In the light of an increasing future demand for long-term care services in ageing societies, families' provision for current and future long-term care needs has been subject to debate. Within this context, there is little discussion about parents' incentives to socialise their children to their own traits to achieve a desired child behaviour. Our study contributes to the literature by analysing to what extent parents transmit filial norms to their children and whether this transmission process affects children's care-giving behaviour if a parent needs long-term care. Using data from the German Family Panel, we initially analyse the transmission of filial norms from mothers and fathers to their children. Second, we examine the importance of filial norms that prevail in the child's local environment. Third, we assess whether an intergenerational transmission of norms transmits into child behaviour if a parent needs long-term care. We estimate linear regression models and account for child and parent characteristics as well as for the living environment. The results show that children have stronger filial norms when both parents report stronger filial norms. But, children also tend to be influenced by average norms in their local environment. Furthermore, children are more likely to provide support to a parent in need when their filial norms are stronger. We conclude that children's filial norms are at least partially shaped via a process of socialisation and that these norms transmit into children's care-giving behaviour if a parent needs long-term care. It is, therefore, important that filial norms that prevail in a society are in accordance with the institutional long-term care system that prevails within that country.

Older adults' engagement in various prosocial activities is a salient question in present-day societies that aim to promote active ageing. However, there are only a few studies focusing on associations between several types of prosocial activities, and they have rarely considered help to relatives and friends separately. Moreover, there is lack of studies considering informal monetary help and charity donations when analysing multiple prosocial activities. Using population-based data of older Finns (N = 2,184), we examined whether providing informal help (i.e. practical help, financial support or personal care) to relatives and friends is associated with participation in volunteering and charity, respectively. Overall, 5 per cent of the participants provided all examined forms of informal help and volunteered, 16 per cent provided two types of help and volunteered, and 23 per cent provided one type of help and volunteered. In addition, 9 per cent of the participants provided all types of informal help and made charitable donations, 33 per cent provided two types of help and made charitable donations, and 54 per cent provided one type of help and made charitable donations. Practical help and care channelled outside the household were associated with an increased probability of volunteering, although they were not associated with the probability of making charitable donations. Practical help, financial support and personal care provided to friends were particularly important predictors of volunteering and charity. These results are discussed in the context of the role overload and role extension hypotheses.

In Japan, care-giving sons are noted for their high rates of abuse of care recipients. This study revealed, for the first time, the difficulties unique to sons caring for their mothers. All sons used long-term care insurance services. However, they provided care that could not be covered by such public services while harbouring psychological distress. In this study, we interviewed 13 sons living with their older mothers as the primary carer and conducted a thematic analysis focusing on their psychological distress. As part of our study findings, we have identified nine themes during analysis: uncomfortable feelings that cannot be mitigated as a son; feeling of futility in being unrecognised as a carer; fear of losing something important; a strong sense of responsibility for one's mother's life; disappointment in being unable to obtain understanding and co-operation from one's siblings in providing care; irritation and anger towards one's wayward mother; guilt about treatment of one's mother; sense of exhaustion due to demanding care; and experiencing hopelessness and despair. Thus, it is important to understand what psychological distress carers experience and to consider possible approaches for their support. The study findings provide suggestions for long-term care support in regions, such as East Asia, where the numbers of son carers are increasing inevitably owing to declining birth rates and ageing population, as in Japan.

Previous research was not able to identify an effect of the COVID-19 pandemic on family care-givers' wellbeing due to cross-sectional data structures, care-giver-specific samples or non-probability sampling designs. In this article, by drawing on longitudinal data from a random and representative sample of the German population aged 40 and older, we overcome methodological limitations of previous research. We examine the impact of the COVID-19 pandemic on the wellbeing (life satisfaction, depressive symptoms, loneliness) of different groups of family care-givers (new care-givers, continuous care-givers, past care-givers) and non-care-givers in Germany. We derived a balanced sample of n = 3,875 individuals aged 43–97 (mean = 66.5 years, standard deviation = 10.2 years) from the German Ageing Survey (DEAS) to explore changes in wellbeing between 2017 (pre-pandemic) and June/July 2020 (pandemic). Using a first-difference approach, we found that the pandemic has a negative impact on both non-care-givers' and family care-givers' wellbeing, with increased levels of depressive symptoms and loneliness compared to pre-pandemic times. Changes in depressive symptoms of family care-givers did not significantly deviate from non-care-givers. However, continuous care-givers showed more pronounced increases in loneliness compared to non-care-givers. Our results suggest that family care-givers' wellbeing merits particular attention when considering the long-term consequences of the COVID-19 pandemic on individuals' wellbeing.

