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Impacts of Informal Caregiving on Caregiver Employment, Health, and Family

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Abstract

As the aging population increases, the demand for informal caregiving is becoming an ever more important concern for researchers and policy-makers alike. To shed light on the implications of informal caregiving, this paper reviews current research on its impact on three areas of caregivers’ lives: employment, health, and family. Because the literature is inherently interdisciplinary, the research designs, sampling procedures, and statistical methods used are heterogeneous. Nevertheless, we are still able to draw several important conclusions: first, despite the prevalence of informal caregiving and its primary association with lower levels of employment, the affected labor force is seemingly small. Second, such caregiving tends to lower the quality of the caregiver’s psychological health, which also has a negative impact on physical health outcomes. Third, the implications for family life remain under investigated. The research findings also differ strongly among subgroups, although they do suggest that female, spousal, and intense caregivers tend to be the most affected by caregiving.

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Notes

  1. The literature was identified by using the following key works and their combinations in Google Scholar, Scopus, and Science Direct: “elderly care,” “informal care,” “aged care,” “employment,” “labor force participation,” “work,” “work hours,” “wage,” “health,” “burden,” “well-being,” “family,” and “relationship.” We also screened the references for any important omissions.

  2. Because the research on implications for the family was sparse, we extended the time span for this topic to a few literature reviews published prior to 2000.

  3. See Albertini et al. (2007) for a theoretical and empirical discussion of European family transfers.

  4. In 2011, 2.5 million people received benefits from the German LTCI, which equals about 3.1 % of the population.

  5. Such research commonly employs one of two survey methods: (i) diary methods, considered the gold standard because they bring in the most accurate information about time use, and (ii) recall methods, which are more widely used because they are easier and cheaper to carry out (Van den Berg et al. 2004).

  6. For example, the 2001 UK census reported 5.2 million informal caregivers in England and Wales, while the 2000 General Household Survey identified 6.8 million for the entire UK (Heitmueller 2007).

  7. Austria, Belgium, Germany, Denmark, France, Italy, the Netherlands, Spain, and Sweden.

  8. The three commonest methods for valuing the amount of informal care are (i) using the caregiver’s opportunity to value the time that could be used to supply labor elsewhere, (ii) valuing the time provided according to possible market substitutes (e.g., nurses or unskilled workers), and (iii) using the caregivers’ reported well-being and valuing the mean time spent on caregiving based on the rise in income necessary to keep caregiver well-being constant when providing one additional hour of care (Van den Berg and Ferrer-i Carbonell 2007). The second method, often termed the “proxy good method,” is the most widely used because of its ease of application (for further information, see Van den Berg et al. 2004, 2005; Van den Berg and Spauwen 2006; Sousa-Poza et al. 2001).

  9. Price varies based on the family relationship between care recipient and caregiver, with family caregiving requiring higher monetary compensation.

  10. For extensions with other time-allocation categories, see Gronan (1977); for a summary of all costs for adult caregivers, see Keating et al. (2014).

  11. Individuals in year t-1 before they become actual caregivers.

  12. For a list of other possible mediators suggested in pre-2006 studies, see Lilly et al. (2007).

  13. Carmichael and Charles (2003) note that they themselves define the direction of causality in this paper arbitrarily. In particular, they assume that care choices are made exogenously and do not consider opportunity costs, although they do not rule out the possible interaction between the mutual effects of care and employment.

  14. The authors divide Europe into the following three areas: (1) Nordic (Sweden and Denmark); (2) Central (Germany, France, Netherlands, Austria, and Switzerland), and (3) Southern (Spain, Italy, and Greece).

  15. “Wear-and-tear” refers to an increasing psychological burden over time, while “adaption” assumes a coping ability that reduces the burden in the long run (Brickman and Campbell 1971).

  16. For details, see Table 2.

  17. Bookwala (2009) observed three caregiver groups in three waves: T1 (1987–1988), T2 (1992–1994), and T3 (2001–2002). Caregivers in T1 were subjected to a baseline interview, “experienced caregivers” provided care in T2 and T3, but only “former caregivers” provided care in T2 and only “recent caregivers” in T3.

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Acknowledgments

This work is part of the project "Ageing, Work & Health" which is funded by the Pfizer-Stiftung fuer Geriatrie & Altersforschung. We would also like to thank two anonymous reviewers for valuable comments.

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  1. Institute for Health Care & Public Management, University of Hohenheim, Fruwirthstr. 48, 70599, Stuttgart, Germany

    Jan Michael Bauer & Alfonso Sousa-Poza

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Correspondence to Jan Michael Bauer.

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Bauer, J., Sousa-Poza, A. Impacts of Informal Caregiving on Caregiver Employment, Health, and Family. Population Ageing 8, 113–145 (2015). https://doi.org/10.1007/s12062-015-9116-0

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