Factors Worsening and Mitigating the Consequences of the COVID-19 Outbreak on the Overall Health of Informal Caregivers of Older People with Long-Term Care Needs Living in Germany and in Italy.

Sara Santini,Andrea Teti,Marco Socci,Giovanni Lamura,Paolo Fabbietti

doi:10.3390/ijerph19031694

Abstract

Population ageing and the higher prevalence of multimorbidity in later life are increasing the demand for Long-Term Care (LTC) worldwide; this has been exacerbated by the COVID-19 pandemic. As in Europe and beyond, the bulk of care for frail older people is carried out by informal caregivers. This study aimed at understanding the factors affecting the overall worsening health of informal caregivers of older people with LTC needs living in Germany and Italy during the outbreak. To this purpose, 319 informal caregivers (149 in Germany and 173 in Italy) were surveyed online in 2020–2021. A logistic regression analysis was performed by country, to obtain an adjusted estimate of the risk of worsening of caregivers’ health. This risk increased by 42% for German caregivers compared to Italian ones, despite the former receiving more formal services. This may depend on different quality standards of LTC services and caregivers’ expectations, and on differing policies concerning migrant care workers (MCWs) during the outbreak, who could not enter Germany and were “trapped” at care recipients’ homes in Italy. Results call for in-home care reforms and policies guaranteeing more effective caregiver support, home care services and fairer working condition for MCWs in both countries.

Highlights

In light of the above, this study aims at advancing the available knowledge on the impact of the COVID-19 outbreak on the perceived overall health of informal caregivers of older people with Long-Term Care (LTC) needs living in Germany and in Italy
This study reveals that the German LTC system, commonly considered as wellstructured and providing many typologies of supports, has not been able to adequately sustain informal caregivers of older people with LTC needs, especially caregivers of older care recipients with psychological/mental health issues
The health of informal caregivers in Germany seems to have been more at risk than that of Italian caregivers, the former received more services

Summary

Introduction

As a consequence of population ageing, the demand for Long-Term Care (LTC) (i.e., the delivery of a range of care services to meet the health needs of people limited in their ability to live independently) is dramatically increasing across the world, threatening LTC systems’ sustainability. This is especially true for those countries with older age structures, like Germany and Italy, the focus of the study presented here, with 21.8% and 23.2% of their population aged 65 and over [1].

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Conclusion