Enabling Ageing in Place: The Potential for Expanded Family Care

Enabling Ageing in Place: The Potential for Expanded Family Care | Research Square window.SnipcartSettings = { analytics: { enabled: false } }; (function() { var accessVector = localStorage.getItem('access_vector') || ''; window.dataLayer = window.dataLayer || []; if (accessVector) { window.dataLayer.push({ user: { profile: { profileInfo: { snid: accessVector } } } }); } })(); (function(w,d,s,l,i){w[l]=w[l]||[];w[l].push({'gtm.start':new Date().getTime(),event:'gtm.js'});var f=d.getElementsByTagName(s)[0],j=d.createElement(s),dl=l!='dataLayer'?'&l='+l:'';j.async=true;j.src='https://www.googletagmanager.com/gtm.js?id='+i+dl;f.parentNode.insertBefore(j,f);})(window,document,'script','dataLayer','GTM-K279D39R'); Browse Preprints In Review Journals COVID-19 Preprints AJE Video Bytes Research Tools Research Promotion AJE Professional Editing AJE Rubriq About Preprint Platform In Review Editorial Policies Our Team Advisory Board Help Center Sign In Submit a Preprint Cite Share Download PDF Research Article Enabling Ageing in Place: The Potential for Expanded Family Care Heidi Gautun, Christopher Bratt This is a preprint; it has not been peer reviewed by a journal. https://doi.org/ 10.21203/rs.3.rs-6882140/v1 This work is licensed under a CC BY 4.0 License Status: Posted Version 1 posted You are reading this latest preprint version Abstract As ageing in place becomes a central component of eldercare strategies, family members of older adults face mounting pressure to provide more care for older people. By analysing data from Norway, this paper explores the potential for expanding family care for older relatives living in their own homes. We address the following questions: (1) To what extent do adult children provide help and care for their ageing parents? (2) Is there potential for expanding family care? (3) Do caregivers need municipal support aimed at supporting family caregivers? In March 2025, we surveyed a nationwide sample of 3,673 respondents aged 45 to 67, each with at least one parent residing in their own home. We analyse the data using descriptive statistics, Confirmatory Factor Analysis and Structural Equation Modelling. Respondents provided various types of practical and administrative help. Seven in ten respondents indicated a willingness to extend care if public care services inadequately meet parents' needs as frailty increases. An equal proportion indicated that other family members would increase care. Four in ten were willing to make one or more significant life adjustments to offer extra care: taking short unpaid leave, reducing working hours, moving in with their parents, opting for early retirement, and/or taking extended unpaid leave, such as for a year. Respondents expressed a need for enhanced municipal support tailored to caregivers. We conclude that implementing low-resource initiatives for family caregivers could be a cost-effective strategy, enabling increased family caregiving while reducing reliance on costly eldercare services and institutional care. Sociology ageing in place family caregivers adult-child caregivers caregiver support services informal care capacity Figures Figure 1 Figure 2 Figure 3 Introduction The European populations are rapidly ageing (Organisation for Economic Co-operation and Development 2023) and strain countries’ health and care services (European Commission 2024). To reduce the demand for costly health and care services and improve older people’s quality of life, authorities in many countries champion “ageing in place” policies, namely a policy aiming to enable older people to live safely in their own homes as long as possible (World Health Organization 2015 ; Pani-Harreman et al. 2022 ; Norwegian Ministry of Health and Care Services 2023 ). Across many European countries, older people are expected to remain in their current home residence even when they are facing an increased need for support due to life changes (Greenfield 2012 ; Norwegian Ministry of Health and Care Services 2023 ; Blix and Ågotnes 2023 ). In Norway, the accelerating growth in the number and proportion of older people over eighty from 2026 led the Parliament to adopt the reform “A full life - all your life” in 2018 (Norwegian Ministry of Health and Care Services 2018 ) and the reform “Stay safe at home” in 2023, aimed at facilitating safe ageing at home (Norwegian Ministry of Health and Care Services 2023 ). Historical Context of Home-Based Care The ambition that people in need of long-term care should receive services outside of institutions is not new (Wilkinson-Meyers et al. 2014 ; Gautun and Grødem 2015 ). In Norway, numerous reforms have been implemented since the early 1990s, transferring responsibility for various groups requiring long-term care from institutions to municipal home care services (Gautun and Grødem 2015 ). Significant expansion of home care services has occurred for younger individuals (below the age of 67) in need of long-term care (Gautun and Grødem 2015 ; Hoen et al. 2023 ; Hagen et al. 2024 ). However, public home care services for older people have not expanded sufficiently to meet the needs once addressed by public eldercare institutions (Hermansen and Gautun 2013 ). Ageing in place is a broad term used by both researchers and policymakers. The term is defined in various ways. A scoping review identifies five key themes within the concept (Pani-Harreman et al. 2021 ). To understand ageing in place, Pani-Harreman et al. highlight a need for research examining ageing in place in relation to place, social networks, support (formal and informal), and the characteristics of older individuals. The current paper research informal care, specifically family care as a precondition for ageing in place. Neighbours and friends may also serve as informal caregivers, but family care represents the most extensive form of informal support provided to older people. Family Caregiving in Norway Even in a country like Norway, with well-developed eldercare services, families provide extensive care for older adults. Research indicates that families provide over 40 per cent of the care for older people in need, measured in full-time equivalent work years (Holmøy et al. 2016 ; Hjemås et al. 2019 ). Most of the assistance provided by family members involves practical and administrative help (Romøren 2004 ; Gautun and Bratt 2023 ). The rapid transition into a digital society (European Comission 2022 ) has resulted in a significant portion of administrative assistance being conducted online (Gautun and Bratt 2023 ). The anticipated sharp rise in the population aged 80 and above beginning in 2026, combined with an expanding gap between the supply and demand for health and care personnel, results in pressure from central and local health authorities on families to offer even more care (Norwegian Ministry of Health and Care Services 2018 , 2023 ). There is insufficient insight into whether families can be mobilized to provide more care. To promote increased caregiving, central health authorities have encouraged municipalities to provide various forms of caregiver support aimed at improving collaboration between family caregivers and elderly care services, as well as offering direct assistance to caregivers (Norwegian Ministry of Health and Care Services 2023 ). However, there is limited understanding of how much support caregivers receive from municipalities, and what type of support caregivers desire. Quantitative research shows that most older people prefer to live at home as they age (Hansen and Daatland 2016 ; Munkejord et al. 2018 ; Sandlie et al. 2023 ). Most older people participating in these surveys are “younger” older people in good health. Older people with multiple care needs and functional and cognitive impairments are typically 80 years or older (Tynkkynen et al. 2022 ) and it is challenging to reach them in survey studies. Therefore, there is limited knowledge on where and how the very oldest, with significant functional and cognitive impairments such as advanced dementia, prefer to live and the conditions that must be in place for safe ageing at home. A scoping review of Scandinavian research reveals that qualitative data collection is the primary method used in studies involving older people with severe health problems or the very oldest as informants (Magnussen et al. 2023 ). These qualitative studies indicate that frail older people view support from family and social network – both emotional and practical - as essential for managing daily life at home (Magnussen et al. 2023 ). A recent Norwegian qualitative study involving older people and their families underscored the crucial role that family caregivers play in enabling frail older people to remain at home (Kvæl 2025 ). Due to the small number of participants in these studies, the findings cannot be generalized, but they do speak for the importance of care provided by family members. Consequently, we need to seek insights from others, such as personnel working in home care services and family caregivers to gain an understanding if the extent to which older people with significant physical and mental impairment live safely at home, and to illuminate the conditions and limitations that facilitate their safe living at home. This paper contributes with this type of research by using a survey addressed to family caregivers, specifically sons and daughters of older people not living in nursing homes. Quantitative research reveals that daughters and sons usually serve as the primary family caregivers - especially when both old spouses have significant impairments, or when older individuals are widowed or live alone (Romøren 2004 ; Herlofson and Ugreninov 2014 ; Haugen 2025 ). Help and care to older people is primarily provided by children aged between 45 and 60 years (Phillips et al. 2002 ; Gautun and Bratt 2023 ; Vangen and Herlofson 2024 ). An increasing number of caregivers are in their 60s when their parents have significant care needs (Gautun and Bratt 2023 ). Research Questions and Methodology We go beyond earlier research by exploring the potential for expanding family care for older people living at home. In addition to researching the extent to which adult children provide support and care to their ageing parents, we ask whether adult children are willing to expand such help and care if eldercare services fail to adequately meet ageing parents’ needs as their frailty increases. We also go beyond earlier research by assessing whether caregiving children request supporting services from the municipalities. In March 2025, these questions were explored through a Norwegian nationwide survey of 3,673 respondents aged 45 to 67, each of whom had at least one living parent residing in the own home. Methods Sample We used data from a nationwide web survey in Norway in February-March 2025. Verian - Norway collected data with the Gallup Panel, which includes a sample of 40,000 consenting individuals aged 15 years and older. The Verian panel is designed to reflect the adult population of Norway and incorporates sampling weights based on gender, two-part age, four-part geography and two-part education statistics. Altogether 3 967 respondents aged 45 to 67, with at least one parent alive, responded (45% response rate). Our analysis focused on respondents with at least one parent residing in their own home (N = 3,673, 55.2% female, mean age = 55.1); reported age of parents was between 68 and 101. More than half of the mothers (53%) and fathers (56%) were 80 years or older; 9 per cent of fathers and 9 per cent of mothers were 90 years or older. The operation of the Gallup Panel and data processing are reported to the Data Protection Authority in Norway (Datatilsynet). The survey is part of the research project Enabling Ageing in Placed, funded by the Research Council of Norway (344102). The data will be deposited with SIKT – the Norwegian Agency for Shared Services in Education and Research - and made available to researchers not involved in the project on August 1, 2028. Measurements The questionnaire assessed background variables: gender, age, education level, income, whether they were employed (fulltime or parttime), and whether they were selfemployed. The questionnaire distinguished between the following education levels: Primary education (10-years in total); Upper secondary general education; Upper secondary vocational education; Vocational college/professional education (1/2–2 years) after upper secondary vocational education; University/college education up to 4 years; University/college education more than 4 years. Respondents were asked whether a parent was still alive (with separate measurements for mother and father) and the geographical distance between the respondent’s home and the parent’s, for mother and father separately (Walking distance; Up to ½ hour travel; Between ½ hour and 1 hour travel; Between 1 and 2 hours travel; Between 2 and 3 hours travel; Between 3 and 4 hours travel; Over 4 hours travel; Lives in another country). A parent’s current need for help and personal care was assessed with nine items, using five-point ordinal scales. We used four of these items to develop composite scores for the need for help (household chores, house maintenance, shopping groceries, and digital technology), and we used a composite score for five items on the need for care (personal hygiene, eating, getting in or out of bed, dressing, and using the toilet). Adult children’s current help and care for parents during the last six months was measured with similar items as used in previous research (Gautun and Bratt 2023 ), assessing administrative help, practical help, and personal care, with the following possible responses for each item: Daily, Weekly, Monthly, Less than once a month, Never. We reverse coded these items so that higher scores implied more help or care provided. Administrative help was assessed with three items: online payments of bills, phoning a doctor or similar health services, and assistance with using digital technology. Practical help was assessed with seven items: household chores, shopping groceries, house maintenance, transport, activities, exercise, follow parent to a doctor. Personal care was assessed with five items as used in earlier research - help in/out bed, dressing, personal hygiene, use toilet, eat – plus three new items on supervision of a parent: supervision of the parent due to dementia, somatic illness, or because they felt unsafe. Anticipated future increase in help and care if public services would be insufficient was assessed with binary items for (1) help and care by the respondent and (2) by others in the family. Respondents who indicated they themselves would provide more help and care to their parent if needed were asked how they would facilitate such help or care: by working less, by taking short unpaid leave, by taking extended leave, by retiring early, by moving in with the parent, or none of the above. As throughout the various questions on future help and care, respondents could tick multiple solutions. Those who indicated they would not be able to increase their help and care to parents were asked for reasons, with the following available responses: not willing, no need for help and care beyond public services, too large geographical distance from the parent, because of work obligations, because of respondent’s own health, because of family obligations, and other reasons. All respondents were asked whether they have received or wanted to receive various types of support from the municipality . The questionnaire used one item for each of the following forms of support from the municipality: information on services for older people, information about support for family caregivers, caregiver contact, participation in caregiver training, participation in support groups, relief care services and care allowance. All these items had three alternative responses: received, would like to receive, and not relevant. Analysis We used (1) descriptive analyses with tables and figures for frequencies, (2) probit regression for associations between various background variables and anticipated increase in informal help and care in the future, and (3) Structural Equation Modelling (SEM) for more extended analyses of respondents’ willingness to increase their help and care if needed. In the latter analysis, current help and care to parents was included as a mediating variable (modelled as a latent variable with Confirmatory Factor Analysis, CFA). The factor analysis of current help and care applied a model developed by earlier research (Gautun and Bratt 2023 ), using a factor model distinguishing between administrative help (e.g. paying bills online), practical help (e.g. cleaning the parent’s home), and personal care. Each of these three forms of assistance was assessed with multiple items, as described in the Methods section. Administrative help, practical help, and personal care were combined as indicators of a higher-order factor representing general Help and Care (as earlier research did). The factor model had good fit. We then added three new items referring to supervision of parents: supervision of parent due to dementia, due to somatic illness, and due to the parent feeling unsafe – initially added as indicators of personal care. The supplementary material provides details on the CFA model used. Analyses used R 4.5.0 (R Core Team 2025 ) and Mplus 8.11 (Muthén and Muthén 2017 ). R packages of particular importance for the current research were knitr 1.50 (Xie 2024 ) to develop the supplemental material, ggplot2 3.5.2 (Wickham 2016 ) for drawing plots, kableExtra 1.4.0 (Zhu 2024 ) to develop tables, and MplusAutomation 1.1.1 (Hallquist and Wiley 2018 ) for running analyses with Mplus. All code used for data management and analyses is available in the Appendix to the supplementary material. Results Nearly all respondents (91%) reported having provided one or more types of help or care to a parent in the last six months; 66 per cent had done so monthly or more frequently. Figure 1 shows frequencies of various forms of help provided to at least one parent; Fig. 2 presents data for personal care. Tables that distinguish between mothers and fathers among the parents are available in the supplementary material (Tables S1 and S2). These frequencies of help and care replicated findings from data collected three years earlier (Gautun and Bratt 2023 ); the results were remarkably similar across. Figures 1 and 2 break down the numbers with more detailed statistics for various forms of help and care; additional analyses appear in the supplementary material. Below, we summarise key patterns. The most common type of help provided was assistance with using digital technology (68%). Other frequent forms of help (59–48%) included house maintenance; transport of a parent; grocery shopping; paying bills, banking, and managing finances on behalf of the parent; and household chores. Also relatively frequent (38–31%) were accompanying a parent to medical appointments; activities outside the home; and maintaining phone contact with public offices or services for the parent. A minority had provided personal care, such as helping a parent dress or undress (7%); assisting with personal hygiene (7%); assisting with eating (6%); helping get in or out of bed (5%); or using the toilet (3%). Supervision, however, was more common: nearly one in three reported supervising a parent because of physical illness or injury (30%) or insecurity (28%), while fewer reported supervision because of cognitive impairment (17%). Figure 2 shows statistics for different forms of personal care. The supplementary material includes figures that distinguish between the gender of the adult child and of the parent (Figures S2 to S9). Daughters and sons showed moderate differences in help, but daughters provided more help to mothers than sons did. Daughters also provided more personal care to both parents. The potential for increased family care Respondents were asked whether they anticipated offering additional help and care should public care services be inadequate. Responses were strikingly similar across daughters and sons. In total, 68 per cent of respondents were willing to increase their help and care if public services proved insufficient in the future (Table 1 ). Similarly, 70 per cent anticipated other family members would increase their contribution. More than half (55%) indicated that both they and other family members would increase their help and care to the parent (Figure S12 in the supplementary material provides details). Table 1 Who will help when parents’ needs increase? Daughters' responses Sons' responses Overall Freq. Percentage Freq. Percentage Freq. Percentage Respondent 1411 69.60% 1096 66.50% 2507 68.25% Others in the family 1406 69.40% 1171 71.10% 2577 70.16% Neighbours/friends 310 15.30% 293 17.80% 603 16.42% Private services 366 18.10% 292 17.70% 658 17.91% Others 68 3.40% 98 5.90% 166 4.52% None 67 3.30% 63 3.80% 130 3.54% Don't know 259 12.80% 219 13.30% 478 13.01% Table note. Multiple answers were possible Among those indicating they were willing to increase their help and care for a parent, one in four indicated they would take short unpaid leave to facilitate such help and care, 15 per cent were willing to reduce working hours, and five per cent would take extended unpaid leave for longer periods such as a year (see Table 2 ). Among those willing to increase their help and care, one in ten indicated they would move in with their parents, and nearly nine per cent would opt for early retirement. However, nearly six in ten would not make any of the adaptations mentioned. Slightly more sons than daughters suggested they would reduce working hours or opt for early retirement (likely reflecting more paid work among men to begin with), while slightly more daughters would take short unpaid leave, accept extended unpaid leave, or move in with a parent. Table 2 How will respondents ensure they can increase help and care? Daughters' responses Sons' responses Overall Freq. Percentage Freq. Percentage Freq. Percentage Work less 289 14.30% 275 16.70% 564 15.40% Take unpaid leave 536 26.50% 356 21.60% 892 24.30% Take long leave 98 4.80% 68 4.10% 166 4.50% Early retirement 159 7.80% 155 9.40% 314 8.60% Cohabit with parent 258 12.70% 174 10.60% 432 11.80% None of the above 1135 56.00% 961 58.40% 2096 57.10% Among respondents reporting they were unable to increase their help and care for a parent, nearly one in three referred to geographical distance as hindering them from increasing their help and care to parents (Table 3 ). Nearly one in five indicated that work commitments prevented them from providing more help and care, and more than one in ten indicated that their own health issues prevented increased help and care. Far fewer (6%) referred to the need to assist other family members. More daughters than sons reported being unable to provide additional help and care due to their own health issues. Table 3 Why do respondents expect not to help parents? Daughters' responses Sons' responses Overall Freq. Percentage Freq. Percentage Freq. Percentage Not willing 126 6.20% 83 5.00% 209 5.70% Parent does not need 966 47.70% 867 52.60% 1833 49.90% Distance too large 548 27.10% 442 26.80% 990 27.00% Own work too demanding 385 19.00% 282 17.10% 667 18.20% Own health 315 15.60% 130 7.90% 445 12.10% Other family members need 139 6.90% 82 5.00% 221 6.00% Other causes 116 5.70% 106 6.40% 222 6.00% SEM analysis of the willingness to increase help and care The supplementary material includes a probit regression with background variables as predictors; here, we focus on the more comprehensive analysis with SEM that included current help and care as a mediating variable. We considered various background variables as predictors (gender, age, parents’ age, education, income, full-time employment, part-time employment, self-employment, and geographical distance from the parent). We added two predictors: parents’ current need for help and their current need for personal care (both as reported by their adult children). We used respondents’ current help and care as a mediating variable (as illustrated in Fig. 1 ). The mediating variable, current help and care, was first tested on its own with CFA. We used the factor model of help and care developed by earlier research but added three items on supervision (supervision because of dementia, somatic illness, and feeling insecure), initially treating these as indicators of personal care. Through inspection of overall model fit, modification indices and residuals, we found that the three supervision items loaded primarily on the factor referred to as Practical help. Detailed results appear in the supplementary material, Tables S3 and S4. Apart from the latent variable representing current help and care, all predictors were normalised to scores between 0 and 1, making their unstandardised coefficients directly comparable. Details of these analyses are available in the supplementary material. Our final model employed a reduced set of predictors depicted in Fig. 3 . The strongest predictor of respondents’ willingness to provide more help and care was geographical distance ( b = -1.06 [-1.32, -0.81] ß = − .26), mirroring this variable’s effect on current help and care ( b = -1.04 [-1.20, -0.89], ß = − .29). The model also included a direct path from personal care to willingness to increase help and care (testing its contribution beyond general Help and Care). The direct path from personal care proved negligible and with a 95 per cent CI indicating it could be either negative or positive. Parents’ current need for help was a strong predictor of current help and care ( b = 1.78 [95% CI = 1.59, 