Economic situation of informal caregivers for older adults in the context of changing long-term care policies: a mixed methods study.

BACKGROUND: Long-term care policies across Europe increasingly rely on informal care amid population ageing and constraints in public expenses. Cash-for-care schemes have been introduced to support informal care and alleviate socio-economic differences between caregivers. This mixed methods study investigates the subjective economic experiences of informal caregivers for older adults in Finland, where the policy initiative has gradually shifted the emphasis of care services from public provision to informal care with the support of Informal Care Allowance (ICA).

METHODS: Drawing from a nationwide survey targeting informal caregivers, we focused on respondents who provided care for older adults aged 65 and over and answered the question on their economic situation (N = 1057). The study employed logistic regression analysis and qualitative content analysis to examine factors associated with economic hardship and caregivers' lived experiences.

RESULTS: Quantitative findings revealed that younger caregivers, those with poor health, those caring for someone other than their spouse, caregivers providing various types of care, those lacking public sector support, those receiving adequate support from the church social work or having unmet church social work-related needs, non-recipients of informal care allowance, and individuals forced to leave employment faced significantly weakened economic situations. Qualitative analysis identified six themes on the economic impact of caregiving: dissatisfaction with the informal care allowance, utility of the informal care allowance, increase in care costs, adverse economic consequences, managing costs associated with care, and caregiving at the sacrifice of working life.

CONCLUSIONS: Informal caregivers in Finland, especially those with low incomes or reduced work due to caregiving, are facing significant financial strain. This may reflect broader shifts in long-term care policy and a decreased public responsibility. While the informal care allowance can help improve caregivers' situations, it remains insufficient, particularly for working-age individuals whose earnings and career opportunities are affected. This could worsen social inequalities in both the short and long term. The divergent interpretations of the purpose of the ICA system underscore the scheme's inadequacy in meeting the diverse needs of caregivers. Future policies should better account for varying circumstances, providing stronger financial support and enabling caregivers to balance employment with care responsibilities.