psychology*; D013315:Stress, Psychological / Q000209:etiology*
keywords: Double-duty care; Healthcare employees; Psychosocial well-being; Sandwiched generation; Triple-duty care; Working caregivers.