Family and friends are the most important source of care for people with LTC needs in OECD countries. Because of the informal nature of the care they provide, it is not easy to get comparable data on the number of people caring for family and friends across countries, nor on the frequency of their caregiving. The data presented in this section come from national or international health surveys and refer to people aged 50 years and over who report providing care and assistance to family members and friends.
On average across OECD countries for which data are available, around 13% of people aged 50 and over reported providing informal care at least weekly in 2019. The share of people aged 50 and over providing informal care was close to or over 20% in Belgium, Austria, the Czech Republic, the United Kingdom and Germany, and less than 10% in Portugal, Greece, Lithuania, the United States, Ireland, the Slovak Republic and Latvia (Figure 10.16). There was also variation in the intensity of the care provided. The lowest rates of daily care provision were found in the Slovak Republic and Latvia.
Intensive caregiving is associated with a reduction in labour force attachment for caregivers of working age, higher poverty rates and a higher prevalence of mental health problems. Many OECD countries have implemented policies to support family carers with a view to mitigating these negative impacts. Two-thirds of OECD countries provide care leave, whether paid or unpaid, while respite care remains fragmented in many countries. Moreover, two‑thirds of OECD countries provide cash benefits to family caregivers; cash-for-care allowances for recipients, which can be used to pay informal caregivers; or periods of paid leave for informal carers. Some countries (such as Australia, Germany and Luxembourg) also provide counselling/training services, but many rely heavily on the voluntary sector (OECD, forthcoming[9]).
On average across OECD countries, 62% of those providing daily informal care were women in 2019 (Figure 10.17). Spain, Greece and Portugal had the greatest gender imbalance: over 70% of informal carers were women. Around two‑thirds of carers are looking after a parent or a spouse, but patterns of caring vary for different age groups. The survey found that younger carers (aged between 50 and 65) were much more likely to be caring for a parent (Figure 10.18). They were more likely to be women and might not be providing care every day. Carers aged over 65 were more likely to be caring for a spouse. Caring for a spouse tends to be more intensive, requiring daily care, and men and women are equally likely to take on this role.
The fact that fewer people provide daily care in countries with stronger formal LTC systems suggests that there is a trade‑off between informal and formal care. Declining family size, increased geographical mobility and rising participation rates of women in the labour market mean that there is a risk that fewer people will be willing and able to provide informal care in the future. Coupled with the effects of an ageing population, this could lead to higher demand for professional LTC services. Public LTC systems will need adequate resources to meet increased demand while maintaining access and quality.
