Informal Caregivers Report Reduced Well-Being, May Not Bounce Back Years Later

People often believe that stepping up to assist an aging or ailing relative with the daily tasks of living will foster a sense of satisfaction and meaning, but this rosy picture may not match up with reality. Taking on a caregiving role reduced individuals’ life satisfaction and mood while increasing feelings of depression, anxiety, and loneliness, particularly during the first two years of caregiving, a study published in Psychological Science shows. 

“This is definitely a time period where some support would be appreciated most. This could come from other members of the family or maybe also from policy, for example from community social workers,” said clinical psychologist Michael D. Krämer (University of Zurich), who coauthored the study with Wiebke Bleidorn, in an interview with APS. 

Krämer and Bleidorn used data from 28,663 caregivers, collected over roughly 20 years in household studies in the Netherlands, Germany, and Australia. Though each of the countries has unique healthcare and welfare programs, all three have universal healthcare systems that provide citizens with access to community-based in-home care that is often combined with informal family caregiving. 

Each year, respondents reported how many hours of informal caregiving they provided per week and completed measures of life satisfaction, depression, anxiety, loneliness, and other psychological states. 

By analyzing these data, the researchers found that older women were most likely to become informal caregivers. Women in all three countries experienced a drop in life satisfaction that persisted throughout their time as a caregiver. For men, on the other hand, only those in Germany reported a decrease in life satisfaction upon becoming caregivers, and this dip dissipated after 2 years of continuous caregiving. 

“It is a well-documented phenomenon that women tend to take on this role more often, and when they do so, they often tend to invest more time into care,” Krämer said. “There is a heightened vulnerability for women in this context, and they might need more support than men in this case.” 

Krämer and Bleidorn also found evidence of reduced well-being that was unique to particular countries: 

• In the first year after becoming a caregiver, German and Australian women and, to a lesser extent, men reported reduced positive mood.  

• Dutch and German caregivers reported increased depression and anxiety. 

• German and Australian caregivers reported increased loneliness. 

• German men reported increased loneliness during the first year of caregiving, while German women reported increased loneliness for 3 years or more after starting to provide informal care. 

“Taken together, we found relatively consistent well-being losses in women after they became informal caregivers and temporally specific well-being losses for men that partly did not extend beyond the first year of the transition to the caregiver role,” Krämer and Bleidorn explained. “While adaptation effects set in for men, women continued to decrease with ongoing caregiving, especially in life satisfaction.” 

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Respondents reported an average of 1 to 2 hours of caregiving per day—possibly because relatives tend to be hospitalized or moved to long-term care facilities when they require more intense levels of caregiving, Krämer said. Still, respondents’ well-being was found to further decrease when they reported more hours of caregiving. Caregiver well-being did not differ according to whether they were also employed full-time, however, and did not differ significantly with the type of care provided. 

These findings conflict with previous research based on set-point theories of well-being, which proposes that people often bounce back to their average levels of emotional well-being after adapting to trying circumstances, and on potential well-being gains that may be associated with caregiving, Krämer and Bleidorn wrote. The contrary findings of Krämer and Bleidorn’s research underscore the need for interventions designed to support informal caregivers during the first 2 years of caregiving, including increased access to formal caregiving programs. 

“Considering the generally negative well-being effects of informal caregiving, policies designed to reduce the need for informal care through easier access to formal long-term care or combined forms of care may alleviate the detrimental effects of informal care,” Krämer and Bleidorn wrote. 

Further research is needed to determine how policy and cultural differences may influence the experiences of informal caregivers. Caregiver well-being may be worse in countries without strong formal care systems or universal healthcare to support families, Krämer said. All three countries in the study also have relatively individualist cultures, which may cause informal caregivers to experience the role as more stressful than those in collectivist cultures where multigenerational households are more common. 

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Reference 

Krämer, M. D., & Bleidorn, W. (2024). The Well-Being Costs of Informal Caregiving. Psychological Science, 0(0).