1.97], ß = .57), but not of willingness to provide more help and care in the future. Although its mediated effect via current help and care was positive (standardized mediation effect = .22), controlling for this mediation made the direct path (current need for help → more help and care in the future) negative: b = − .60 [-0.94, -0.27], ß = − .16. Parents’ need for care was unrelated to current help and care but negatively predicted anticipated future increase in help and care, with a small effect size ( b = -0.89 [-1.36, -0.41], ß = − .13). Supporting services In a final analysis, we investigated respondents’ use of or request for support from the municipality. A minority of the respondents received these types of municipal caregiver support: information about available services for their ageing parents, information about caregiver support, having a caregiver contact, participating in caregiver training, support groups, relief care services, and care allowance (see Table 4 ). Table 4 Received or wanted support by the municipality Overall sample Provided personal care in last six months Type of support N Percentage N Percentage Information about available services Received 230 6.3% 178 12.4% Wants 1458 40.0% 811 56.7% Not relevant 1962 53.8% 442 30.9% Information about support to caregivers Received 142 3.9% 108 7.6% Wants 1332 36.5% 774 54.2% Not relevant 2171 59.6% 546 38.2% Caregiver contact Received 113 3.1% 86 6.0% Wants 1080 29.7% 663 46.5% Not relevant 2448 67.2% 677 47.5% Participated in caregiver training Received 77 2.1% 60 4.2% Wants 625 17.2% 403 28.3% Not relevant 2937 80.7% 960 67.5% Participated in support group Received 44 1.2% 36 2.5% Wants 371 10.2% 252 17.7% Not relevant 3221 88.6% 1133 79.7% Relief care services Received 59 1.6% 53 3.7% Wants 555 15.3% 408 28.7% Not relevant 3021 83.1% 960 67.6% Care allowance Received 24 0.7% 19 1.3% Wants 478 13.3% 324 22.9% Not relevant 3104 86.1% 1073 75.8% Four out of ten expressed a need for information about available eldercare services in the municipality. Respondents also needed more information about caregiver support, a caregiver contact, and relief services. However, few expressed a need for support groups (10%) or for care allowance (13%). These numbers were higher among respondents who had provided personal care during the last six months (see Table 3 ). Among personal care providers, demand for municipal support was substantially higher across all categories, highlighting the greater strain experienced by intensive caregivers. Discussion A majority reported having provided help or care to older parents in the last six months. Most common was assistance with digital technology (reported by two in three). Other frequently reported tasks included house maintenance, transport, grocery shopping, managing finances, and household chores. Additionally, for each of the following tasks, approximately a third reported having performed them: accompanying parents to medical appointments or care services, supporting activities outside the parent’s home, and maintaining phone contact with public offices and services on behalf of the parent. Personal care for parents was rarer, with similar numbers as in earlier Norwegian studies (Romøren 2004 ; Gautun and Hagen 2010 ; Gautun and Bratt 2023 ). However, approximately one in three reported supervision of a parent because of physical illness or injury, a similar number reported supervision because the parent had felt insecure; and nearly two out of ten due to cognitive impairment or dementia. We found only moderate differences between daughters and sons in help provided to parents, though daughters provided more help to mothers than sons did. Daughters also reported more personal care for both mothers and fathers. A considerable potential for expanding family-provided care for older people In recent years, older people’ relatives have faced increasing pressure to provide more help and care. Central authorities, local authorities, and eldercare services now all exert such pressure on family members (Jakobsson et al. 2016 ; Norwegian Ministry of Health and Care Services 2018 , 2023 ). However, little has been known about the realism of these appeals. Surveys show the population believes public eldercare services should bear the primary responsibility for providing care to older people (Lingsom 1989 ; Herlofson et al. 2019 ). This view aligns with the legal obligation of public authorities in Norway to provide care and support to care-needing adults. However, health authorities increasingly signal that demographic changes will widen the gap between supply and demand for public health and care services (Norwegian Ministry of Health and Care Services 2023 ). Authorities are now preparing the population for an emerging reality in which older people will have access to more limited public eldercare services. Our analyses indicate that citizens are increasingly aware of this shift in eldercare provision and its implications for family responsibility. Seven of ten respondents expressed willingness to increase help and care to parents should public services prove insufficient. A similar number reported that other family members would increase contributions. More than half of the respondents stated that both they and other family members would increase their assistance to parents. These responses were strikingly similar across daughters and sons. The sociologist Hagestad ( 1999 ) has described the family as an "omnibus institution," meaning that the family steps in to fulfil caregiving needs that the welfare state fails to address. Previous research, as well as the current study, confirms this observation about family's adaptive caregiving role. The welfare state contributes with medical and personal care, while next of kin provide substantial practical help and support. Most respondents in the current study are willing to contribute more if needed. Willing to make significant life adjustments to offer extra care Among respondents willing to increase help and care for a parent, a quarter indicated they would take short unpaid leave to facilitate such assistance, while others indicated they would reduce working hours (15%) or take extended unpaid leave for up to a year (5%). One in ten were willing to move in with their parents, and approximately one in ten would consider early retirement. Nearly 60% would not make such adjustments. Sons were more likely to reduce working hours or retire early, while daughters were more inclined to take short unpaid leave, extended leave, or move in with a parent. Developing policies to facilitate family care The willingness to reduce work to facilitate helping and caring for parents comes at a cost – even for society at large. If caregivers choose to reduce their working hours or take early retirement to provide care for older relatives, this could conflict with society’s growing need for people of working age remaining in full employment. The increasing demand for caregivers to provide more care while continuing to work underscores the need for a collaboration between authorities responsible for eldercare policy and those overseeing labour market policies (Gautun and Bratt 2024 ). Different authorities ought to collaborate in developing policies that facilitate the ability to balance the roles of full-time employees and caregivers. Specifically, labour policies need to prevent employees from retiring permanently due to caregiving. This would be possible by establishing a legal right for caregivers who take early retirement for caregiving to return to full-time employment if the caregiving period ends prior to the general retirement age. Shifting governments have emphasized the need for support for family caregivers of older relatives (Norwegian Ministry of Health and Care Services 2018 , 2023 ). In 2023, the government launched a four-year "Stay Safe at Home" reform, recommending that municipalities provide various types of caregiver support (Norwegian Ministry of Health and Care Services 2023 ). Only a minority of respondents had received this caregiver support from their municipality. Four in ten indicated they needed information on available eldercare services. Respondents also need more information on caregiver support, caregiver contact, and relief services. However, few expressed need for support groups or care allowance. Our survey demonstrates the necessity of enhanced municipal support tailored to caregivers. However, limited resources and personnel shortages in municipalities may motivate authorities to deprioritise caregiver support. That could easily be counterproductive. Implementing low-resource initiatives for family caregivers can be a low-cost measure benefitting expanded family caregiving and reducing the need for costly eldercare services or institutional care. Implications of not having children One group of older people is not covered by our research nor by initiatives to mobilise family members as caregivers: childless older people. Statistics from Statistics Norway shows that one in four older individuals (aged 67 and older) living alone lack family nearby, defined as within a 30-minute driving distance (Haugen 2025 ). Some of these individuals are childless, and also have no other family members who might provide help and care (Haugen 2025 ). A particularly vulnerable group of childless older adults that has received little attention is older immigrants living alone. In total, 32% of older adults with an immigrant background (aged 67 and above) live alone (Statistics Norway 2025 1 ). This group includes men who never married and established a family. Research shows that individuals with an immigrant background are less likely to use health and care services (Syse and Tønnessen 2022 ). Childless older immigrants is especially at risk of having their needs for eldercare services unmet. Authorities planning to involve family members to provide help and care to older people also need to develop plans for how to address the needs of the older people who have no family to help them, so that ageing in place is realistic even for the childless older people. Conclusion An ageing in place policy mounts pressure on families to offer additional care for older people. This study reveals significant potential for expanding family-provided care for older people in Norway. The findings emphasize the need for enhanced municipal support tailored to caregivers. Implementing low-resource initiatives for family caregivers could serve as a cost-effective strategy, fostering increased family caregiving while reducing reliance on costly eldercare services and institutional care. References Blix BH, Ågotnes G (2023) Aging Successfully in the Changing Norwegian Welfare State: A Policy Analysis Framed by Critical Gerontology. Gerontologist 63:1228–1237. https://doi.org/10.1093/geront/gnac177 European Comission (2022) Digital Economy and Society Index (DESI) 2022 | Shaping Europe’s digital future. https://digital-strategy.ec.europa.eu/en/library/digital-economy-and-society-index-desi-2022 . Accessed 11 Jun 2025 Gautun H, Bratt C (2023) Help and Care to Older Parents in the Digital Society. 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Gerontologist 52:1–12. https://doi.org/10.1093/geront/gnr108 Hagen TP, Aarflot M, Tjerbo T (2024) Brukerne blir yngre, psykiske lidelser øker: Dypdykk i pleie- og omsorgstjenestene omsorgstjenestene [Users Are Getting Younger, Mental Illnesses Are Increasing: A Deep Dive into Care and Nursing Services]. Health Economic Network. University of Oslo Hagestad G (1999) Familien på eldrebølgen [The family institution in an ageing society]. In: Brandth B, Moxnes K (eds) Familie for tiden – Stabilitet og forandring [Todays family – Stability and Change]. Tano Aschehoug. Tano Achehoug, Oslo, Oslo Hallquist MN, Wiley JF (2018) MplusAutomation : An R Package for Facilitating Large-Scale Latent Variable Analyses in M plus . Struct Equation Modeling: Multidisciplinary J 25:621–638. https://doi.org/10.1080/10705511.2017.1402334 Hansen T, Daatland SO (2016) Aldring, mestringsbetingelser og livskvalitet [Ageing, Coping Conditions and Quality of Life]. The Norwegian Directorate of Health., Oslo Haugen SM (2025) 1 av 4 aleneboende eldre har ingen familie i nærheten [One in two older individuals living alone have no family nearby]. In: Statistics Norway. https://www.ssb.no/sosiale-forhold-og-kriminalitet/levekar/artikler/1-av-4-aleneboende-eldre-har-ingen-familie-i-naerheten . Accessed 11 Jun 2025 Herlofson K, Daatland SO, Veenstra M (2019) Generasjoner imellom: Holdninger til familiens ansvar øst og vest i Europa [Between Attitudes Toward Family Responsibility in Eastern and Western Europe]. Nordisk Østforum 33:34–53. https://doi.org/10.23865/noros.v33.1392 Herlofson K, Ugreninov E (2014) Er omsorgsfulle fedre omsorgsfulle sønner? - Likestilling hjemme og hjelp til eldre foreldre. TfS 55:322–346. https://doi.org/10.18261/ISSN1504-291X-2014-03-03 Hermansen Å, Gautun H (2013) Yngreomsorgen i møte med eldreomsorgen – hvordan påvirkes pleie- og omsorgstilbudet til de aller eldste? [Younger care services meeting elder care – how is the care and nursing service for the very oldest affected?]