Health and health service use of Australian female live-in caregivers at multiple caregiver trajectory timepoints: a population-based dataset with time-matched controls.

OBJECTIVE: To compare health and health service use in female live-in caregivers along multiple timepoints with population-based controls over a 20-year period. METHODS: Data from 6000 women aged 50-77 caring for someone who was ill, disabled or frail, were collected over eight waves of Australian Longitudinal Study on Women's Health 1946-51 cohort (from 2001 to 2022). Physical functioning (PF), general mental health (MH), depressive symptoms, stress and general practitioner (GP) and medical specialist visits were compared between caregivers and time-matched controls, before, during and after caregiving. Fully adjusted mixed linear models or logistic regression, including sensitivity analyses by caregiving intensity, were conducted. RESULTS: In adjusted results, caregivers and controls had similar initial levels of PF, but caregivers had significantly poorer PF over time including during [2.39 (-3.68, -1.10)] and after stopping caregiving [-2.19 (-3.51, -0.87)]. Caregivers had poorer MH on all three measures [eg, -5.56 (-6.61, -4.51) on SF-36 MH] and more GP visits across the study than controls, with the poorest scores in the period before stopping caregiving. Accessing medical specialists did not differ between caregivers and controls until after stopping caregiving, when caregivers had higher odds [1.22 (1.06, 1.40)]. Associations were stronger in caregivers providing higher intensity care. CONCLUSIONS: Caregiver physical and MH was poorest and GP visits highest prior to stopping caregiving, while specialist visits increased after stopping caregiving. Interventions to assist caregivers manage their own health needs, particularly in the period before stopping caregiving, and assisting them maintain health service use throughout and following caregiving cessation should be tested.