Children of non-self-sufficient parents let down by public welfare system

Taking care of a non-self-sufficient parent can involve an emotional and physical effort that weighs on adult children even after their parent’s death. Research conducted by economists at Ca’ Foscari University of Venice and at Université Paris Dauphine, which resulted in the publication of the article “End-of-life care and depression” in Applied Economics Letters, indicates that the efforts that caregivers invest in assisting a parent may be related to an increased likelihood of experiencing depressive symptoms.  

Women are often the main caregivers and are therefore more likely to be affected. Depressive symptoms tend to arise during the last months of the parent’s life and reach their peak immediately after his or her death. Depression is caused not only by the inevitable grief and sadness following the loss of a loved one, but also by the effort and stress that affect caregivers, in particular in countries where the welfare system is underdeveloped and underfinanced. 

“Data confirms that adult children, and women in particular, must devote themselves completely and with great emotional and physical effort to their parent or parents when the public welfare system does not guarantee adequate care and assistance to non-self-sufficient elderly people,” says Giacomo Pasini, professor of Econometrics at Ca’ Foscari University of Venice and co-author of the study with Agar Brugiavini, Elena Bassoli, and Eric Bosang.

The research group analysed data from the Survey of Health, Ageing and Retirement in Europe (Share), a research infrastructure for studying the effects of health, social, economic and environmental policies over the life-course of European citizens aged 50 or older.

By comparing the relationship between the death of non-self-sufficient mothers and the depression of their children in various countries, the researchers demonstrated that the situation is worse where there is a lack of investment in public welfare. In countries in which services such as home-based assistance, rest homes, and hospices are scarce, family members have to shoulder a greater burden and the responsibility of making choices for the elderly person involved.

Taking care of a non-self-sufficient elderly person at home is unsustainable both economically and in terms of health for his or her caregiver — typically, a woman.

“Our research shows that this is not a cultural issue, but one related to public spending in healthcare,” says Professor Pasini. “The data shows this. There is a correlation between the discomfort that adult children experience while taking care of their elderly parents and the percentage of GDP allocated to the assistance of the elderly.”

Some of the most virtuous countries in elderly healthcare include the Netherlands, Sweden, Denmark, Switzerland, and Belgium — which allocate over 2% of their GDP to dedicated services and public healthcare facilities (2014 data). Germany, France and Austria invest between 1.5 and 1.8% of their GDP. Italy invests just under 1% of its GDP, along with the Czech Republic, Slovenia, and Spain.