Aims. This study investigates caregiver distress among informal carers of community-living older adults (≥65 years) with complex needs in New Zealand. It describes distress trends over time, assesses the impact of the COVID-19 pandemic, and examines associations between distress and sociodemographic or health factors.
Methods. Analysis of 231,277 assessments from 144,358 participants was conducted using repeated interRAI-HC data (2012–2020). Caregiver distress was defined as answering yes to one or more of three specific questions within the assessment. Patterns over time were modelled with fractional polynomial regression. Multivariable multilevel mixed-effects Poisson regression analysed factors influencing distress. COVID-19 impact was assessed as a step change from the date of the NZ lockdown (March 21, 2020).
Results. Caregiver distress prevalence increased from 35.1% in 2012 to a peak of 48.5% at the onset of lockdown, and rising to 46.9% by December 2020. The COVID-19 period was associated with a small but statistically significant increase in caregiver distress (Population Attributable Fraction: 0.56%). Factors associated with increased distress included caregiver relationship and in particular spousal caregiving, higher dependency levels, and female gender. Māori and Pacific caregivers reported lower distress, which was likely influenced by cultural support systems.
Conclusion. Caregiver distress has risen significantly in recent years, and this study has highlighted a limited but measurable impact from the pandemic. Persistent high levels of distress highlight the importance of targeted support policies, addressing dependency-related burdens, gender disparities, and cultural considerations. Comprehensive strategies are essential to sustain informal caregiving as a cornerstone of aging-in-place policies.