Abstract
Although high-intensity caregiving has been found to be associated with a greater prevalence of mental health problems, little is known about the specifics of this relationship. This study clarified the burden of informal caregivers quantitatively and provided policy implications for long-term care policies in countries with aging populations. Using data collected from a nationwide five-wave panel survey in Japan, I examined two causal relationships: (1) high-intensity caregiving and mental health of informal caregivers, and (2) high-intensity caregiving and continuation of caregiving. Considering the heterogeneity in high-intensity caregiving among informal caregivers, control function model which allows for heterogeneous treatment effects was used.This study uncovered three major findings. First, hours of caregiving was found to influence the continuation of high-intensity caregiving among non-working informal caregivers and irregular employees. Specifically, caregivers who experienced high-intensity caregiving (20–40 h) tended to continue with it to a greater degree than did caregivers who experienced ultra-high-intensity caregiving (40 h or more). Second, high-intensity caregiving was associated with worse mental health among non-working caregivers, but did not have any effect on the mental health of irregular employees. The control function model revealed that caregivers engaging in high-intensity caregiving who were moderately mentally healthy in the past tended to have serious mental illness currently. Third, non-working caregivers did not tend to continue high-intensity caregiving for more than three years, regardless of co-residential caregiving. This is because current high-intensity caregiving was not associated with the continuation of caregiving when I included high-intensity caregiving provided during the previous period in the regression. Overall, I noted distinct impacts of high-intensity caregiving on the mental health of informal caregivers and that such caregiving is persistent among non-working caregivers who experienced it for at least a year. Supporting non-working intensive caregivers as a public health issue should be considered a priority.
Highlights
Co-residential informal caregiving leads to increased stress and lowered psychological health
While little was known until now about the specifics of the negative relation between high-intensity caregiving and caregivers’ mental health in Japan, the present study shed some light on this area
There were distinct impacts of high-intensity caregiving on the mental health of informal caregivers
Summary
Co-residential informal caregiving leads to increased stress and lowered psychological health. In 2006, Japan revised its social long-term care insurance (LTCI) entitlement for mildly disabled older people into a “prevention system,” which aims to help those eligible for support to better maintain their independence.. In 2006, Japan revised its social long-term care insurance (LTCI) entitlement for mildly disabled older people into a “prevention system,” which aims to help those eligible for support to better maintain their independence.3 Such approaches can be combined with more adequate support strategies for family caregivers [3]. The use of a short-term stay service funded by the LTCI has demonstrated positive effects on the well-being of family caregivers. This service is perhaps the most efficient, followed by home-helper services [5]. Greater use of day-care and respite shortstay services have indicated that such services might provide traditional female caregivers with temporary relief from their care burden [6].6
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