Relationship between informal caregiving and paid employment among later-career adults: a scoping review.
Creators: name: Corna, Laurie
name: Altomare, Daniele
Publisher: name: Zenodo
Year: 2025
Subjects: informal caregiving
paid employment
labor market

description: SCOPING REVIEW – PROTOCOL

 

TITLE

Relationship between informal caregiving and paid employment among later-career adults: a scoping review.

 

ABSTRACT

Background. The demand for informal caregiving, especially for older people, is expected to increase in the coming decades due to population ageing and long-term care policy orientations that prioritize community-based care. However, informal caregivers are often later-career adults actively engaged in the labor market, balancing their professional responsibilities with caregiving duties. This dual role can create significant conflicts, as the demands of caregiving frequently clash with employment priorities, increasing stress and workload for caregivers. The aim of this scoping review is to investigate the relationship between informal caregiving and paid employment among later-career adults.

Methods. This scoping review will be conducted in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses for Scoping Reviews (PRISMA-ScR) methodology and guidelines. Both peer-reviewed studies and gray literature will be included to provide a comprehensive overview. The search strategy will be applied across multiple databases, supplemented by hand-searching and consultation with experts. A two-step screening process will be used to assess eligibility, followed by data extraction and synthesis. Findings will be synthesized in narrative and tabular formats.

Presentation of results and dissemination. The results will be submitted for publication in relevant scientific journals and disseminated through academic conferences and stakeholder networks to inform policy and practice.

 

Start date: October 2024.

Anticipated completion date: March 2025.

 

Team members and roles

· Prof. Dr. Laurie Corna (Project leader – Principal Investigator): screening and data extraction, data interpretation, scoping review manuscript writing.

· Dr. Daniele Altomare (Project member – Researcher): screening and data extraction, data interpretation, scoping review manuscript writing.

 

 

1. BACKGROUND

The provision of informal, unpaid care to family members who are ill, infirm, or disabled, is a central pillar of long-term care systems. Estimates suggest that the contributions of informal caregivers, if monetized, would be equivalent to between 40% and 90% of the overall cost of long-term care provision in Europe.1 The demand for informal caregiving, especially for older people, is expected to increase in the coming decades due to population ageing and long-term care policy orientations that prioritize community-based care.2,3 The growing demand for informal care is expected to outpace the supply of informal carers, leading to what some have termed a care crisis,4 with relevant consequences for healthcare systems and society.

This picture is further complicated by the evolving profile of informal caregivers. Today, a significant proportion of informal caregivers are later-careers adults (50-65 years) caring for an ageing parent or parent-in-law. Women, in particular, disproportionately bear the burden of intensive caregiving responsibilities.5,6 At the same time, these adults—particularly women—are now more educated and maintain stronger ties to the labor market than ever before. Maintaining high levels of labor market participation in the years approaching retirement is increasingly encouraged due to growing concerns about labor shortages and pension sustainability. However, the demands of informal caregiving often conflict with the labor market priorities, placing additional strain on caregivers and prompting decisions about the roles they occupy. This added burden can lead to consequences such as reduced work hours, career interruptions, or even premature labor market exits, particularly for women who disproportionately shoulder caregiving responsibilities.

Addressing these conflicts is crucial to supporting caregivers’ needs and preferences with respect to participation in paid employment and providing informal care. However, several important gaps remain in our understanding of the relationship between informal caregiving and employment. First, only limited evidence exists regarding the association between informal caregiving and employment among later-career adults,6–9 and even less has accounted for unobserved heterogeneity to address known selection effects. Second, while decisions regarding caregiving and employment are made in reference to current circumstances (e.g., current employment, earnings potential, etc.),10 as well as (gendered) longer-term experiences with respect to caregiving and employment,11–13 contemporaneous factors are often prioritized in analyses, potentially over-estimating their influence. Thirdly, in the last decade, research has shown how the provision of informal care is influenced by socioeconomic position, with those possessing fewer economic resources more likely to provide care, potentially further disadvantaging them down the line.14–17 However, assessment of how socioeconomic position, as well as its interaction with life-course factors, shape whether and how individuals combine informal caregiving with paid work is in its infancy.

