Perceived autonomy of informal care recipients and the relevance of self-esteem

This study aimed to analyze the longitudinal associations between receipt of (spousal and adult child) care and perceived autonomy, and their moderation by self-esteem. Data from the population-based longitudinal German Ageing Survey (2014, 2017) were used. Perceived autonomy was assessed using Schwarzer's perceived autonomy in old age scale and self-esteem was assessed using Rosenberg's global self-esteem scale. Adjusted fixed effects regression analyses indicated a significant association between both forms of care and reduced autonomy. A significant interaction effect between receipt of care from adult children and self-esteem was found. Recipients of care from adult children with lower levels of self-esteem perceived less autonomy once receiving care, while those with high self-esteem did not perceive a difference. The study's findings indicate that the receipt of informal care was perceived to reduce the care recipient's autonomy, when received from either a spouse or adult children. However, self-esteem was indicated to be either a risk (in the case of low self-esteem) or prevention factor (in the case of high self-esteem) among recipients of care from adult children. This was found irrespective of the care recipient's age. Thus, autonomy should be supported among all informal care recipients and additional actions are recommended to identify and foster self-esteem among recipients of care from adult children in particular.