Although the literature on informal care-giving for older parents shows that daughters have a higher tendency to provide care compared with sons, only a few studies have focused on the gender composition of all children or parents’ entire range of care options. Our study examines the effect of children's gender composition on informal and formal care types, as well as the informal care network. Using data from the 2015 Survey of Health, Ageing and Retirement in Europe (N = 40,312), we found that parents with daughters tended to use less formal care because daughters take on additional informal care-giving responsibilities. Daughters were the main care-givers among parents’ informal care networks. Further analysis indicated that daughters-in-law play an important role in the care-giving process when parents have only sons. We concluded that the presence of a daughter among the children reduces the use of formal care. The results indicated that children's gender composition is an important factor in explaining the allocation of informal care to parents.

The three-way intersection of gender, relationship-to-care-recipient and care-giving demands has not, to our knowledge, been examined in relation to the wellbeing of family care-givers. We explore inequalities in depressive symptoms and life satisfaction, comparing wives, husbands, daughters and sons providing very-intensive care (36+ hours/week) with those providing less care and disparities between these groups in the factors related to disadvantage. Data from the Canadian Longitudinal Study on Aging (N = 5,994) support the existence of differences between the groups. Very-intensive care-giving wives report the most depressive symptoms and lowest life satisfaction; less-intensive care-giving sons report the fewest depressive symptoms, and less-intensive care-giving daughters report the highest life satisfaction. However, group differences in life satisfaction disappear among very-intensive care-givers. Drawing on Intersectionality and Stress Process theories, data from regression analyses reveal a non-significant gender–relationship–demand interaction term, but, health, socio-economic and social support resources play a strong mediating role between care demand and wellbeing. Analyses of the eight groups separately reveal diversity in the care-giving experience. Among less-intensive care-givers, the mediating role of resources remains strong even as differences are evident. Among very-intensive care-givers, the role of resources is less and differences in wellbeing between the groups are magnified. Policy implications emphasise the imperative to personalise services to meet the varied needs of care-givers.

Older parents in China rely heavily on their adult children for instrumental assistance. In different multi-child families, multiple offspring may co-operate in providing instrumental support to older parents in distinct ways in terms of how much support they provide on average and how much differentiation exists between them when they provide such support within a family. We aimed to identify different within-family patterns in relation to multiple offspring's instrumental support to an older parent in Chinese multi-child families, and to investigate potential predictors for different within-family patterns. Using data from the China Family Panel Studies (2016), we had a working sample of 5,790 older adults aged 60+ (mean = 68.54, standard deviation = 6.60). We employed latent profile analysis (LPA) to classify within-family patterns and multinomial logistic regression to investigate predictors. Our findings identified three within-family patterns: dissociated (59.10%), highly differentiated (29.60%) and united-filial (11.30%). Older parents in the highly differentiated families tended to be older, mothers, divorced/widowed and to have poorer physical health compared to their counterparts in the dissociated families. In contrast, the composition characteristics of multiple adult children played more important roles in determining the united-filial within-family pattern. The united-filial families were more likely to have fewer adult children, at least one adult daughter and at least one co-residing adult child.

We carried out a narrative review and thematic analysis of literature on the physical health care, mental health care and social care of trans older adults to ascertain what is known about older trans adults’ contacts with and use of health and social care. Thirty papers were found: a majority originated in the United States of America. Five themes were identified: experience of discrimination/prejudice and disrespect; health inequalities; socio-economic inequalities; positive practice; and staff training and education. The first three themes present challenges for providers and service users. Experiences of discrimination/prejudice and disrespect over the course of their lives powerfully influence how older trans adults engage with care services and practitioners. Health and socio-economic inequalities suggest that older trans adults are likely to have greater need of services and care. The remaining two themes offer opportunities for service improvement. We conclude that more research is needed, that there is a strong argument for taking a lifecourse perspective in a spirit of cultural humility, and that contextual societal factors influence service users and providers. We identify positive trans-inclusive practices which we commend to services. More needs to be done now to make older adult services appropriate and welcoming for trans service users.