Research on these issues is particularly timely given the rapid ageing of the population, a growing emphasis on community-oriented long-term care, women’s changing educational profile and increasing presence in the labor market. This knowledge could provide insight and strategies to better support informal caregivers. The aim of this scoping review is to investigate the relationship between informal caregiving and paid employment among later-career adults.

 

 

2. METHODS

This scoping review will be conducted in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses for Scoping Reviews (PRISMA-ScR)20 methodology and guidelines, ensuring a systematic and transparent approach.

 

2.1. Research question

How do variables such as gender, socioeconomic position, life-course experiences in the labor market, and cultural and practical factors shape the relationship between informal care and paid employment among later-career adults (50-65 years)?

 

2.2. Inclusion and exclusion criteria for studies

This scoping review will focus on peer-reviewed and grey literature.

Inclusion criteria. All studies addressing both the population (i.e., later-career adults involved in the labor market) and outcomes (i.e., relationship between informal caregiving and paid employment) of interest will be included in this scoping review, regardless of the geographical origin.

Exclusion criteria. Studies specifically focusing only on childcare and caring for adult children with disabilities will be excluded.

 

2.3. Search strategy

A comprehensive literature search across the following databases will be conducted.

· PubMed

· SocINDEX with Full Text (via EBSCO)

· PsycInfo

· Web Of Science

· SSOAR

· Elsevier Science Direct

· IBSS International Bibliography of the Social Sciences (ProQuest)

· Sociological Abstracts (ProQuest)

Moreover, additional grey (e.g., published reports) literature will be searched through the expertise and links of team members and collaborators.

 

2.4. Selection process

First, duplicate publications will be removed. Next, all remaining publications will undergo a two-step screening process. In the first step, titles and abstracts will be reviewed to identify potentially relevant studies and exclude those that are not relevant. In the second step, full-text will be reviewed confirm eligibility and relevance for inclusion.

The RAYYAN software will be used to manage the entire article selection process, from duplicates removal to screening.

 

2.5. Data extraction strategy

All articles will be stored in RAYYAN where two reviewers (Prof. Dr. Laurie Corna and Dr. Daniele Altomare) will access and work on full-text review. Relevant data will be extracted and systematically organized into comprehensive narrative and tabular summaries, which will be documented in an Excel sheet, highlighting key themes and gaps in the literature. The narrative summaries will provide detailed descriptions of key findings, while the tabular format will facilitate comparison across studies by highlighting variables such as study design, population characteristics, and outcomes.

 

2.6. Risk of bias assessment/approach to critical appraisal

Due to the broad focus of this scoping review, no pre-defined strategies are implemented.

 

2.7. Ethics approval

Ethics approval for this scoping review is not applicable.

 

2.8. Funding

This work is funded by the Swiss National Science Foundation (project title: “Understanding the intersection of informal caregiving for older people and paid employment among later-career adults in Switzerland: a gendered, life course perspective”; project number: 10HW-9_220515; Principal Investigator: Prof. Dr. Laurie Corna).

 

 

3. PRESENTATION OF RESULTS AND DISSEMINATION

The results that ensue from this scoping review might be presented using text, diagrams and tables to communicate the main findings. This might include a diagram detailing the inclusionary/exclusionary mapping of articles, and various charts and tables that categorize and compare article findings.

The results will be submitted for publication in relevant scientific journals and disseminated through academic conferences and stakeholder networks to inform policy and practice.

 

 

4. REFERENCES

1. Triantafillou, J. et al. Informal Care in the Long-Term Care System - A European Overview. https://interlinks.euro.centre.org/sites/default/files/WP5%20Informal%20care_ExecutiveSummary_FINAL_1.pdf (2011).

2. Pellegrini, S., Dutoit, L., Pahud, O. & Dorn, M. Bedarf an Alters- Und Langzeitpflege in Der Schweiz. https://www.obsan.admin.ch/sites/default/files/2022-05/Obsan_03_2022_BERICHT.pdf (2022).

