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Population aging is increasing exponentially, and the demand for long-term care is also growing rapidly; According to the World Health Organization (WHO), about two out of every three people who reach old age need long-term support for daily living. Long-term care systems around the world are struggling to cope with these growing demands; According to the UN Decade of Healthy Ageing progress report (2021-2023), only about 33% of reporting countries have sufficient resources to integrate long-term care into existing health and social care systems. Inadequate long-term care systems place an increasing burden on informal caregivers (most commonly family members and partners), who not only play a key role in maintaining the health and functioning of care recipients, but also serve as guides to complex health systems that ensure the timeliness and continuity of care services. Around 76 million informal carers provide care in Europe; In Organisation for Economic Co-operation and Development (OECD) countries, about 60% of older people are fully cared for by informal caregivers. With the increasing reliance on informal caregivers, there is an urgent need to establish appropriate support systems.

Caregivers are often older themselves and may have chronic, frailty or age-related disabilities. Compared with younger caregivers, the physical demands of care work can exacerbate these pre-existing medical conditions, leading to greater physical strain, anxiety, and poor self-assessment of health. A 2024 study  found that older adults with informal caregiving responsibilities experienced a sharp decline in physical health compared to non-caregivers of the same age. Older caregivers who provide care for patients requiring intensive care are particularly vulnerable to adverse effects. For example, the burden on older caregivers is increased in cases where caregivers with dementia exhibit apathy, irritability, or increased impairments in instrumental activities of daily living.

The gender imbalance among informal caregivers is significant: caregivers are often middle-aged and older women, especially in low – and middle-income countries. Women are also more likely to provide care for complex conditions such as dementia. Female caregivers reported higher levels of depressive symptoms and functional decline than male caregivers. In addition, the burden of care has a negative impact on health care behavior (including preventive services); A study conducted in 2020 among women ages 40 to 75 showed a negative association between hours of care work and mammogram acceptance.

Care work has associated negative consequences and support must be provided for older carers. A critical first step in building support is to invest more in long-term care systems, especially when resources are limited. While this is critical, broad changes in long-term care will not happen overnight. It is therefore important to provide immediate and direct support to older caregivers, such as through training to enhance their understanding of the symptoms of illness exhibited by their caregivers and to support them to better manage care-related burdens and worries. It is important to develop policies and interventions from a gender perspective to eliminate gender inequalities in informal long-term care. Policies must take into account potential gender impacts; For example, cash subsidies for informal caregivers may have unintended negative effects on women, discouraging their labor force participation and thus perpetuating traditional gender roles. The preferences and opinions of caregivers must also be taken into account; Caregivers often feel neglected, undervalued, and report being left out of the patient’s care plan. Carers are directly involved in the care process, so it is vital that their views are valued and incorporated into clinical decision-making. Finally, more research is needed to better understand the unique health challenges and needs of older caregivers and to inform interventions; A systematic review of studies on psychosocial interventions for caregivers shows that older caregivers remain underrepresented in such studies. Without sufficient data, it is impossible to provide reasonable and targeted support.

An ageing population will not only lead to a continuous increase in the number of older people requiring care, but also a corresponding increase in the number of older people undertaking care work. Now is the time to reduce this burden and focus on the often overlooked workforce of older caregivers. All older persons, whether care recipients or caregivers, deserve to live healthy lives