Research highlights unmet care needs among older parents in biological and stepfamilies

As people age and require more care, their partners or adult children are often their front line of caretakers.

But as divorce has become more common among older adults, University of Michigan researchers sought to understand the role of stepchildren in providing care for their aging stepparents. The researchers, led by family demographer Sarah Patterson, found what they refer to as a “step gap"—that is, older adults in need of care with only biological children are more than twice as likely to be cared for by their adult children than older adults with any stepchildren.

But they also found the same high rate of unmet needs—about 50%—among those with only biological and any stepchildren. Unmet needs include having to go without showering or getting dressed, or not getting a hot meal or clean laundry because of a lack of help, said Patterson, research investigator at the Institute for Social Research’s Survey Research Center. Their research is published in the Journals of Gerontology: Social Sciences.

Overall, what we find is that unmet needs are quite high among older adults with care needs, whether they have stepfamilies or not.”

Sarah Patterson, research investigator

Previous research looked at subgroups of older adults, such as those without partners, or only examined individual adult children’s help to their parents, but the U-M researchers wanted to understand the dynamics of the whole family.

“We know that family relationships don’t exist in isolation—we all operate within a family system,” said Patterson, also a postdoctoral affiliate at the Population Studies Center. “When research only looks at individual relationships, like between a mother and a daughter, it might miss the dynamics of the larger family system.”

The researchers used nationally representative, anonymized data from more than 2,000 older adults, drawn from the 2015 National Health and Aging Trend Study. The study provides information on the health and functioning of older adults as well as the kind of care that older adults receive, including who is providing care and whether the participants have unmet needs.

The researchers also considered whether the older adult received any paid care over the previous month, whether the participant was married or living with a partner, and whether they had received care from their partner over the previous month.

Even when older adults have partners who could care for them, the researchers found that those with only biological children were more likely to receive help from their adult children than those with a stepfamily. But the researchers still did not see any difference in unmet care needs by family type among partnered older adults.

“We take this to mean that even if people have access to a partner, even if they have access to adult children to care for them, older adults in the U.S. still have high rates of unmet needs for care,” Patterson said. “Partners and children are seen as front-line caregivers. We just expect they will take care of older family members, and I think what our study says is that they might need help doing so.”