. Fontene Forskning Hjemås G, Zhiyang J, Kornstad T, Stølen NM (2019) Arbeidsmarkedet for helsepersonell fram mot 2035 [Labour Marked for Health personell, projection towards 2035] Hoen BT, Abrahamsen DR, Berntsen ØI, Isachsen ØB (2023) Hjemmetjenestens målgrupper og organisering [Target Groups and Organization of Home Care Services]. Statistics Norway Holmøy E, Haugstveit FV, Otnes B (2016) Behovet for arbeidskraft og omsorgsboliger i pleie- og omsorgssektoren mot 2060 [The need for personnel and care – residents in the care sector until 2060]. Statistics Norway Jakobsson N, Kotsadam A, Syse A, Øien H (2016) Gender bias in public long-term care? A survey experiment among care managers. J Econ Behav Organ 131:126–138. https://doi.org/10.1016/j.jebo.2015.09.004 Kvæl LAH (2025) Ageing in place or stuck in place: A critical qualitative study on older adults’ independence across six municipalities in Norway. Soc Sci Med 375:118098. https://doi.org/10.1016/j.socscimed.2025.118098 Lingsom S (1989) Filial Responsibility in the Welfare State. J Appl Gerontol 8:18–35. https://doi.org/10.1177/073346488900800103 Magnussen SF, Øvern KM, Devik SA (2023) Trygg i eget hjem? – fra et brukerperspektiv [Safe at home? A literature review of what older people perceive as important to feeling safe at home]. Senter for omsorgsforskning Munkejord MC, Eggebø H, Schönfelder W (2018) Hjemme best? En tematisk analyse av eldres fortellinger om omsorg og tryggheti eget hjem. TFO 4:16–26. https://doi.org/10.18261/issn.2387-5984-2018-01-03 Muthén LK, Muthén BO (2017) Mplus User’s Guide, Eighth Edition. Muthén & Muthén, Los Angeles, CA Norwegian Ministry of Health and Care Services (2023) Fellesskap og meistring Bu trygt heime [Community and Coping – Live Safely at Home Report to the Storting (White Paper)] Norwegian Ministry of Health and Care Services (2018) A full life - all your life: A Quality Reform for Older Persons. Norwegian Government Pani-Harreman KE, Bours GJJW, Zander I et al (2021) Definitions, key themes and aspects of ‘ageing in place’: a scoping review. Aging Soc 41:2026–2059. https://doi.org/10.1017/S0144686X20000094 Pani-Harreman KE, Van Duren JMA, Kempen GIJM, Bours GJJW (2022) The conceptualisation of vital communities related to ageing in place: a scoping review. Eur J Ageing 19:49–62. https://doi.org/10.1007/s10433-021-00622-w Phillips JE, Bernard M, Chittenden M (2002) Juggling Work and Care: The Experiences of Working Carers of Older Adults. Policy, Bristol R Core Team (2025) R: A language and environment for statistical computing Romøren TI (2004) Last Years of Long Lives: The Larvik Study. Routledge, London Sandlie HC, Flåto M, Gulbrandsen L (2023) Eldres boligønsker og bosituasjon. [[Housing Conditions and Preferences og Older People] Syse A, Tønnessen M (2022) Flere eldre innvandrere blant framtidens brukere av omsorgstjenester. TFO 8:8–29. https://doi.org/10.18261/tfo.8.2.2 Tynkkynen L-K, Pulkki J, Tervonen-Gonçalves L et al (2022) Health system reforms and the needs of the ageing population—an analysis of recent policy paths and reform trends in Finland and Sweden. Eur J Ageing 19:221–232. https://doi.org/10.1007/s10433-022-00699-x Vangen H, Herlofson K (2024) Why care? How filial responsibility norms and relationship quality matter for subsequent provision of care to ageing parents. Aging Soc 44:2703–2727. https://doi.org/10.1017/S0144686X23000235 Wickham H (2016) ggplot2: Elegant Graphics for Data Analysis. Springer, New York Wilkinson-Meyers L, Brown P, McLean C, Kerse N (2014) Met and unmet need for personal assistance among community-dwelling New Zealanders 75 years and over. Health Soc Care Community 22:317–327. https://doi.org/10.1111/hsc.12087 World Health Organization (2015) World report on ageing and health. World Health Organization Xie Y (2024) knitr: A General-Purpose Package for Dynamic. Report Generation in R Zhu H (2024) kableExtra: Construct Complex Table with kable and Pipe Syntax, R package version 1.4.0 Footnotes Statistics provided by Magnus Haug, Senior Advisor, Section for Population Statistics Norway (January 3, 2025) Additional Declarations The authors declare no competing interests. Supplementary Files SupplementaryMaterialEnablingAgeinginPlace.pdf Supplemental Material for Gautun & Bratt: Enabling Ageing in Place Cite Share Download PDF Status: Posted Version 1 posted You are reading this latest preprint version Research Square lets you share your work early, gain feedback from the community, and start making changes to your manuscript prior to peer review in a journal. As a division of Research Square Company, we’re committed to making research communication faster, fairer, and more useful. We do this by developing innovative software and high quality services for the global research community. Our growing team is made up of researchers and industry professionals working together to solve the most critical problems facing scientific publishing. Also discoverable on Platform About Our Team In Review Editorial Policies Advisory Board Help Center Resources Author Services Accessibility API Access RSS feed Manage Cookie Preferences © Research Square 2026 | ISSN 2693-5015 (online) Privacy Policy Terms of Service Do Not Sell My Personal Information {"props":{"pageProps":{"initialData":{"identity":"rs-6882140","acceptedTermsAndConditions":true,"allowDirectSubmit":true,"archivedVersions":[],"articleType":"Research Article","associatedPublications":[],"authors":[{"id":470506540,"identity":"0536b7bb-aea0-42e5-8ea9-bf160c7266ff","order_by":0,"name":"Heidi Gautun","email":"data:image/png;base64,iVBORw0KGgoAAAANSUhEUgAAAZAAAAAyAQMAAABI0h/eAAAABlBMVEX///8AAABVwtN+AAAACXBIWXMAAA7EAAAOxAGVKw4bAAAAuUlEQVRIiWNgGAWjYBACgwMgsoKBgY80LQfOMDCwgXgHiNZysI0kLecXP5P+OM/Gno29O/HxB4Y7cgS12N94ZiZxcFtaYhvP2c1AK58ZE7blxgGQlsMJbBK52yQOMBxObCCs5fg3iYNzDtsDtWz/QZyW8z1AWxoOM7YBbWEg0haeYoszxyB+kThjcJgIv5w/vvFGRY2NPT9778YPFRWHCYcYg0QCigmENTAw8B8gRtUoGAWjYBSMaAAALotFlY+D6fkAAAAASUVORK5CYII=","orcid":"https://orcid.org/0000-0001-7258-1543","institution":"Norwegian Social Research, NOVA, Oslo Metropolitan University","correspondingAuthor":true,"prefix":"","firstName":"Heidi","middleName":"","lastName":"Gautun","suffix":""},{"id":470506952,"identity":"229bcda7-5005-4a41-b014-b178dbd23f54","order_by":1,"name":"Christopher Bratt","email":"","orcid":"https://orcid.org/0000-0001-5838-8739","institution":"Department of Psychology, INN Inland University Norway","correspondingAuthor":false,"prefix":"","firstName":"Christopher","middleName":"","lastName":"Bratt","suffix":""}],"badges":[],"createdAt":"2025-06-12 16:23:17","currentVersionCode":1,"declarations":{"humanSubjects":true,"vertebrateSubjects":false,"conflictsOfInterestStatement":false,"humanSubjectEthicalGuidelines":true,"humanSubjectConsent":true,"humanSubjectClinicalTrial":false,"humanSubjectCaseReport":false,"vertebrateSubjectEthicalGuidelines":false},"doi":"10.21203/rs.3.rs-6882140/v1","doiUrl":"https://doi.org/10.21203/rs.3.rs-6882140/v1","draftVersion":[],"editorialEvents":[],"editorialNote":"","failedWorkflow":false,"files":[{"id":84678370,"identity":"1dcf3e7b-0d93-4bd5-ae1a-2b63aa16f6a8","added_by":"auto","created_at":"2025-06-16 07:55:12","extension":"png","order_by":1,"title":"Figure 1","display":"","copyAsset":false,"role":"figure","size":212668,"visible":true,"origin":"","legend":"\u003cp\u003e\u003cem\u003eFrequencies of helping at least one parent\u003c/em\u003e\u003c/p\u003e","description":"","filename":"1.png","url":"https://assets-eu.researchsquare.com/files/rs-6882140/v1/9e87976ba51862cb4a169439.png"},{"id":84678371,"identity":"05c52674-8252-481c-b4ad-ce7e4e1c4c11","added_by":"auto","created_at":"2025-06-16 07:55:12","extension":"png","order_by":2,"title":"Figure 2","display":"","copyAsset":false,"role":"figure","size":160409,"visible":true,"origin":"","legend":"\u003cp\u003e\u003cem\u003eFrequencies of providing personal care and supervision for at least one parent\u003c/em\u003e\u003c/p\u003e","description":"","filename":"2.png","url":"https://assets-eu.researchsquare.com/files/rs-6882140/v1/fc8a38d2d6c0952812df73c5.png"},{"id":84678375,"identity":"14436e75-cc85-49f0-86ec-ace57977c649","added_by":"auto","created_at":"2025-06-16 07:55:12","extension":"png","order_by":3,"title":"Figure 3","display":"","copyAsset":false,"role":"figure","size":126941,"visible":true,"origin":"","legend":"\u003cp\u003e\u003cem\u003eSEM model with predictors of current and anticipated own help and care when needs increase\u003c/em\u003e\u003c/p\u003e\n\u003cp\u003e\u003cem\u003eFigure note\u003c/em\u003e. Dashed grey lines refer to paths with 95% CI including both negative and positive values. Estimates are standardised. Indicators of administrative help, practical help, and personal care are not shown.\u003c/p\u003e","description":"","filename":"3.png","url":"https://assets-eu.researchsquare.com/files/rs-6882140/v1/86f95258fb45ac028636cd62.png"},{"id":84679910,"identity":"226d02a7-3b59-4ba3-8b2c-043ba8a8ca0c","added_by":"auto","created_at":"2025-06-16 08:11:13","extension":"pdf","order_by":0,"title":"","display":"","copyAsset":false,"role":"manuscript-pdf","size":1328586,"visible":true,"origin":"","legend":"","description":"","filename":"manuscript.pdf","url":"https://assets-eu.researchsquare.com/files/rs-6882140/v1/1de2bacc-e884-4fa1-be54-aedd9dc95783.pdf"},{"id":84678369,"identity":"d24c894b-c675-4f82-80ea-0266b6134cc4","added_by":"auto","created_at":"2025-06-16 07:55:12","extension":"pdf","order_by":1,"title":"","display":"","copyAsset":false,"role":"supplement","size":309953,"visible":true,"origin":"","legend":"\u003cp\u003eSupplemental Material for\u003c/p\u003e\n\u003cp\u003eGautun \u0026amp; Bratt: Enabling Ageing in Place\u003c/p\u003e","description":"","filename":"SupplementaryMaterialEnablingAgeinginPlace.pdf","url":"https://assets-eu.researchsquare.com/files/rs-6882140/v1/54bc197c198c2a73eea21457.pdf"}],"financialInterests":"The authors declare no competing interests.","formattedTitle":"\u003cp\u003eEnabling Ageing in Place: The Potential for Expanded Family Care\u003c/p\u003e","fulltext":[{"header":"Introduction","content":"\u003cp\u003eThe European populations are rapidly ageing (Organisation for Economic Co-operation and Development 2023) and strain countries\u0026rsquo; health and care services (European Commission 2024). To reduce the demand for costly health and care services and improve older people\u0026rsquo;s quality of life, authorities in many countries champion \u0026ldquo;ageing in place\u0026rdquo; policies, namely a policy aiming to enable older people to live safely in their own homes as long as possible (World Health Organization \u003cspan citationid=\"CR38\" class=\"CitationRef\"\u003e2015\u003c/span\u003e; Pani-Harreman et al. \u003cspan citationid=\"CR28\" class=\"CitationRef\"\u003e2022\u003c/span\u003e; Norwegian Ministry of Health and Care Services \u003cspan citationid=\"CR25\" class=\"CitationRef\"\u003e2023\u003c/span\u003e). Across many European countries, older people are expected to remain in their current home residence even when they are facing an increased need for support due to life changes (Greenfield \u003cspan citationid=\"CR7\" class=\"CitationRef\"\u003e2012\u003c/span\u003e; Norwegian Ministry of Health and Care Services \u003cspan citationid=\"CR25\" class=\"CitationRef\"\u003e2023\u003c/span\u003e; Blix and \u0026Aring;gotnes \u003cspan citationid=\"CR1\" class=\"CitationRef\"\u003e2023\u003c/span\u003e). In Norway, the accelerating growth in the number and proportion of older people over eighty from 2026 led the Parliament to adopt the reform \u0026ldquo;A full life - all your life\u0026rdquo; in 2018 (Norwegian Ministry of Health and Care Services \u003cspan citationid=\"CR26\" class=\"CitationRef\"\u003e2018\u003c/span\u003e) and the reform \u0026ldquo;Stay safe at home\u0026rdquo; in 2023, aimed at facilitating safe ageing at home (Norwegian Ministry of Health and Care Services \u003cspan citationid=\"CR25\" class=\"CitationRef\"\u003e2023\u003c/span\u003e).