The cost of caring: a scoping review of qualitative evidence on the financial wellbeing implications of unpaid care to older adults

Abstract

Growing numbers of people help and support family members, friends or others due to long-term health problems, disability or older age–related needs. While care-giving can bring fulfilment and meaning to peoples’ lives, it can negatively affect individuals’ financial wellbeing. Much of the evidence in this area is quantitative, while the subjective, in-depth experience of how unpaid care decisions affect financial wellbeing remains relatively underexplored. This scoping review explores what is known about how unpaid carers experience and understand the financial consequences of providing care. It identified 35 studies containing qualitative evidence and, through thematic analysis, identified four overarching themes: (1) direct and indirect costs of caring; (2) social, cultural and institutional care and work decision-making; (3) the unequal cost of caring; and (4) personal finance and carer wellbeing. Findings indicate that unpaid caring affects financial wellbeing in multiple, overlapping ways. The financial consequences are experienced unequally, with systems, circumstances and contexts serving to exacerbate or reduce these negative effects. Crucially, our analysis reveals the paucity of qualitative research specifically focused on unpaid carers’ financial wellbeing. There is a significant gap in the literature regarding whether, and how, individuals understand the future financial implications of unpaid care-giving, or whether longer-term financial consequences are considered when making decisions about care. Future research designed to address this gap, with greater emphasis on the personal, social and structural influences on care-related financial decision-making, could offer important insights for developing policies and practices aimed at improving the financial wellbeing of carers as they age.