Caregivers and Loneliness in the English Longitudinal Study of Ageing

Abstract

Informal caregivers represent around 26% (13.6 million) of the UK population. Alongside the known health and wellbeing consequences of caregiving, caregivers have been identified as being at higher risk of loneliness. However, current research among caregivers is inadequate. Mostly, specific subgroups of caregivers are analysed in isolation (e.g. dementia caregivers or spousal caregivers), and therefore the diverse caregiving population is under-represented in the literature. Specifically, there is a lack of evidence on the determinants of loneliness among caregivers. What limited research that has been conducted, suggests that the typical determinants applicable to the general population are not consistent amongst caregivers. Therefore, because caregiving-specific risk factors are not clearly understood, support services and policy-makers cannot work to effectively prevent loneliness. Furthermore, individually, both caregiving and loneliness are associated with adverse health and wellbeing outcomes, but there is an absence of research investigating the impact on health and wellbeing for caregivers who are lonely. It is hypothesised that the combined impact of loneliness and caregiving could have worse health and wellbeing outcomes than either characteristic alone.
Using quantitative secondary data analysis of the English Longitudinal Study of Ageing, this thesis explored, both cross-sectionally and longitudinally, the effects of caregiving on loneliness. This thesis addressed the aforementioned research gaps by comparing a wide range of caregivers, including those providing care at different intensities, and to a variety of care recipients. Additionally, caregiving-specific determinants of loneliness were investigated, as well as examining how the health and wellbeing impacts of loneliness differed between caregivers and non-caregivers. The results indicated that caregiving was associated with loneliness, but depended on the loneliness measure used. As such caregivers were more likely to be lonely using the UCLA loneliness scale, but not a direct question. Additionally, the determinants differed for caregivers and non-caregivers: health appeared to play a larger role in non-caregivers’ loneliness, whereas within caregivers, care provision to adult-children was a determinant of loneliness. Finally, as predicted, the combined impact of caregiving and loneliness was associated with worse health and wellbeing outcomes across a number of measures.
Overall, there was limited evidence of a long-term effect of caregiving on loneliness, which implies that the impact of caregiving is acute rather than chronic, highlighting a need for early intervention. Finally, the evidence suggests that caregiving may have more substantial effects on mental health and wellbeing than for physical health, which provides direction for policy development.

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ORCID for Rosalind Willis: orcid.org/0000-0001-6687-5799

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