Willingness and preparedness to provide care: interviews with individuals of different ages and with different caregiving experiences

Abstract

Background At present, the provision of informal care to older relatives is an essential pillar of the long-term care system in Germany. However, the impact of demographic and social changes on informal caregiving remains unclear. Methods Thirty-three semi-structured interviews were conducted with care consultants, informal caregivers and people without any caregiving experience to explore if people are willing to provide older adult care and how prepared these are with regard to the possibility of becoming care dependent themselves. Results In total, three main categories (willingness to provide care, willingness to receive care and information as preparation) with several sub-categories were identified during the content analysis. While almost all interviewees were willing to provide care for close family members, most were hesitant to receive informal care. Other factors such as the available housing space, flexible working hours and the proximity of relatives were essential indicators of a person’s preparedness to provide informal care. It is, however, unclear if care preferences change over time and generations. Six out of 12 informal caregivers and nine out of 14 care consultants also reported an information gap. Because they do not possess adequate information, informal caregivers do not seek help until it is too late and they experience high physical and mental strain. Despite the increased efforts of care consultants in recent years, trying to inform caregivers earlier was seen as almost impossible. Conclusions The very negative perception of caregiving as a burden was a reoccurring theme throughout all interviews and influenced people’s willingness to receive care as well as seeking timely information. Despite recent political efforts to strengthen home-based care in Germany, it remains unclear whether political efforts will be effective in changing individuals’ perceptions of informal caregiving and their willingness to be better prepared for the highly likely scenario of having to care for a close relative or becoming care dependent at a later stage in life.

Willingness to provide informal care to older adults in Germany: a discrete choice experiment

“…For the availability of informal caregivers in a country, a key determinant is the willingness of individuals to provide the number of care hours required for the care-dependent person [ 4 ]. Even though the needed care time per day or the expected duration of caregiving is difficult to plan ahead [ 6 ], it is important to know what people can imagine in terms of providing informal care. Studies show that with increasing care dependency, the necessary care time per day is often higher than our maximum level of 8 h care time per day [ 41 , 42 ].…”

“…Results from a systematic literature review of the scientific databases PubMed, Scopus, and Dimdi [ 26 ] and 33 semi-structured qualitative interviews [ 6 , 27 ] were used to identify the most relevant attributes and corresponding levels. While the type and severity of a care dependency as well as the (relationship to) the care-dependent person are important determinants for a person’s willingness to provide care [ 6 ], we decided to solely focus on relevant attributes that describe informal caregiving situations in the DCE. Five quantitative attributes with three levels each were identified.…”

“…Nevertheless, current care systems rely on people’s willingness to provide informal care, as the professional care structures and workforce in place are not able to provide care to the increasing number of care-dependent older adults. When it comes to understanding the reasons for people to take on the role of an informal caregiver, arguments are complex and still not well understood [ 6 ]. On the one hand, many studies have highlighted the immense burden informal caregivers’ face in many life settings.…”

Positive Mental Health and Mental Health Literacy of Informal Caregivers: A Scoping Review

“…Taking responsibility for caring for a person requires the combination of two conditions: availability to provide care and adequacy to do so [ 33 ]. In fact, assuming the responsibility of caring for a person with dependencies may signify, for those who are not prepared, a largely negative impact on their well-being, characterized as a state of burden [ 32 , 33 ]. When the burden of care exceeds the capacity of the informal caregiver, then situations of anxiety (#7, #1), depression (#1), fear (#7), and stress (#1, #2, #6) may arise.…”

Testing the informal care model: intrapersonal change in care provision intensity during the first lockdown of the COVID-19 pandemic

“…provide care. Many scholars directly built their work on the model (for instance, Brettschneider et al 2019 ; Calvó-Perxas et al 2018 ; de Jong et al 2021 ; Kaschowitz & Brandt 2017 ; Palmer 2019 ; Peng and Anstey 2019 ; Suanet et al 2019 ; Verbakel, et al 2017 ; Vos et al 2020 ). Directly empirical assessing the Informal Care Model , de Klerk et al ( 2021 ) identified, in line with the Informal Care Model , both sociodemographic factors as well as individual barriers and beliefs as determinants for different types of informal care relationships in the Netherlands.…”