Research concerning the effects of migrants on elder care in affluent receiving countries has been substantial, but we know little about the effects of migrant care on elder care in sending countries. There also is limited research on elder care in the context of the return migration of migrant care workers. This theoretical article explores the potential relevance of a social network perspective, which views individuals and countries as being interconnected even when they are miles apart. A multi-level framework that considers macro-, meso- and micro-level perspectives is introduced to better account for current migrant care arrangements. The macro-level perspective takes into account country-level characteristics including policies, geography and cultural preferences; the meso-level perspective takes into account the characteristics of the entire network, which may spread over different countries; and the micro-level perspective concerns the unique characteristics of the individuals who make up the network. This approach proposes that the effects of migrant home care go way beyond the care recipient–care-giver dyads or triads to incorporate many individuals and countries that are transnationally interconnected via the work of care. This article also aims to increase public and scientific awareness to the potential impact of migrant care and return migration on elder care in the sending countries by stressing a transnational social network perspective.

The article investigates the conditions of multiple engagement in the private and public realm in the second half of life. More specifically, I look at the relationship between informal care-giving and formal volunteering in a country-comparative way. Based on longitudinal data from the Survey of Health, Ageing and Retirement, 2004–2015, I investigate the 50+ population in 13 European countries. Controlling for unobserved heterogeneity by using conditional fixed-effect logistic regression models, I confirm earlier findings that care-givers are more likely to volunteer than non-care-givers; this effect is independent of care-giving intensity but only true for those who care outside their own household. As to macro-level influences, I find that both care-in-kind and cash-for-care expenditures increase the likelihood of volunteering among the 50+ population. The effect of cash-for-care expenditure is even stronger for the group of those who give intensive care outside their own households than for non-care-givers. Moreover, I find effects related to family's and women's role in society. First, I show a negative effect of a country's societal norm of family orientation on volunteering participation for those giving sporadic care outside their household but also among non-care-givers. Second, in countries with higher female labour market participation among the middle-aged, the volunteering likelihood is higher for sporadic female care-givers outside their own household but also among female non-care-givers.

Considering the important role that paid support workers play in care of older people with dementia, it is vital that researchers and relevant organisations understand the factors that lead to them feeling valued for the work that they do, and the consequences of such valuing (or lack thereof). The current study employed semi-structured interviews to understand the individual experiences of 15 support workers based both in residential care homes and private homes. The General Inductive Approach was used to analyse the interview transcriptions and to develop a conceptual model that describes the conditions that lead to support workers feeling valued for the work that they do. This model consists of organisational or individual strategies, the context in which support work takes place, and various interactions, actions and intervening conditions that facilitate or prevent support workers feeling valued. A significant finding in this research was the role of interpersonal relationships and interactions which underlie all other aspects of the conceptual model developed here. By understanding the importance of how employers, families of older adults with dementia and peers interact with support workers, we may promote not only the quality of work that support workers deliver, but also the wellbeing of the support workers themselves.

Many persons with dementia live at home and are cared for by their relatives. If the relatives are still employed, this can lead to higher burden and losses in their work-life. The interplay between informal care-giving and working is complex. Different studies have explored this issue, but the results have not been yet synthesised. In this mixed-studies review, we elucidate the underlying complexity. Our objective is to identify the factors related to care-giving that influence employment, and to describe their impact on dementia care-givers’ employment. We performed a literature search of primary studies using four databases and one meta-database, and retrieved English- and German-language articles. We used the Mixed Methods Appraisal Tool to assess their methodological quality. Evidence identified was synthesised by a parallel-results convergent synthesis design. We included 55 qualitative, quantitative and mixed-method studies published up to January 2018. The emerging model identified factors linked to the care recipient with dementia, the informal care-giver and the care-giving context. The impacts of these factors on care-givers’ employment are mostly negative (e.g. stopped/reduced work, decreased job performance). Nevertheless, the results provide encouraging insights as working can counterbalance care-giving strain, and managing both roles can enhance care-givers’ wellbeing. Practical efforts should focus on enabling informal care-givers to better manage the balance between care-giving and work responsibilities.