3. Eling, M. & Elvedi, M. Die Zukunft Der Langzeitpflege in Der Schweiz. https://www.ivw.unisg.ch/wp-content/uploads/2023/08/Band66-Langfassung.pdf (2019).

4. Fast, J., Keating, N., Eales, J., Kim, C. & Lee, Y. Trajectories of family care over the lifecourse: evidence from Canada. Ageing Soc 41, 1145–1162 (2021).

5. Otto, U., Leu, A., Bischofberger, I., Gerlich, R. & Riguzzi, M. Sondaggio Presso La Popolazione Sui Bisogni Di Sostegno e Di Sgravio Dei Familiari Assistenti. https://www.aramis.admin.ch/Default?DocumentID=65946&Load=true (2019).

6. Perrig-Chiello, P., Höpflinger, F. & Hutchison, S. AgeCare-Suisse Latine. I Congiunti Curanti Delle Persone Anziane Nella Svizzera Latina (Incluso Un Confronto Con La Svizzera Germanofona). https://www2.supsi.ch/cms/ispat/s064/ (2011).

7. Ciccarelli, N. & Van Soest, A. Informal Caregiving, Employment Status and Work Hours of the 50+ Population in Europe. Economist (Leiden) 166, 363–396 (2018).

8. Keita Fakeye, M. B., Samuel, L. J., Drabo, E. F., Bandeen-Roche, K. & Wolff, J. L. Caregiving-Related Work Productivity Loss Among Employed Family and Other Unpaid Caregivers of Older Adults. Value Health 26, 712–720 (2023).

9. Lilly, M. B., Laporte, A. & Coyte, P. C. Labor market work and home care’s unpaid caregivers: a systematic review of labor force participation rates, predictors of labor market withdrawal, and hours of work. Milbank Q 85, 641–690 (2007).

10. Moussa, M. M. The relationship between elder care-giving and labour force participation in the context of policies addressing population ageing: a review of empirical studies published between 2006 and 2016. Ageing Soc 39, 1281–1310 (2019).

11. Carmichael, F. & Ercolani, M. G. Unpaid caregiving and paid work over life-courses: Different pathways, diverging outcomes. Soc Sci Med 156, 1–11 (2016).

12. Nguyen, H. T. & Connelly, L. B. The Dynamics of Informal Care Provision in an Australian Household Panel Survey: Previous Work Characteristics and Future Care Provision. Economic Record 93, 395–419 (2017).

13. McMunn, A., Lacey, R. & Webb, E. Life course partnership and employment trajectories and parental caregiving at age 55: prospective findings from a British Birth Cohort Study.   Longitudinal and Life Course Studies      (2020)    (In press).  11, 495–518 (2020).

14. Floridi, G., Carrino, L. & Glaser, K. Socioeconomic Inequalities in Home-Care Use Across Regional Long-term Care Systems in Europe. J Gerontol B Psychol Sci Soc Sci 76, 121–132 (2021).

15. Quashie, N. T., Wagner, M., Verbakel, E. & Deindl, C. Socioeconomic differences in informal caregiving in Europe. Eur J Ageing 19, 621–632 (2021).

16. Brandt, M., Kaschowitz, J. & Quashie, N. T. Socioeconomic inequalities in the wellbeing of informal caregivers across Europe. Aging Ment Health 26, 1589–1596 (2022).

17. Heger, D. & Korfhage, T. Short- and Medium-Term Effects of Informal Eldercare on Labor Market Outcomes. Fem Econ 26, 205–227 (2020).

18. da Roit, B. & Naldini, M. Should I Stay or Should I Go? Combining Work and Care for an Older Parent in Italy. South Eur Soc Polit 15, 531–551 (2010).

19. Greenwood, N., Mackenzie, A., Wilson, N. & Cloud, G. Managing uncertainty in life after stroke: a qualitative study of the experiences of established and new informal carers in the first 3 months after discharge. Int J Nurs Stud 46, 1122–1133 (2009).

20. Tricco, A. C. et al. PRISMA extension for scoping reviews (PRISMA-ScR): Checklist and explanation. Ann Intern Med 169, 467–473 (2018).