Care giving and social engagement in arthritis: keeping a balance

      Purpose: Osteoarthritis is associated with pain and disability and as a result there has been some interest in examining the receipt of care among those with arthritis. What has garnered less attention is care giving by this population. The purpose of this study was to describe both care giving and care receipt, and social engagement, in a nationally representative sample of later working age (age 45–64 years) people with arthritis.
      Methods: Analysis was based on the first wave data from the Canadian Longitudinal Study on Aging (CLSA), a nationally representative sample of people aged 45–85. The questionnaire covers socio-demographic, health, functioning, social, and work variables. Analyses were limited to participants aged 45–64 (n = 12,319).
      Results: Overall, in this working age population 30% reported arthritis; 17% reported OA, a further 9% other or unknown (likely OA) type of arthritis and 4% reported rheumatoid arthritis. Arthritis was reported more frequently by women than men. Most people with arthritis were married (75%), and 70% had more than a high school education. A high proportion (70%) of people with arthritis were overweight or obese. The majority of individuals with arthritis (68%) reported difficulty with at least one daily activity – most frequently were crouching, kneeling or stooping; standing up after sitting; and standing for a long period. As expected, people receiving care were somewhat more likely to report difficulty with daily living activities. Overall, more than 85% were currently in the labour force, and most were socially connected (e.g. 80% took part in community-based activities at least once a week). Care receivers were only slightly less likely than care providers to be in the labour force and to report taking part in community based activities.
      Taking both informal and formal care together, around 20% of people with arthritis in this age group received some form of care, with the majority of care being informal only. A small proportion received professional care – most often assistance around the house (3%) and medical care (2.5%). Overall, 18% received some kind of non-professional assistance: 14% around the house, 11% with transportation, and 10% with meal preparation. Nearly 60% of the informal care received came from someone living in the same household. Almost half of care had been received for 6 months or less, although 22% reported receiving care for 5 years or more.
      Over half of individuals with arthritis (53%) reported providing some kind of care to others. Of the 20% of individuals with OA who received care, half also provided care. Care was most frequently provided to individuals living in another household, and a similar proportion of men and women provided care. The most frequent types of care provided were assistance with transportation (39%), assistance around the house (31%), and assistance with meal preparation (25%). Care was provided for a median of 12 weeks in the past year and 5 hours per week. Overall findings for people with OA were similar to those with arthritis as a whole. The proportions of people with OA and RA reporting receiving and giving care were similar.
      Conclusions: Against a backdrop of substantial limitations in activities, the majority of people with osteoarthritis in the later decades of working life were in the work force and engaged in the community. At the same time, more than half provided care to others, far more than the proportion that received care. The need to provide care and at the same time balance work and a social and family life for individuals with OA and arthritis in general may impact their ability to engage in arthritis self-management activities and care for themselves.