Informal care: choice or constraint?
Hareth Al-Janabi, Fiona Carmichael, Jan Oyebode
PMID 28401583WHAT IT FOUND
Most carers who answered said caring was a free choice, but many also felt constrained by duty, money or lack of help.
Those reporting more choice had higher well-being. The study cannot show choice caused better well-being.
Key findings
01Carers were grouped as 32.6% free-choice, 48.7% constrained-choice and 18.7% unfree.
02Perceived choice was lower among carers who provided 50 or more hours per week, personal care, or main caring.
03Constrained choice relative to no free choice was associated with nearly half a point higher life satisfaction, 0.02 higher capability, 6.7 points better caring experience and lower odds of being unhappy (odds ratio 0.68).
STILL TO COME
How it was doneWhat they foundWhat it means for OTs
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What it does not show
The study is cross-sectional, so it cannot show that perceived choice causes higher well-being. Many carers did not answer the choice question, and those who did were less likely to be in intensive caring roles, so results may not apply to the most burdened carers. The sample was limited to one city in England. Key details such as relationship, duration of caring, co-residence and multiple caring roles were not available. Well-being and choice were self-reported, and no intervention was tested.
Declared interests
Funding: Hareth Al-Janabi was supported by an MRC early career fellowship. No other conflicts are reported in the supplied text.
The easy way to misread this
Do not conclude that increasing carers' choice will improve their well-being. This is a cross-sectional survey, so better well-being may have made choice feel more available, and no intervention was tested.