\u003c/p\u003e\n\u003ch3\u003eHistorical Context of Home-Based Care\u003c/h3\u003e\n\u003cp\u003eThe ambition that people in need of long-term care should receive services outside of institutions is not new (Wilkinson-Meyers et al. \u003cspan citationid=\"CR37\" class=\"CitationRef\"\u003e2014\u003c/span\u003e; Gautun and Gr\u0026oslash;dem \u003cspan citationid=\"CR5\" class=\"CitationRef\"\u003e2015\u003c/span\u003e). In Norway, numerous reforms have been implemented since the early 1990s, transferring responsibility for various groups requiring long-term care from institutions to municipal home care services (Gautun and Gr\u0026oslash;dem \u003cspan citationid=\"CR5\" class=\"CitationRef\"\u003e2015\u003c/span\u003e). Significant expansion of home care services has occurred for younger individuals (below the age of 67) in need of long-term care (Gautun and Gr\u0026oslash;dem \u003cspan citationid=\"CR5\" class=\"CitationRef\"\u003e2015\u003c/span\u003e; Hoen et al. \u003cspan citationid=\"CR17\" class=\"CitationRef\"\u003e2023\u003c/span\u003e; Hagen et al. \u003cspan citationid=\"CR8\" class=\"CitationRef\"\u003e2024\u003c/span\u003e). However, public home care services for older people have not expanded sufficiently to meet the needs once addressed by public eldercare institutions (Hermansen and Gautun \u003cspan citationid=\"CR15\" class=\"CitationRef\"\u003e2013\u003c/span\u003e).\u003c/p\u003e \u003cp\u003eAgeing in place is a broad term used by both researchers and policymakers. The term is defined in various ways. A scoping review identifies five key themes within the concept (Pani-Harreman et al. \u003cspan citationid=\"CR27\" class=\"CitationRef\"\u003e2021\u003c/span\u003e). To understand ageing in place, Pani-Harreman et al. highlight a need for research examining ageing in place in relation to place, social networks, support (formal and informal), and the characteristics of older individuals. The current paper research informal care, specifically family care as a precondition for ageing in place. Neighbours and friends may also serve as informal caregivers, but family care represents the most extensive form of informal support provided to older people.\u003c/p\u003e \u003cdiv id=\"Sec3\" class=\"Section2\"\u003e \u003ch2\u003eFamily Caregiving in Norway\u003c/h2\u003e \u003cp\u003e Even in a country like Norway, with well-developed eldercare services, families provide extensive care for older adults. Research indicates that families provide over 40 per cent of the care for older people in need, measured in full-time equivalent work years (Holm\u0026oslash;y et al. \u003cspan citationid=\"CR18\" class=\"CitationRef\"\u003e2016\u003c/span\u003e; Hjem\u0026aring;s et al. \u003cspan citationid=\"CR16\" class=\"CitationRef\"\u003e2019\u003c/span\u003e). Most of the assistance provided by family members involves practical and administrative help (Rom\u0026oslash;ren \u003cspan citationid=\"CR31\" class=\"CitationRef\"\u003e2004\u003c/span\u003e; Gautun and Bratt \u003cspan citationid=\"CR3\" class=\"CitationRef\"\u003e2023\u003c/span\u003e). The rapid transition into a digital society (European Comission \u003cspan citationid=\"CR2\" class=\"CitationRef\"\u003e2022\u003c/span\u003e) has resulted in a significant portion of administrative assistance being conducted online (Gautun and Bratt \u003cspan citationid=\"CR3\" class=\"CitationRef\"\u003e2023\u003c/span\u003e). The anticipated sharp rise in the population aged 80 and above beginning in 2026, combined with an expanding gap between the supply and demand for health and care personnel, results in pressure from central and local health authorities on families to offer even more care (Norwegian Ministry of Health and Care Services \u003cspan citationid=\"CR26\" class=\"CitationRef\"\u003e2018\u003c/span\u003e, \u003cspan citationid=\"CR25\" class=\"CitationRef\"\u003e2023\u003c/span\u003e). There is insufficient insight into whether families can be mobilized to provide more care. To promote increased caregiving, central health authorities have encouraged municipalities to provide various forms of caregiver support aimed at improving collaboration between family caregivers and elderly care services, as well as offering direct assistance to caregivers (Norwegian Ministry of Health and Care Services \u003cspan citationid=\"CR25\" class=\"CitationRef\"\u003e2023\u003c/span\u003e). However, there is limited understanding of how much support caregivers receive from municipalities, and what type of support caregivers desire.\u003c/p\u003e \u003cp\u003eQuantitative research shows that most older people prefer to live at home as they age (Hansen and Daatland \u003cspan citationid=\"CR11\" class=\"CitationRef\"\u003e2016\u003c/span\u003e; Munkejord et al. \u003cspan citationid=\"CR23\" class=\"CitationRef\"\u003e2018\u003c/span\u003e; Sandlie et al. \u003cspan citationid=\"CR32\" class=\"CitationRef\"\u003e2023\u003c/span\u003e). Most older people participating in these surveys are \u0026ldquo;younger\u0026rdquo; older people in good health. Older people with multiple care needs and functional and cognitive impairments are typically 80 years or older (Tynkkynen et al. \u003cspan citationid=\"CR34\" class=\"CitationRef\"\u003e2022\u003c/span\u003e) and it is challenging to reach them in survey studies. Therefore, there is limited knowledge on where and how the very oldest, with significant functional and cognitive impairments such as advanced dementia, prefer to live and the conditions that must be in place for safe ageing at home. A scoping review of Scandinavian research reveals that qualitative data collection is the primary method used in studies involving older people with severe health problems or the very oldest as informants (Magnussen et al. \u003cspan citationid=\"CR22\" class=\"CitationRef\"\u003e2023\u003c/span\u003e). These qualitative studies indicate that frail older people view support from family and social network \u0026ndash; both emotional and practical - as essential for managing daily life at home (Magnussen et al. \u003cspan citationid=\"CR22\" class=\"CitationRef\"\u003e2023\u003c/span\u003e). A recent Norwegian qualitative study involving older people and their families underscored the crucial role that family caregivers play in enabling frail older people to remain at home (Kv\u0026aelig;l \u003cspan citationid=\"CR20\" class=\"CitationRef\"\u003e2025\u003c/span\u003e). Due to the small number of participants in these studies, the findings cannot be generalized, but they do speak for the importance of care provided by family members.\u003c/p\u003e \u003cp\u003eConsequently, we need to seek insights from others, such as personnel working in home care services and family caregivers to gain an understanding if the extent to which older people with significant physical and mental impairment live safely at home, and to illuminate the conditions and limitations that facilitate their safe living at home.\u003c/p\u003e \u003cp\u003eThis paper contributes with this type of research by using a survey addressed to family caregivers, specifically sons and daughters of older people not living in nursing homes. Quantitative research reveals that daughters and sons usually serve as the primary family caregivers - especially when both old spouses have significant impairments, or when older individuals are widowed or live alone (Rom\u0026oslash;ren \u003cspan citationid=\"CR31\" class=\"CitationRef\"\u003e2004\u003c/span\u003e; Herlofson and Ugreninov \u003cspan citationid=\"CR14\" class=\"CitationRef\"\u003e2014\u003c/span\u003e; Haugen \u003cspan citationid=\"CR12\" class=\"CitationRef\"\u003e2025\u003c/span\u003e). Help and care to older people is primarily provided by children aged between 45 and 60 years (Phillips et al. \u003cspan citationid=\"CR29\" class=\"CitationRef\"\u003e2002\u003c/span\u003e; Gautun and Bratt \u003cspan citationid=\"CR3\" class=\"CitationRef\"\u003e2023\u003c/span\u003e; Vangen and Herlofson \u003cspan citationid=\"CR35\" class=\"CitationRef\"\u003e2024\u003c/span\u003e). An increasing number of caregivers are in their 60s when their parents have significant care needs (Gautun and Bratt \u003cspan citationid=\"CR3\" class=\"CitationRef\"\u003e2023\u003c/span\u003e).\u003c/p\u003e \u003c/div\u003e\n\u003ch3\u003eResearch Questions and Methodology\u003c/h3\u003e\n\u003cp\u003eWe go beyond earlier research by exploring the potential for expanding family care for older people living at home. In addition to researching the extent to which adult children provide support and care to their ageing parents, we ask whether adult children are willing to expand such help and care if eldercare services fail to adequately meet ageing parents\u0026rsquo; needs as their frailty increases. We also go beyond earlier research by assessing whether caregiving children request supporting services from the municipalities. In March 2025, these questions were explored through a Norwegian nationwide survey of 3,673 respondents aged 45 to 67, each of whom had at least one living parent residing in the own home.\u003c/p\u003e"},{"header":"Methods","content":"\u003cdiv id=\"Sec6\" class=\"Section2\"\u003e \u003ch2\u003eSample\u003c/h2\u003e \u003cp\u003eWe used data from a nationwide web survey in Norway in February-March 2025. Verian - Norway collected data with the Gallup Panel, which includes a sample of 40,000 consenting individuals aged 15 years and older. The Verian panel is designed to reflect the adult population of Norway and incorporates sampling weights based on gender, two-part age, four-part geography and two-part education statistics.\u003c/p\u003e \u003cp\u003eAltogether 3 967 respondents aged 45 to 67, with at least one parent alive, responded (45% response rate). Our analysis focused on respondents with at least one parent residing in their own home (N\u0026thinsp;=\u0026thinsp;3,673, 55.2% female, mean age\u0026thinsp;=\u0026thinsp;55.1); reported age of parents was between 68 and 101. More than half of the mothers (53%) and fathers (56%) were 80 years or older; 9 per cent of fathers and 9 per cent of mothers were 90 years or older.\u003c/p\u003e \u003cp\u003eThe operation of the Gallup Panel and data processing are reported to the Data Protection Authority in Norway (Datatilsynet). The survey is part of the research project Enabling Ageing in Placed, funded by the Research Council of Norway (344102). The data will be deposited with SIKT \u0026ndash; the Norwegian Agency for Shared Services in Education and Research - and made available to researchers not involved in the project on August 1, 2028.\u003c/p\u003e \u003c/div\u003e\n\u003ch3\u003eMeasurements\u003c/h3\u003e\n\u003cp\u003eThe questionnaire assessed background variables: gender, age, education level, income, whether they were employed (fulltime or parttime), and whether they were selfemployed. The questionnaire distinguished between the following education levels: Primary education (10-years in total); Upper secondary general education; Upper secondary vocational education; Vocational college/professional education (1/2\u0026ndash;2 years) after upper secondary vocational education; University/college education up to 4 years; University/college education more than 4 years. Respondents were asked whether a parent was still alive (with separate measurements for mother and father) and the geographical distance between the respondent\u0026rsquo;s home and the parent\u0026rsquo;s, for mother and father separately (Walking distance; Up to \u0026frac12; hour travel; Between \u0026frac12; hour and 1 hour travel; Between 1 and 2 hours travel; Between 2 and 3 hours travel; Between 3 and 4 hours travel; Over 4 hours travel; Lives in another country).\u003c/p\u003e \u003cp\u003e \u003cem\u003eA parent\u0026rsquo;s current need for help and personal care\u003c/em\u003e was assessed with nine items, using five-point ordinal scales. We used four of these items to develop composite scores for the need for help (household chores, house maintenance, shopping groceries, and digital technology), and we used a composite score for five items on the need for care (personal hygiene, eating, getting in or out of bed, dressing, and using the toilet). Adult children\u0026rsquo;s \u003cem\u003ecurrent help and care for parents\u003c/em\u003e during the last six months was measured with similar items as used in previous research (Gautun and Bratt \u003cspan citationid=\"CR3\" class=\"CitationRef\"\u003e2023\u003c/span\u003e), assessing administrative help, practical help, and personal care, with the following possible responses for each item: Daily, Weekly, Monthly, Less than once a month, Never. We reverse coded these items so that higher scores implied more help or care provided. \u003cem\u003eAdministrative help\u003c/em\u003e was assessed with three items: online payments of bills, phoning a doctor or similar health services, and assistance with using digital technology. \u003cem\u003ePractical help\u003c/em\u003e was assessed with seven items: household chores, shopping groceries, house maintenance, transport, activities, exercise, follow parent to a doctor. \u003cem\u003ePersonal care\u003c/em\u003e was assessed with five items as used in earlier research - help in/out bed, dressing, personal hygiene, use toilet, eat \u0026ndash; plus three new items on supervision of a parent: supervision of the parent due to dementia, somatic illness, or because they felt unsafe.