Explaining the gaps between types of caregivers

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How to explain the fact that regular caregivers who care for their child or spouse are the most at risk of psychological distress or health, financial and work consequences? To address this question, regression models can be used to take different factors, especially the level of intensity of the care provided (i.e., the number of hours per week) and the number of tasks performed for the care recipient into account. The following variables are also considered: the number of years of care provided to the recipient, the health problem for which the caregiver is providing care, whether the caregiver is considered the primary caregiver, the tasks carried out as well as other characteristics.

When all these factors were held constant, the gaps between types of caregivers were much smaller in all models (Table A.1). For example, in the case of psychological distress, disregarding other factors, the probability that caregivers of children would express a high level of psychological distress was 21 percentage points higher than for regular caregivers of a parent (and 16 percentage points higher for those caring for a spouse). However, when all other factors were taken into account, this gap narrowed to 6 percentage points (both for those caring for a spouse and for a child).

In other words, the fact that those caring for a spouse or child were more likely to have greater symptoms of psychological distress is largely due to certain risk factors specific to their role (greater number of hours, diversity of tasks, primary caregiver).

With regard to consequences on health and reduction of work hours, the gaps between types of caregivers were narrowed even more when all of the other factors were taken into account. However, even after accounting for these factors, family caregivers who cared for a child always spent more than all other types of caregivers.

Another finding is that, for caregivers, caring for a person with a mental health problem or Alzheimer’s particularly increased the risk of being highly distressed, as shown by other studies.Note 1 Women, caregivers caring for at least one other person, caregivers who were considered the primary caregiver, those caring for a person with cancer and those receiving care themselves were also more likely to experience an elevated level of psychological distress. However, family caregivers who looked after children in addition to looking after their parents or other adults (referred to as the "sandwich generation" in some studiesNote 2) were no more likely to experience a high level of psychological distress than others.

Finally, in all models, the number of hours of care and the number of types of care provided were both associated with a higher risk of incurring one of the four consequences evaluated. However, having provided care for a longer period was not an especially influential factor.

Table A.1
Regression models, predicted probabilities and marginal effects, 2012

Table summary
This table displays the results of regression models increased symptoms of psychological distress, effects of care on overall health, total annual caregiving-related expenses (tobit model) and reduced work hours , calculated using predicted probability and marginal effect units of measure (appearing as column headers).
  Increased symptoms of psychological distress Effects of care on overall health Total annual caregiving-related expenses (Tobit model) Reduced work hoursNote 1
predicted probability marginal effect predicted probability
Relationship between recipient and family caregiver (without controls)  
Grandparents 0.08Note * 0.05Note * -2,038Note * 0.13
Friends, neighbours or colleagues 0.16Note * 0.11Note * -2,327Note * 0.08Note *
Father-in-law, mother-in-law or other family member 0.23Note * 0.14Note * -540 0.13Note *
Father or mother 0.30 0.22 ref. 0.17
Spouse 0.46Note * 0.38Note * 2,182Note * 0.25Note *
Son or daughter 0.51Note * 0.38Note * 3,049Note * 0.25Note *
Relationship between recipient and family caregiver (with controls)  
Grandparents 0.15Note * 0.10Note * -1,185Note * 0.18
Friends, neighbours or colleagues 0.21Note * 0.14Note * -396 0.10Note *
Father-in-law, mother-in-law or other family member 0.26 0.16Note * -53 0.13
Father or mother 0.28 0.21 ref. 0.16
Partner 0.35Note * 0.26Note * 858 0.19
Son or daughter 0.34Note * 0.25 2,021Note * 0.21
Number of hours of care or help per week  
2 to 4 hours 0.20 0.13 ref. 0.11
5 to 9 hours 0.27Note * 0.19Note * 419 0.16Note *
10 to 29 hours 0.32Note * 0.24Note * 1,298Note * 0.20Note *
30 hours or more 0.34Note * 0.26Note * 1,980Note * 0.19Note *
Number of types of tasks performed  
3 or less 0.15 0.13 ref. 0.10
4 0.22Note * 0.16 838Note * 0.12
5 0.25Note * 0.18Note * 1,314Note * 0.16Note *
6 0.30Note * 0.22Note * 2,705Note * 0.17Note *
7 0.34Note * 0.23Note * 2,612Note * 0.20Note *
8 0.39Note * 0.25Note * 4,002Note * 0.15
9 0.47Note * 0.31Note * 6,643Note * 0.27Note *
Provided care to at least one other person  
No 0.25 0.18 ref. 0.14
Yes 0.30Note * 0.22Note * 1,017Note * 0.17Note *
Family caregiver is considered primary caregiver by main recipient  
No 0.23 0.16 ref. 0.15
Yes 0.31Note * 0.22Note * 627 0.16
Main health problem for which recipient received care  
Mental health, Alzheimer's or dementia, developmental problem or disability
No 0.25 0.19 ref. 0.15
Yes 0.37Note * 0.24Note * 782 0.18
No 0.26 0.19 ref. 0.14
Yes 0.35Note * 0.23Note * 278 0.24Note *
Sex of family caregiver  
Male 0.19 0.13 ref. 0.16
Female 0.33Note * 0.24Note * -1,080 0.15
Receives care or assistance in addition to providing it  
No 0.26 0.19 ref. 0.16
Yes 0.35Note * 0.27Note * 262 0.11



  1. See Tremont 2011; Pinquart and Sörensen 2003; Ory et al. 1999. Other studies have also shown that when mental health problems coexist with depression and physical health problems, the consequences for the caregiver can be even greater (see, for example, Teri 1994).
  2. See Williams 2004.
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