Abstract
AbstractThe impact that providing care to ageing parents has on adult children's lives may depend on the long-term care (LTC) context. A common approach to test this is to compare whether the impact of care-giving varies between countries with different LTC coverage. However, this approach leaves considerable room for omitted variable bias. We use individual fixed-effects analyses to reduce bias in the estimates of the effects of informal care-giving on quality of life, and combine this with a difference-in-difference approach to reduce bias in the estimated moderating impact of LTC coverage on these effects. We draw on longitudinal data for Sweden and Denmark from the Survey of Health, Ageing and Retirement in Europe (SHARE) collected between 2004 and 2015. Both countries traditionally had generous LTC coverage, but cutbacks were implemented at the end of the 20th century in Sweden and more recently in Denmark. We use this country difference in the timing of the cutbacks to shed light on effects of LTC coverage on the impact care-giving has on quality of life. Our analyses show that care-giving was more detrimental for quality of life in Sweden than in Denmark, and this difference weakened significantly when LTC coverage was reduced in Denmark, but not in Sweden. This suggests that LTC coverage shapes the impact of care-giving on quality of life.
Highlights
When parents develop health limitations adult children often take on support tasks in response (Silverstein et al, 2006; Blomgren et al, 2012)
We investigated the impact of providing care to ageing parents on adult children’s quality of life in Sweden and Denmark
Both countries were traditionally characterised by generous long-term care (LTC) coverage, but in the 1990s in Sweden and more recently in Denmark there has been substantial retrenchment of provision
Summary
When parents develop health limitations adult children often take on support tasks in response (Silverstein et al, 2006; Blomgren et al, 2012). 1292 T van den Broek and E Grundy with health limitations have increasingly been shifted from the state to informal networks, most notably the family (Pavolini and Ranci, 2008; Ranci and Pavolini, 2015). Given that providing informal care is associated with a wide range of economic and non-economic costs (Fast et al, 1999), it has been argued that shifting care responsibilities from the state to the family would better be framed as cost redistribution than as cost-containment, and that policy makers should take into account the implications of informal care-giving for the lives of those engaged in it (Kotsadam, 2011; Van den Broek, 2013). The aim of the current study is to shed light on how the coverage of home-based LTC services may shape changes in quality of life that may occur when people become care providers for their ageing parents
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