Caregiving, Employment and Social Isolation: Challenges for Rural Carers in Australia

Abstract

Australia has one of the world’s highest life expectancy rates, and there is a rapidly growing need for informal caregivers to support individuals who are ageing, have chronic illness or a lifelong disability. These informal carers themselves face numerous physical and psychological stressors in attempting to balance the provision of care with their personal life, their work commitments and family responsibilities. However, little is known about the specific challenges facing rural carers and the barriers that limit their capacity to provide ongoing support. A cross-sectional survey composed of open-ended responses and demographic/socioeconomic measures used routinely by the Australian Bureau of Statistics (ABS) and the Australian Institute of Health & Welfare (AIHW) was used with a cohort of 225 rurally-based carers within New South Wales, Australia. Demographic questions specified the respondents’ age, gender, employment, caregiving status, condition of and relationship to the care recipient, postcode, residency status, and distance and frequency travelled to provide care. Open-ended comments sections were provided to allow participants to describe any issues and problems associated with caregiving including employment, travel, residency, carer support groups and any other general information. The results show that most rural carers were middle-aged women supporting a spouse or a child. Unpredictability associated with providing care exacerbated demands on carers’ time, with many reporting significant employment consequences associated with inflexibility and limited job options in rural locations. Specific issues associated with travel requirements to assist with care were reported, as were the impacts of care provision on the respondents’ own personal health. The majority of carers were aware of the social supports available in their local rural community, but did not access them, leaving the carers vulnerable to marginalisation. Problems associated with employment were noted as resulting in financial pressures and associated personal stress and anxiety for the caregivers. While this issue is not necessarily limited to rural areas, it would appear that the lack of opportunity and flexibility evident in rural areas would exacerbate this problem for non-metropolitan residents. The participants also identified specific barriers to the provision of care in rural areas, including the significant impact of travel. Access to support services, such as carer groups, were rarely accessed due to a mix of factors including inaccessibility, poor timing and a lack of anonymity. Financially, there was considerable evidence of hardship, and there is an urgent need for a comprehensive review of government and community-based support to better meet the needs of rural carers.

A multilevel mixed effects analysis of informal carers health in Australia: the role of community participation, social support and trust at small area level

“…It is recognised that overall informal cares suffer from worse health outcomes compared to non-cares [1][2][3]; this study investigated an important question that if these disparities could be moderated through carers' social capital. For example, the study investigated if the nature of the local community and community social capital experienced at the personal level moderated carer's health.…”

“…The health and wellbeing of carers are considered as important as, and are essential to, the health and wellbeing of their care recipients. Yet, informal carers suffer from worse general and mental health outcomes than non-carers [1][2][3] Informal carers play a main role in providing care for someone, closely related to them, a friend or a neighbour, primarily in the home environment with a range of physical, mental and end-of-life health conditions, and disability [4]. They make a significant contribution to the care and wellbeing of people with a disability, mental illness, chronic condition, terminal illness and the elderly [5].…”

“…Some groups of carers suffer worse health outcome than non-carers, defined by their age and gender (women 50 years and above) and the health conditions of care recipients (Alzheimer’s disease/dementia/mental health) [ 10 , 11 ]. Some Australian studies have found an additional burden on informal carers in rural areas because of inaccessibility of services and absence of social support services [ 2 , 3 ]. A recent study found that marginalisation of informal carers in rural areas further exacerbates the impact of caregiving on their health [ 2 ].…”

The impact of caregiving on the health status of regional carers in Australia: Findings from a mixed‐method study

“…Carers in regional settings are more likely to face barriers with accessing support stemming from transport difficulties. 23 In addition, given the small size of rural communities, confidentiality issues may arise when carers share details of their lives with others living in their local community. Similar to other studies undertaken in rural and regional settings, it was evident carers in our study received significant benefit from peers and personal relationships, which provided significant social capital and enhanced their capacity to continue caregiving.…”

A Multilevel Mixed Effects Analysis of Informal Carers Health in Australia: The role of Community Participation, Social Support and Trust at Small Area level.

“…Some Australian studies have found an additional burden on informal carers in rural areas because of inaccessibility of services and absence of social support services 2 3 . A recent study found that marginalisation of informal carers in rural areas further exacerbates the impact of caregiving on their health 2 . These researchers found that caregiving can have cascading negative health effects when combined with reduced social interactions and geographical isolation as in rural and remote areas 2 12 .…”