\u003c/p\u003e \u003cp\u003e\u003cem\u003eAnticipated future increase in help and care\u003c/em\u003e if public services would be insufficient was assessed with binary items for (1) help and care by the respondent and (2) by others in the family. Respondents who indicated they themselves would provide more help and care to their parent if needed were asked how they would facilitate such help or care: by working less, by taking short unpaid leave, by taking extended leave, by retiring early, by moving in with the parent, or none of the above. As throughout the various questions on future help and care, respondents could tick multiple solutions. Those who indicated they would not be able to increase their help and care to parents were asked for reasons, with the following available responses: not willing, no need for help and care beyond public services, too large geographical distance from the parent, because of work obligations, because of respondent\u0026rsquo;s own health, because of family obligations, and other reasons.\u003c/p\u003e \u003cp\u003eAll respondents were asked whether they have received or wanted to receive various types of \u003cem\u003esupport from the municipality\u003c/em\u003e. The questionnaire used one item for each of the following forms of support from the municipality: information on services for older people, information about support for family caregivers, caregiver contact, participation in caregiver training, participation in support groups, relief care services and care allowance. All these items had three alternative responses: received, would like to receive, and not relevant.\u003c/p\u003e \u003cdiv id=\"Sec8\" class=\"Section2\"\u003e \u003ch2\u003eAnalysis\u003c/h2\u003e \u003cp\u003eWe used (1) descriptive analyses with tables and figures for frequencies, (2) probit regression for associations between various background variables and anticipated increase in informal help and care in the future, and (3) Structural Equation Modelling (SEM) for more extended analyses of respondents\u0026rsquo; willingness to increase their help and care if needed. In the latter analysis, current help and care to parents was included as a mediating variable (modelled as a latent variable with Confirmatory Factor Analysis, CFA).\u003c/p\u003e \u003cp\u003eThe factor analysis of current help and care applied a model developed by earlier research (Gautun and Bratt \u003cspan citationid=\"CR3\" class=\"CitationRef\"\u003e2023\u003c/span\u003e), using a factor model distinguishing between administrative help (e.g. paying bills online), practical help (e.g. cleaning the parent\u0026rsquo;s home), and personal care. Each of these three forms of assistance was assessed with multiple items, as described in the Methods section. Administrative help, practical help, and personal care were combined as indicators of a higher-order factor representing general Help and Care (as earlier research did). The factor model had good fit. We then added three new items referring to supervision of parents: supervision of parent due to dementia, due to somatic illness, and due to the parent feeling unsafe \u0026ndash; initially added as indicators of personal care. The supplementary material provides details on the CFA model used.\u003c/p\u003e \u003cp\u003eAnalyses used R 4.5.0 (R Core Team \u003cspan citationid=\"CR30\" class=\"CitationRef\"\u003e2025\u003c/span\u003e) and Mplus 8.11 (Muth\u0026eacute;n and Muth\u0026eacute;n \u003cspan citationid=\"CR24\" class=\"CitationRef\"\u003e2017\u003c/span\u003e). R packages of particular importance for the current research were knitr 1.50 (Xie \u003cspan citationid=\"CR39\" class=\"CitationRef\"\u003e2024\u003c/span\u003e) to develop the supplemental material, ggplot2 3.5.2 (Wickham \u003cspan citationid=\"CR36\" class=\"CitationRef\"\u003e2016\u003c/span\u003e) for drawing plots, kableExtra 1.4.0 (Zhu \u003cspan citationid=\"CR40\" class=\"CitationRef\"\u003e2024\u003c/span\u003e) to develop tables, and MplusAutomation 1.1.1 (Hallquist and Wiley \u003cspan citationid=\"CR10\" class=\"CitationRef\"\u003e2018\u003c/span\u003e) for running analyses with Mplus. All code used for data management and analyses is available in the Appendix to the supplementary material.\u003c/p\u003e \u003c/div\u003e"},{"header":"Results","content":"\u003cp\u003eNearly all respondents (91%) reported having provided one or more types of help or care to a parent in the last six months; 66 per cent had done so monthly or more frequently. Figure\u0026nbsp;\u003cspan class=\"InternalRef\"\u003e1\u003c/span\u003e shows frequencies of various forms of help provided to at least one parent; Fig.\u0026nbsp;\u003cspan class=\"InternalRef\"\u003e2\u003c/span\u003e presents data for personal care. Tables that distinguish between mothers and fathers among the parents are available in the supplementary material (Tables S1 and S2).\u003c/p\u003e\n\u003cp\u003eThese frequencies of help and care replicated findings from data collected three years earlier (Gautun and Bratt \u003cspan class=\"CitationRef\"\u003e2023\u003c/span\u003e); the results were remarkably similar across. Figures\u0026nbsp;\u003cspan class=\"InternalRef\"\u003e1\u003c/span\u003e and \u003cspan class=\"InternalRef\"\u003e2\u003c/span\u003e break down the numbers with more detailed statistics for various forms of help and care; additional analyses appear in the supplementary material. Below, we summarise key patterns.\u003c/p\u003e\n\u003cp\u003eThe most common type of help provided was assistance with using digital technology (68%). Other frequent forms of help (59\u0026ndash;48%) included house maintenance; transport of a parent; grocery shopping; paying bills, banking, and managing finances on behalf of the parent; and household chores. Also relatively frequent (38\u0026ndash;31%) were accompanying a parent to medical appointments; activities outside the home; and maintaining phone contact with public offices or services for the parent.\u003c/p\u003e\n\u003cp\u003eA minority had provided personal care, such as helping a parent dress or undress (7%); assisting with personal hygiene (7%); assisting with eating (6%); helping get in or out of bed (5%); or using the toilet (3%). Supervision, however, was more common: nearly one in three reported supervising a parent because of physical illness or injury (30%) or insecurity (28%), while fewer reported supervision because of cognitive impairment (17%). Figure\u0026nbsp;\u003cspan class=\"InternalRef\"\u003e2\u003c/span\u003e shows statistics for different forms of personal care.\u003c/p\u003e\n\u003cp\u003eThe supplementary material includes figures that distinguish between the gender of the adult child and of the parent (Figures S2 to S9). Daughters and sons showed moderate differences in help, but daughters provided more help to mothers than sons did. Daughters also provided more personal care to both parents.\u003c/p\u003e\n\u003ch3\u003eThe potential for increased family care\u003c/h3\u003e\n\u003cp\u003eRespondents were asked whether they anticipated offering additional help and care should public care services be inadequate. Responses were strikingly similar across daughters and sons. In total, 68 per cent of respondents were willing to increase their help and care if public services proved insufficient in the future (Table \u003cspan class=\"InternalRef\"\u003e1\u003c/span\u003e). Similarly, 70 per cent anticipated other family members would increase their contribution. More than half (55%) indicated that both they and other family members would increase their help and care to the parent (Figure S12 in the supplementary material provides details).\u003c/p\u003e\n\u003cdiv class=\"gridtable\"\u003e\n \u003ctable id=\"Tab1\" style=\"width: 534px;\" border=\"1\"\u003e\n \u003ccaption\u003e\n \u003cdiv class=\"CaptionNumber\"\u003eTable 1\u003c/div\u003e\n \u003cdiv class=\"CaptionContent\"\u003e\n \u003cp\u003e\u003cem\u003eWho will help when parents\u0026rsquo; needs increase?\u003c/em\u003e\u003c/p\u003e\n \u003c/div\u003e\n \u003c/caption\u003e\n \u003cthead\u003e\n \u003ctr\u003e\n \u003cth style=\"width: 110px;\" align=\"left\"\u003e\u0026nbsp;\u003c/th\u003e\n \u003cth style=\"width: 128px;\" colspan=\"2\" align=\"left\"\u003e\n \u003cp\u003eDaughters\u0026apos; responses\u003c/p\u003e\n \u003c/th\u003e\n \u003cth style=\"width: 138.694px;\" colspan=\"3\" align=\"left\"\u003e\n \u003cp\u003eSons\u0026apos; responses\u003c/p\u003e\n \u003c/th\u003e\n \u003cth style=\"width: 132.222px;\" colspan=\"3\" align=\"left\"\u003e\n \u003cp\u003eOverall\u003c/p\u003e\n \u003c/th\u003e\n \u003c/tr\u003e\n \u003c/thead\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 110px;\" align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd style=\"width: 41px;\" align=\"left\"\u003e\n \u003cp\u003eFreq.\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 87px;\" align=\"left\"\u003e\n \u003cp\u003ePercentage\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 20.3495px;\" colspan=\"2\" align=\"left\"\u003e\n \u003cp\u003eFreq.\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 125.345px;\" align=\"left\"\u003e\n \u003cp\u003ePercentage\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 20px;\" colspan=\"2\" align=\"left\"\u003e\n \u003cp\u003eFreq.\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 126.414px;\" align=\"left\"\u003e\n \u003cp\u003ePercentage\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 110px;\" align=\"left\"\u003e\n \u003cp\u003eRespondent\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 41px;\" align=\"left\"\u003e\n \u003cp\u003e1411\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 87px;\" align=\"left\"\u003e\n \u003cp\u003e69.60%\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 20px;\" align=\"left\"\u003e\n \u003cp\u003e1096\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 125.694px;\" colspan=\"2\" align=\"left\"\u003e\n \u003cp\u003e66.50%\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 20px;\" align=\"left\"\u003e\n \u003cp\u003e2507\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 128.414px;\" colspan=\"2\" align=\"left\"\u003e\n \u003cp\u003e68.25%\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 110px;\" align=\"left\"\u003e\n \u003cp\u003eOthers in the family\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 41px;\" align=\"left\"\u003e\n \u003cp\u003e1406\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 87px;\" align=\"left\"\u003e\n \u003cp\u003e69.40%\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 20px;\" align=\"left\"\u003e\n \u003cp\u003e1171\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 125.694px;\" colspan=\"2\" align=\"left\"\u003e\n \u003cp\u003e71.10%\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 20px;\" align=\"left\"\u003e\n \u003cp\u003e2577\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 128.414px;\" colspan=\"2\" align=\"left\"\u003e\n \u003cp\u003e70.16%\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 110px;\" align=\"left\"\u003e\n \u003cp\u003eNeighbours/friends\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 41px;\" align=\"left\"\u003e\n \u003cp\u003e310\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 87px;\" align=\"left\"\u003e\n \u003cp\u003e15.30%\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 20px;\" align=\"left\"\u003e\n \u003cp\u003e293\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 125.694px;\" colspan=\"2\" align=\"left\"\u003e\n \u003cp\u003e17.80%\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 20px;\" align=\"left\"\u003e\n \u003cp\u003e603\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 128.414px;\" colspan=\"2\" align=\"left\"\u003e\n \u003cp\u003e16.42%\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 110px;\" align=\"left\"\u003e\n \u003cp\u003ePrivate services\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 41px;\" align=\"left\"\u003e\n \u003cp\u003e366\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 87px;\" align=\"left\"\u003e\n \u003cp\u003e18.10%\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 20px;\" align=\"left\"\u003e\n \u003cp\u003e292\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 125.694px;\" colspan=\"2\" align=\"left\"\u003e\n \u003cp\u003e17.70%\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 20px;\" align=\"left\"\u003e\n \u003cp\u003e658\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 128.414px;\" colspan=\"2\" align=\"left\"\u003e\n \u003cp\u003e17.91%\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 110px;\" align=\"left\"\u003e\n \u003cp\u003eOthers\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 41px;\" align=\"left\"\u003e\n \u003cp\u003e68\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 87px;\" align=\"left\"\u003e\n \u003cp\u003e3.40%\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 20px;\" align=\"left\"\u003e\n \u003cp\u003e98\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 