Impact of the Outbreak of the COVID-19 Pandemic on Formal and Informal Care of Community-Dwelling Older Adults: Cross-National Clustering of Empirical Evidence from 23 Countries

Abstract

The COVID-19 pandemic has been dramatically affecting the life of older adults with care needs and their family caregivers. This study illustrates how the initial outbreak of the pandemic changed the supply of formal and informal care to older adults in European countries and Israel and assesses the resilience of these countries in providing support to their older populations by means of a mix of both types of care. We subjected data from the Survey of Health, Ageing and Retirement in Europe COVID-19 period (SHARE-COVID-19) across 23 European countries (including Israel) to descriptive and cluster analyses. In the first wave of the outbreak, a significant proportion of older adults in European countries received informal help, with an increase in the frequency of informal help received from children, neighbors, friends, or colleagues and a decrease in that received from other relatives. In most countries, difficulties in receiving home care services from professional providers were reported. Seven clusters were identified, reflecting different combinations of changes in the formal/informal care provision. In most countries, informal care is more resilient than home care services that formal providers deliver. Since they are an essential source for sustainable care, their challenges related to care should be addressed. The impact of the pandemic does not follow the traditional characterization of welfare regimes. A clustering effort may yield more understanding of the priorities that future care policies should exhibit at the national level and may identify potential systems for policymakers to enhance sustainability of care for community-dwelling older adults.

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

“…Thus, the study confirms the lower resilience of the Italian formal and informal care supports in response to the reduction of the care services during the pandemic compared to Germany [63]. In addition, this study identifies MCWs as one of the main sources of resilience in the German and Italian LTC systems and advances further hypotheses for the interpretation of the results coming from previous and future studies focusing on the response of the LTC systems to the challenges posed by the COVID-19 health crisis.…”

“…This study, which reached an overall sample of 2468 European caregivers from 16 countries, is focused on two sub-samples of 146 informal caregivers living in Germany and 173 in Italy, providing care to older people aged 65 and over having LTC needs (i.e., experiencing multiple chronic diseases limiting their activities of daily living). Since several studies have analysed the consequences of the first pandemic wave in Spring 2020 [46][47][48][49][50][51][52][59][60][61][62][63], an added value of the study is that it provides evidence about the impact of the COVID-19 outbreak in winter 2020-2021, a critical period in which the effects of the first and following pandemic waves in Europe may have cumulated over time.…”

“…These two countries belong to two different welfare systems according to the classification of Esping-Andersen [6] and have been recently assigned to two different clusters by Tur-Sinai et al (2021) [63]. This research analysed the response of LTC systems to the challenges posed by the pandemic and showed that Germany demonstrated high resilience in terms of both informal care (i.e., that provided by children, other relatives and non-relatives, like neighbours) and formal home-based care services, while Italy was characterised by a medium-low level of resilience, with weaker support by both informal care networks and formal home care [63]. The latter study stemmed from the hypothesis that caregivers' health could have been influenced by the decrease/cancellation/postponement of social and health care services because of the outbreak and by the peculiarities of the LTC system characterizing the two countries.…”

Informal care in times of a public health crisis: Objective burden, subjective burden and quality of life of caregivers in the Netherlands during the COVID‐19 pandemic

“…Studies from various countries show that gender (Lorenz‐Dant & Comas‐Herrera, 2021 ; Raiber & Verbakel, 2021 ; Zwar et al, 2022 ), age (Budnick et al, 2021 ; Hofstaetter et al, 2022 ), employment (Truskinovsky et al, 2022 ), living situation of the care recipient (Prins et al, 2021 ; Smaling et al, 2022 ), relationship to the care recipient (Tur‐sinai et al, 2021 ) and network (Allen et al, 2022 ) were important characteristics that distinguish how caregivers were affected. Studies in the Netherlands found that there were differences between men and women, and between those in different relationships to the care recipient (Prins et al, 2021 ; Raiber & Verbakel, 2021 ; Smaling et al, 2022 ; Tur‐sinai et al, 2021 ) Previous literature thus shows that consequences differed across countries, which may be due to differences in measures, COVID impact and healthcare system (Lorenz‐Dant & Comas‐Herrera, 2021 ; Santini et al, 2022 ; Tur‐sinai et al, 2021 ). In the Netherlands, there were relative large increases in informal care and decreases in formal care compared to other countries (Tur‐sinai et al, 2021 ).…”

“…Studies in the Netherlands found that there were differences between men and women, and between those in different relationships to the care recipient (Prins et al, 2021 ; Raiber & Verbakel, 2021 ; Smaling et al, 2022 ; Tur‐sinai et al, 2021 ) Previous literature thus shows that consequences differed across countries, which may be due to differences in measures, COVID impact and healthcare system (Lorenz‐Dant & Comas‐Herrera, 2021 ; Santini et al, 2022 ; Tur‐sinai et al, 2021 ). In the Netherlands, there were relative large increases in informal care and decreases in formal care compared to other countries (Tur‐sinai et al, 2021 ).…”