Caring for the Oldest Old: How Family Caregiving Reshapes Daily Life, Health and Work

As populations age, increasing numbers of adults aged 80 years and older depend on family members for practical, emotional and personal support. Although caregiver “burden” is well recognised, this concept does not fully describe how caregiving reorganises everyday life, competes with employment and leisure, and affects caregivers’ ability to look after themselves. Blin and colleagues explored these issues in a study published in May 2026 using two complementary perspectives: the Stress Process Model, which describes how caregiving generates direct and indirect stressors, and Occupational Balance, meaning the perceived balance and satisfaction across everyday activities such as work, self-care, family responsibilities and leisure. The study focused specifically on family caregivers of adults aged ≥80 years and examined whether experiences differed between working and retired caregivers. How the study was conducted This exploratory qualitative study was carried out in the Provence-Alpes-Côte d’Azur region of France between December 2020 and June 2022 as part of the SCOPE project. The SCOPE project is a research program designed to identify the needs of FCGs of older adults and to develop tailored support strategies. Family caregivers were eligible if they provided regular unpaid emotional, organisational, domestic, financial or personal support to an adult aged at least 80 years. Seventeen semi-structured interviews were included in the final analysis. Interviews explored caregiving responsibilities, effects on physical, psychological, social and professional life, and caregivers’ perceived support needs. Who were the caregivers? Caregivers had a mean age of 63 years (range 40–87), and 13 of 17 were women. Eleven were adult children and four were spouses. Ten participants were retired, six were employed and one was unemployed. The people receiving care had a mean age of 86.7 years (range 80–99). Caregiving as a largely invisible role A striking finding was that many participants did not identify themselves as “caregivers”. Twelve of 17 described what they did mainly as ordinary family responsibilities, including shopping, housework and administrative support. Retired participants often framed caregiving as part of normal family life, whereas working caregivers were more likely to describe it as a second job. This lack of caregiver identity may have practical consequences: people who do not see themselves as caregivers may be less likely to recognise their own support needs or seek formal assistance. Psychological strain and concern about the future Caregiving produced both positive and negative experiences. Some participants reported closer relationships with the person they supported, but many described substantial emotional and practical strain. Psychological exhaustion was reported by 14 of 17 caregivers, while 13 of 17 expressed strong concern about the future of the older person. Working caregivers also described changing schedules, taking leave, reducing employment or, in some cases, stopping work entirely. These findings illustrate the combination of “primary” stressors arising directly from caregiving and “secondary” stressors such as work–care conflict, financial pressure and social isolation. When caregiving crowds out everyday life Care responsibilities frequently dominated participants’ routines. Shopping, housework, meal preparation and administrative tasks often displaced self-care and leisure. This pattern reflects occupational imbalance: caregiving did not simply increase workload but changed the overall distribution of meaningful activities. The disruption appeared particularly marked among employed caregivers. They described greater time scarcity and more frequent abandonment of leisure and social activities. Retired caregivers more often described adapting their routines rather than giving activities up completely. Support needs differ across life stages Caregivers identified financial, organisational, informational and care-coordination needs. Nine of 17 specifically highlighted the need to adapt or secure the older adult’s living environment. Working caregivers tended to emphasise financial strain, respite and practical organisational support, whereas retired caregivers more often sought information, advice and help navigating services. Importantly, most participants said their own needs had never been formally assessed by a professional. Better communication between healthcare and social-care providers, psychological support, simplified administration and a clearly identified care coordinator were repeatedly viewed as potential improvements. What healthcare professionals can take from the study The findings suggest that supporting family caregivers requires more than screening for “burden.” Clinicians should consider how caregiving is affecting work, sleep, self-care, leisure, social participation and the caregiver’s ability to maintain meaningful activities. The authors propose systematic assessment of caregiver needs, support adapted to employment and life stage, and stronger coordination between health and social services. A designated care manager may be particularly valuable where caregivers are effectively carrying the responsibility for navigating fragmented systems themselves. Overall, caregiving for adults aged 80 and over should be understood not only as a source of stress, but as a major reorganisation of daily life. Recognising and supporting the caregiver may therefore be important both for caregiver well-being and for sustaining the autonomy and quality of life of the older person receiving care.