125.694px;\" colspan=\"2\" align=\"left\"\u003e\n \u003cp\u003e5.90%\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 20px;\" align=\"left\"\u003e\n \u003cp\u003e166\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 128.414px;\" colspan=\"2\" align=\"left\"\u003e\n \u003cp\u003e4.52%\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 110px;\" align=\"left\"\u003e\n \u003cp\u003eNone\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 41px;\" align=\"left\"\u003e\n \u003cp\u003e67\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 87px;\" align=\"left\"\u003e\n \u003cp\u003e3.30%\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 20px;\" align=\"left\"\u003e\n \u003cp\u003e63\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 125.694px;\" colspan=\"2\" align=\"left\"\u003e\n \u003cp\u003e3.80%\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 20px;\" align=\"left\"\u003e\n \u003cp\u003e130\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 128.414px;\" colspan=\"2\" align=\"left\"\u003e\n \u003cp\u003e3.54%\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 110px;\" align=\"left\"\u003e\n \u003cp\u003eDon\u0026apos;t know\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 41px;\" align=\"left\"\u003e\n \u003cp\u003e259\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 87px;\" align=\"left\"\u003e\n \u003cp\u003e12.80%\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 20px;\" align=\"left\"\u003e\n \u003cp\u003e219\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 125.694px;\" colspan=\"2\" align=\"left\"\u003e\n \u003cp\u003e13.30%\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 20px;\" align=\"left\"\u003e\n \u003cp\u003e478\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 128.414px;\" colspan=\"2\" align=\"left\"\u003e\n \u003cp\u003e13.01%\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n \u003ctfoot\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 602.785px;\" colspan=\"9\"\u003e\u003cem\u003eTable note.\u003c/em\u003e Multiple answers were possible\u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tfoot\u003e\n \u003c/table\u003e\n\u003c/div\u003e\n\u003cp\u003eAmong those indicating they were willing to increase their help and care for a parent, one in four indicated they would take short unpaid leave to facilitate such help and care, 15 per cent were willing to reduce working hours, and five per cent would take extended unpaid leave for longer periods such as a year (see Table\u0026nbsp;\u003cspan class=\"InternalRef\"\u003e2\u003c/span\u003e). Among those willing to increase their help and care, one in ten indicated they would move in with their parents, and nearly nine per cent would opt for early retirement. However, nearly six in ten would not make any of the adaptations mentioned. Slightly more sons than daughters suggested they would reduce working hours or opt for early retirement (likely reflecting more paid work among men to begin with), while slightly more daughters would take short unpaid leave, accept extended unpaid leave, or move in with a parent.\u003c/p\u003e\n\u003cdiv class=\"gridtable\"\u003e\n \u003ctable id=\"Tab2\" style=\"width: 476px;\" border=\"1\"\u003e\n \u003ccaption\u003e\n \u003cdiv class=\"CaptionNumber\"\u003eTable 2\u003c/div\u003e\n \u003cdiv class=\"CaptionContent\"\u003e\n \u003cp\u003e\u003cem\u003eHow will respondents ensure they can increase help and care?\u003c/em\u003e\u003c/p\u003e\n \u003c/div\u003e\n \u003c/caption\u003e\n \u003cthead\u003e\n \u003ctr\u003e\n \u003cth style=\"width: 109px;\" align=\"left\"\u003e\u0026nbsp;\u003c/th\u003e\n \u003cth style=\"width: 128px;\" colspan=\"2\" align=\"left\"\u003e\n \u003cp\u003eDaughters\u0026apos; responses\u003c/p\u003e\n \u003c/th\u003e\n \u003cth style=\"width: 92px;\" colspan=\"2\" align=\"left\"\u003e\n \u003cp\u003eSons\u0026apos; responses\u003c/p\u003e\n \u003c/th\u003e\n \u003cth style=\"width: 94px;\" colspan=\"2\" align=\"left\"\u003e\n \u003cp\u003eOverall\u003c/p\u003e\n \u003c/th\u003e\n \u003c/tr\u003e\n \u003c/thead\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 109px;\" align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd style=\"width: 41px;\" align=\"left\"\u003e\n \u003cp\u003eFreq.\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 87px;\" align=\"left\"\u003e\n \u003cp\u003ePercentage\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 28px;\" align=\"left\"\u003e\n \u003cp\u003eFreq.\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 64px;\" align=\"left\"\u003e\n \u003cp\u003ePercentage\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 26.1667px;\" align=\"left\"\u003e\n \u003cp\u003eFreq.\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 61px;\" align=\"left\"\u003e\n \u003cp\u003ePercentage\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 109px;\" align=\"left\"\u003e\n \u003cp\u003eWork less\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 41px;\" align=\"left\"\u003e\n \u003cp\u003e289\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 87px;\" align=\"left\"\u003e\n \u003cp\u003e14.30%\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 28px;\" align=\"left\"\u003e\n \u003cp\u003e275\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 64px;\" align=\"left\"\u003e\n \u003cp\u003e16.70%\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 33px;\" align=\"left\"\u003e\n \u003cp\u003e564\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 61px;\" align=\"left\"\u003e\n \u003cp\u003e15.40%\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 109px;\" align=\"left\"\u003e\n \u003cp\u003eTake unpaid leave\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 41px;\" align=\"left\"\u003e\n \u003cp\u003e536\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 87px;\" align=\"left\"\u003e\n \u003cp\u003e26.50%\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 28px;\" align=\"left\"\u003e\n \u003cp\u003e356\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 64px;\" align=\"left\"\u003e\n \u003cp\u003e21.60%\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 33px;\" align=\"left\"\u003e\n \u003cp\u003e892\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 61px;\" align=\"left\"\u003e\n \u003cp\u003e24.30%\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 109px;\" align=\"left\"\u003e\n \u003cp\u003eTake long leave\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 41px;\" align=\"left\"\u003e\n \u003cp\u003e98\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 87px;\" align=\"left\"\u003e\n \u003cp\u003e4.80%\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 28px;\" align=\"left\"\u003e\n \u003cp\u003e68\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 64px;\" align=\"left\"\u003e\n \u003cp\u003e4.10%\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 33px;\" align=\"left\"\u003e\n \u003cp\u003e166\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 61px;\" align=\"left\"\u003e\n \u003cp\u003e4.50%\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 109px;\" align=\"left\"\u003e\n \u003cp\u003eEarly retirement\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 41px;\" align=\"left\"\u003e\n \u003cp\u003e159\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 87px;\" align=\"left\"\u003e\n \u003cp\u003e7.80%\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 28px;\" align=\"left\"\u003e\n \u003cp\u003e155\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 64px;\" align=\"left\"\u003e\n \u003cp\u003e9.40%\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 33px;\" align=\"left\"\u003e\n \u003cp\u003e314\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 61px;\" align=\"left\"\u003e\n \u003cp\u003e8.60%\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 109px;\" align=\"left\"\u003e\n \u003cp\u003eCohabit with parent\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 41px;\" align=\"left\"\u003e\n \u003cp\u003e258\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 87px;\" align=\"left\"\u003e\n \u003cp\u003e12.70%\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 28px;\" align=\"left\"\u003e\n \u003cp\u003e174\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 64px;\" align=\"left\"\u003e\n \u003cp\u003e10.60%\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 33px;\" align=\"left\"\u003e\n \u003cp\u003e432\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 61px;\" align=\"left\"\u003e\n \u003cp\u003e11.80%\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 109px;\" align=\"left\"\u003e\n \u003cp\u003eNone of the above\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 41px;\" align=\"left\"\u003e\n \u003cp\u003e1135\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 87px;\" align=\"left\"\u003e\n \u003cp\u003e56.00%\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 28px;\" align=\"left\"\u003e\n \u003cp\u003e961\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 64px;\" align=\"left\"\u003e\n \u003cp\u003e58.40%\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 33px;\" align=\"left\"\u003e\n \u003cp\u003e2096\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 61px;\" align=\"left\"\u003e\n \u003cp\u003e57.10%\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n \u003c/table\u003e\n\u003c/div\u003e\n\u003cp\u003eAmong respondents reporting they were unable to increase their help and care for a parent, nearly one in three referred to geographical distance as hindering them from increasing their help and care to parents (Table\u0026nbsp;\u003cspan class=\"InternalRef\"\u003e3\u003c/span\u003e). Nearly one in five indicated that work commitments prevented them from providing more help and care, and more than one in ten indicated that their own health issues prevented increased help and care. Far fewer (6%) referred to the need to assist other family members. More daughters than sons reported being unable to provide additional help and care due to their own health issues.\u003c/p\u003e\n\u003cdiv class=\"gridtable\"\u003e\n \u003ctable id=\"Tab3\" border=\"1\"\u003e\n \u003ccaption\u003e\n \u003cdiv class=\"CaptionNumber\"\u003eTable 3\u003c/div\u003e\n \u003cdiv class=\"CaptionContent\"\u003e\n \u003cp\u003e\u003cem\u003eWhy do respondents expect not to help parents?\u003c/em\u003e\u003c/p\u003e\n \u003c/div\u003e\n \u003c/caption\u003e\n \u003cthead\u003e\n \u003ctr\u003e\n \u003cth align=\"left\"\u003e\u0026nbsp;\u003c/th\u003e\n \u003cth colspan=\"2\" align=\"left\"\u003e\n \u003cp\u003eDaughters\u0026apos; responses\u003c/p\u003e\n \u003c/th\u003e\n \u003cth colspan=\"2\" align=\"left\"\u003e\n \u003cp\u003eSons\u0026apos; responses\u003c/p\u003e\n \u003c/th\u003e\n \u003cth colspan=\"2\" align=\"left\"\u003e\n \u003cp\u003eOverall\u003c/p\u003e\n \u003c/th\u003e\n \u003c/tr\u003e\n \u003c/thead\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eFreq.\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003ePercentage\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eFreq.\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003ePercentage\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eFreq.