The extent to which, and the reasons why, children help to care for their parents are examined in an extensive range of literature. Although care for parents essentially takes place in parent–child dyads, many of these studies acknowledge that the amount of care a child gives is generally the outcome of collective decisions in multiple-child families. However, to our knowledge, no research in Europe enhances our understanding of how sibling characteristics influence an individual child's care-giving. Using data for 14 European countries from the Survey of Health, Ageing and Retirement in Europe, the present study relates pre-care-giving sibling characteristics to children's subsequent start of giving care. This longitudinal approach allows correction for the endogenous nature of time-changing predictors. The analysis demonstrates that daughters start to care more often when they have brothers instead of sisters. This pattern of gendered intergenerational care particularly applies to southern European countries. We also observe that both pre-care-giving parent–sibling frequency of contact and geographic distances predict children's care-giving transition strongly. Children who are closer to their parents than siblings in terms of contact and proximity have higher odds of care-taking. Finally, being the only child without a job enhances the start of care-giving as well. The results suggest that sibling characteristics are an important factor in explaining intergenerational care differences between children in Europe.

In light of current pressures within formal social care services, informal carers assume an important role in meeting the care needs of a growing number of older people. Research suggests relationships between care-giving and health are complex and not yet fully understood. Recently, wide-ranging associations between sleep and health have been identified, however, our understanding of the links between care-giving and sleep is limited at present. This study assesses longitudinal patterns in co-resident care-giving and problematic sleep among older people in the United Kingdom. Our sample included 2,470 adults aged 65 years and older from the UK Household Longitudinal Study. Problematic sleep was defined as two or more problems in going to sleep, staying asleep or sleep quality. Using logistic regression models, we assessed how co-resident care-giving status, intensity and transitions influence the likelihood of problematic sleep in the following year, adjusting for potential confounding factors. Adjusted analyses found co-resident care-givers were 1.49 (95% confidence interval = 1.06–2.08) times more likely to report problematic sleep in the following year, relative to those not providing care. Care-giving over 20 hours per week and continuous co-resident care-giving also significantly increased the odds of problematic sleep. This suggests older co-resident care-givers may be at greater risk of incurring sleep problems than non-care-givers. Further longitudinal research is needed to investigate care-giver-specific consequences of poor sleep.

Across Europe a rising number of migrants are reaching higher ages. As old age is related to care dependency, care-giving within migrant families is becoming more important. To date, little research has focused on health outcomes for migrant care-givers. Theories and empirical evidence suggest differences in the relationship of care-giving and health between migrants and non-migrants due to differences in support, income, norms and values. Furthermore, across Europe the degree of formal care supply and the obligation to provide informal care vary considerably and presumably lead to different health outcomes of care-giving in different countries. Based on data from the Survey of Health, Ageing and Retirement in Europe (Waves 1, 2, 4, 5 and 6) and the English Longitudinal Study of Ageing (Waves 2–6), this paper studies the relationship between informal care-giving inside the household and health for migrant and non-migrant care-givers across Europe and analyses changes in health. In most countries migrant care-givers are in worse self-perceived and mental health compared to non-migrant care-givers. When controlling for important influences no differences in the relationship between health and care-giving for migrants and non-migrants can be found. Moreover, care-giving deteriorates mental health irrespective of origin. The country models showed that for non-migrants care-giving is most detrimental in Southern welfare states whereas for migrants care-giving is also burdening in Nordic welfare states.

