Cost of long-term care and balancing caregiver wellbeing: a narrative review

ABSTRACT

Introduction

Long-term care (LTC) refers to care and support services that are required by individuals who lack the ability to perform important daily routines and may be dependent on others for personal, social and medical needs over a sustained period of time. LTC may be broadly categorized into formal and informal care, where formal care is provided by professionals who are compensated to provide these services and informal care captures the care services provided without compensation by family members, friends, or other unpaid individuals.

Areas Covered

In this narrative review, we identify and synthesize evidence to evaluate the cost of long-term care while balancing the needs of caregivers. We searched Embase and EconLit for studies published from 2010 to November 2023. Our search strategy used a combination of keywords such as ‘long-term care,’ ‘caregiver burden,’ ‘caregiver support,’ ‘cost of care,’ and ‘caregiver wellbeing.’ We include both formal and informal LTC, as well as predictors of caregiver wellbeing.

Expert Commentary

The review highlights the global variability in LTC costs and the significant burden on caregivers, emphasizing the need for policy interventions and comprehensive insurance schemes. Future research should focus on standardized assessment tools, intervention effectiveness, and integrating caregiver support into healthcare models, ensuring holistic and sustainable LTC solutions.

KEYWORDS:

• Caregiving
• long-term care
• costs
• caregiver wellbeing

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Declaration of Interests:

TJ Mattingly reports unrelated research support from the National Institute of Minority Health and Health Disparities (NIMHD), the Food and Drug Administration (FDA), the Alzheimer’s Association and unrelated consulting fees from the Pharmaceutical Research and Manufacturers of America (PhRMA), Pharmaceutical Care Managed Association (PCMA), and Arnold Ventures in the previous 24 months. The authors have no other relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript apart from those disclosed.

Reviewer disclosures:

Peer reviewers on this manuscript have no relevant financial or other relationships to disclose.

Article highlights

• This paper looks at the costs of long-term care (LTC), which helps people who need support over a long time, and how this care affects the family members or friends who provide it. Costs can be very different depending on where you live, because of how health systems and insurance work.

• Caregiving, often unpaid, imposes significant physical, mental, financial, and social burdens on caregivers, and worsened by the need to balance caregiving with full-time employment.

• Formal LTC includes paid services in facilities or at home, while informal LTC primarily involves unpaid family caregiving. Informal care often leads to high opportunity costs and financial strain. Our review gives updated information on these costs and suggests ways to help caregivers.

• The review emphasizes the need for policy interventions, comprehensive insurance schemes, and standardized assessment tools to support caregivers and ensure sustainable LTC solutions.

Supplementary material

Supplemental data for this article can be accessed online at https://doi.org/10.1080/14737167.2024.2383406.

Additional information

Funding

This paper was not funded.