Given an ageing population and increased participation by women in the labour force, the relationship between unpaid care and the availability of women to the labour force is gaining in importance as an issue. This article assesses the impact of unpaid care on transitions into employment by women aged between 45 and 59 years. It uses the German Socio-Economic Panel (SOEP) from the years 2001–2014 to estimate Cox regression models for 6,201 employed women. The results indicate that women with higher caring responsibilities and women with lower caring responsibilities are heterogeneous in terms of the socio-economic characteristics that they exhibit: higher-intensity care providers tend to have a lower level of educational attainment and a weaker attachment to the labour force than women with less-intensive caring responsibilities. Furthermore, while women with more-intensive caring roles are highly likely to exit the labour market altogether, female carers with less-intensive roles seem to be able to combine work and care better. These results highlight the importance of providing more affordable institutional and professional care services, especially for low- and medium-income families.

As the population ages, older adults are increasingly expected to play multiple productive roles. This study examined how hours of paid or unpaid work were associated with volunteering among older Japanese. Data came from the 2012 National Survey of the Japanese Elderly, a nationwide survey of Japanese aged 60 and older (N = 1,324). We performed multinominal logistic regression analyses to predict volunteering (regular or occasional versus non-volunteer) based on hours of paid work and unpaid work for family consisting of sick/disabled care, grandchild care and household chores. Those who worked moderate hours were most likely to be a regular volunteer while working 150 hours or more per month had a lower probability of volunteering, regardless of whether the work was paid or unpaid. Thus, full-time level work competed with volunteering for both paid and unpaid work for family, but it was more so for paid work. By types of activities, doing household chores and substantial grandchild care were positively associated with volunteering, and the latter complementary relationship was explained by a larger community network among grandparents. Our findings indicate that delaying retirement from full-time paid work may reduce the supply of regular volunteers in the community. Thus, policies to increase part-time work for older adults as well as the types of volunteer work in which paid workers can participate are necessary.

The aim of this study is to explore how community-dwelling older people with cognitive problems and their care-givers (dyads) perceive their own social participation, how care-givers evaluate the social participation of the people they care for and what factors they perceive as influential. In this qualitative study, we performed 13 semi-structured, in-depth interviews with dyads who participated in the Social Fitness Programme. We used content analysis to analyse the interviews thematically. Social participation perceptions include changes over time and a discrepancy in perspectives. All the people with cognitive problems and most care-givers perceived a decreased social participation. Most people with cognitive problems answered that they were satisfied, in contrast to most care-givers who were dissatisfied with the decreased social participation of the people they cared for. Analysing the influencing factors resulted in five themes: behavioural, physical, social environmental, physical environmental and activity-related. People with cognitive problems and their care-givers displayed a discrepancy in social participation perspectives. This becomes a major dilemma, especially for younger care-givers. A key element is a sometimes deliberate choice of people with cognitive problems to refrain from social participation to protect themselves from the consequences of cognitive problems and from encounters with others. This highlights the dynamics of social participation as an interaction between personal factors and the social and physical environment in which social participation occurs.

This paper systematically reviews empirical research published between 2006 and 2016 on the relationship between informal care-giving to elders and labour force participation (LFP). It does so in the context of Organisation for Economic Co-operation and Development policy responses to population ageing. In this context, conclusions regarding the LFP and care-giving relationship should at least be applicable to the sub-population of working-aged individuals who are most likely to provide informal elder care. Currently, these are women in mid-life and the recipients of their care are mostly extra-residential parents. The review's key conclusion is that mid-life women care-givers of elderly parents are significantly likely to reduce their working hours and also to work fewer hours relative to their non-care-giving counterparts. In drawing this conclusion, the review shows that studies finding only modest care-giving effects on LFP either do not adequately control for care-giving intensity or their conclusions apply to sub-populations less likely to be affected by policies addressing population ageing.

Using data from the Cebu Longitudinal Health and Nutrition Survey (1994, 1998, 2002, 2005, 2007, 2012), we utilise latent class analysis to develop time-use class membership to characterise the degree to which women in Cebu are subject to the double burden of work and family responsibilities in mid- and later life. Results suggest that close to a third of the sample are engaged in high-intensity work for pay (either outside or home-based), while combining it with a substantial amount of household chores and with a low level of personal time in a span of 18 years. Our latent transition analysis also shows that, with the addition of grandchildren into the household, some women experience a shift in time-use class membership by becoming high-intensity care-givers or by completely transitioning out of the work arena, while others remain double-burdened with active involvement in both work and family responsibilities.