\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003ePercentage\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eNot willing\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e126\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e6.20%\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e83\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e5.00%\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e209\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e5.70%\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eParent does not need\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e966\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e47.70%\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e867\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e52.60%\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e1833\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e49.90%\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eDistance too large\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e548\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e27.10%\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e442\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e26.80%\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e990\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e27.00%\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eOwn work too demanding\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e385\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e19.00%\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e282\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e17.10%\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e667\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e18.20%\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eOwn health\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e315\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e15.60%\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e130\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e7.90%\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e445\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e12.10%\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eOther family members need\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e139\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e6.90%\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e82\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e5.00%\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e221\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e6.00%\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eOther causes\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e116\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e5.70%\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e106\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e6.40%\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e222\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e6.00%\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n \u003c/table\u003e\n\u003c/div\u003e\n\u003cdiv id=\"Sec11\" class=\"Section2\"\u003e\n \u003ch2\u003eSEM analysis of the willingness to increase help and care\u003c/h2\u003e\n \u003cp\u003eThe supplementary material includes a probit regression with background variables as predictors; here, we focus on the more comprehensive analysis with SEM that included current help and care as a mediating variable. We considered various background variables as predictors (gender, age, parents\u0026rsquo; age, education, income, full-time employment, part-time employment, self-employment, and geographical distance from the parent). We added two predictors: parents\u0026rsquo; current need for help and their current need for personal care (both as reported by their adult children). We used respondents\u0026rsquo; current help and care as a mediating variable (as illustrated in Fig.\u0026nbsp;\u003cspan class=\"InternalRef\"\u003e1\u003c/span\u003e).\u003c/p\u003e\n \u003cp\u003eThe mediating variable, current help and care, was first tested on its own with CFA. We used the factor model of help and care developed by earlier research but added three items on supervision (supervision because of dementia, somatic illness, and feeling insecure), initially treating these as indicators of personal care. Through inspection of overall model fit, modification indices and residuals, we found that the three supervision items loaded primarily on the factor referred to as Practical help. Detailed results appear in the supplementary material, Tables S3 and S4.\u003c/p\u003e\n \u003cp\u003eApart from the latent variable representing current help and care, all predictors were normalised to scores between 0 and 1, making their unstandardised coefficients directly comparable. Details of these analyses are available in the supplementary material. Our final model employed a reduced set of predictors depicted in Fig.\u0026nbsp;\u003cspan class=\"InternalRef\"\u003e3\u003c/span\u003e.\u003c/p\u003e\n \u003cp\u003eThe strongest predictor of respondents\u0026rsquo; willingness to provide more help and care was geographical distance (\u003cem\u003eb\u003c/em\u003e = -1.06 [-1.32, -0.81] \u003cem\u003e\u0026szlig;\u003c/em\u003e = \u0026minus;\u0026thinsp;.26), mirroring this variable\u0026rsquo;s effect on current help and care (\u003cem\u003eb\u003c/em\u003e = -1.04 [-1.20, -0.89], \u003cem\u003e\u0026szlig;\u003c/em\u003e = \u0026minus;\u0026thinsp;.29). The model also included a direct path from personal care to willingness to increase help and care (testing its contribution beyond general Help and Care). The direct path from personal care proved negligible and with a 95 per cent CI indicating it could be either negative or positive.\u003c/p\u003e\n \u003cp\u003eParents\u0026rsquo; current need for help was a strong predictor of current help and care (\u003cem\u003eb\u003c/em\u003e\u0026thinsp;=\u0026thinsp;1.78 [95% CI\u0026thinsp;=\u0026thinsp;1.59, 1.97], \u003cem\u003e\u0026szlig;\u003c/em\u003e = .57), but not of willingness to provide more help and care in the future. Although its mediated effect via current help and care was positive (standardized mediation effect\u0026thinsp;=\u0026thinsp;.22), controlling for this mediation made the direct path (current need for help \u0026rarr; more help and care in the future) negative: \u003cem\u003eb\u003c/em\u003e\u0026thinsp;=\u0026thinsp;\u0026minus;\u0026thinsp;.60 [-0.94, -0.27], \u003cem\u003e\u0026szlig;\u003c/em\u003e = \u0026minus;\u0026thinsp;.16. Parents\u0026rsquo; need for care was unrelated to current help and care but negatively predicted anticipated future increase in help and care, with a small effect size (\u003cem\u003eb\u003c/em\u003e = -0.89 [-1.36, -0.41], \u003cem\u003e\u0026szlig;\u003c/em\u003e = \u0026minus;\u0026thinsp;.13).\u003c/p\u003e\n\u003c/div\u003e\n\u003cdiv id=\"Sec12\" class=\"Section2\"\u003e\n \u003ch2\u003eSupporting services\u003c/h2\u003e\n \u003cp\u003eIn a final analysis, we investigated respondents\u0026rsquo; use of or request for support from the municipality. A minority of the respondents received these types of municipal caregiver support: information about available services for their ageing parents, information about caregiver support, having a caregiver contact, participating in caregiver training, support groups, relief care services, and care allowance (see Table\u0026nbsp;\u003cspan class=\"InternalRef\"\u003e4\u003c/span\u003e).\u003c/p\u003e\n \u003cdiv class=\"gridtable\"\u003e\n \u003ctable id=\"Tab4\" style=\"width: 348px;\" border=\"1\"\u003e\n \u003ccaption\u003e\n \u003cdiv class=\"CaptionNumber\"\u003eTable 4\u003c/div\u003e\n \u003cdiv class=\"CaptionContent\"\u003e\n \u003cp\u003e\u003cem\u003eReceived or wanted support by the municipality\u003c/em\u003e\u003c/p\u003e\n \u003c/div\u003e\n \u003c/caption\u003e\n \u003cthead\u003e\n \u003ctr\u003e\n \u003cth style=\"width: 85px;\" align=\"left\"\u003e\u0026nbsp;\u003c/th\u003e\n \u003cth style=\"width: 88px;\" colspan=\"2\" align=\"left\"\u003e\n \u003cp\u003eOverall sample\u003c/p\u003e\n \u003c/th\u003e\n \u003cth style=\"width: 135.021px;\" colspan=\"2\" align=\"left\"\u003e\n \u003cp\u003eProvided personal care\u003c/p\u003e\n \u003cp\u003ein last six months\u003c/p\u003e\n \u003c/th\u003e\n \u003c/tr\u003e\n \u003c/thead\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 85px;\" align=\"left\"\u003e\n \u003cp\u003eType of support\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 27px;\" align=\"left\"\u003e\n \u003cp\u003eN\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 61px;\" align=\"left\"\u003e\n \u003cp\u003ePercentage\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 42.0208px;\" align=\"left\"\u003e\n \u003cp\u003eN\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 93px;\" align=\"left\"\u003e\n \u003cp\u003ePercentage\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 312px;\" colspan=\"5\" align=\"left\"\u003e\n \u003cp\u003eInformation about available services\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 85px;\" align=\"left\"\u003e\n \u003cp\u003eReceived\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 27px;\" align=\"left\"\u003e\n \u003cp\u003e230\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 61px;\" align=\"left\"\u003e\n \u003cp\u003e6.3%\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 42.0208px;\" align=\"left\"\u003e\n \u003cp\u003e178\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 93px;\" align=\"left\"\u003e\n \u003cp\u003e12.4%\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 85px;\" align=\"left\"\u003e\n \u003cp\u003eWants\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 27px;\" align=\"left\"\u003e\n \u003cp\u003e1458\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 61px;\" align=\"left\"\u003e\n \u003cp\u003e40.0%\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 42.0208px;\" align=\"left\"\u003e\n \u003cp\u003e811\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 93px;\" align=\"left\"\u003e\n \u003cp\u003e56.7%\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 85px;\" align=\"left\"\u003e\n \u003cp\u003eNot relevant\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 27px;\" align=\"left\"\u003e\n \u003cp\u003e1962\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 61px;\" align=\"left\"\u003e\n \u003cp\u003e53.8%\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 42.0208px;\" align=\"left\"\u003e\n \u003cp\u003e442\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 93px;\" align=\"left\"\u003e\n \u003cp\u003e30.9%\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 312px;\" colspan=\"5\" align=\"left\"\u003e\n \u003cp\u003eInformation about support to caregivers\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 85px;\" align=\"left\"\u003e\n \u003cp\u003eReceived\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 27px;\" align=\"left\"\u003e\n \u003cp\u003e142\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 61px;\" align=\"left\"\u003e\n \u003cp\u003e3.9%\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 42.0208px;\" align=\"left\"\u003e\n \u003cp\u003e108\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 93px;\" align=\"left\"\u003e\n \u003cp\u003e7.6%\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 85px;\" align=\"left\"\u003e\n \u003cp\u003eWants\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 27px;\" align=\"left\"\u003e\n \u003cp\u003e1332\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 61px;\" align=\"left\"\u003e\n \u003cp\u003e36.5%\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 42.0208px;\" align=\"left\"\u003e\n \u003cp\u003e774\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 93px;\" align=\"left\"\u003e\n \u003cp\u003e54.2%\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 85px;\" align=\"left\"\u003e\n \u003cp\u003eNot relevant\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 27px;\" align=\"left\"\u003e\n \u003cp\u003e2171\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 61px;\" align=\"left\"\u003e\n \u003cp\u003e59.6%\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 42.0208px;\" align=\"left\"\u003e\n \u003cp\u003e546\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 93px;\" align=\"left\"\u003e\n \u003cp\u003e38.2%\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 312px;\" colspan=\"5\" align=\"left\"\u003e\n \u003cp\u003eCaregiver contact\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 85px;\" align=\"left\"\u003e\n \u003cp\u003eReceived\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 27px;\" align=\"left\"\u003e\n \u003cp\u003e113\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 61px;\" align=\"left\"\u003e\n \u003cp\u003e3.1%\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 42.0208px;\" align=\"left\"\u003e\n \u003cp\u003e86\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 93px;\" align=\"left\"\u003e\n \u003cp\u003e6.0%\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 85px;\" align=\"left\"\u003e\n \u003cp\u003eWants\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 27px;\" align=\"left\"\u003e\n \u003cp\u003e1080\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 61px;\" align=\"left\"\u003e\n \u003cp\u003e29.7%\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 42.0208px;\" align=\"left\"\u003e\n \u003cp\u003e663\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 93px;\" align=\"left\"\u003e\n \u003cp\u003e46.5%\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 85px;\" align=\"left\"\u003e\n \u003cp\u003eNot relevant\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 27px;\" align=\"left\"\u003e\n \u003cp\u003e2448\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 61px;\" align=\"left\"\u003e\n \u003cp\u003e67.2%\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 42.0208px;\" align=\"left\"\u003e\n \u003cp\u003e677\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 93px;\" align=\"left\"\u003e\n \u003cp\u003e47.5%\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 312px;\" colspan=\"5\" align=\"left\"\u003e\n \u003cp\u003eParticipated in caregiver training\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 85px;\" align=\"left\"\u003e\n \u003cp\u003eReceived\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 27px;\" align=\"left\"\u003e\n \u003cp\u003e77\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 61px;\" align=\"left\"\u003e\n \u003cp\u003e2.1%\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 42.0208px;\" align=\"left\"\u003e\n \u003cp\u003e60\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 93px;\" align=\"left\"\u003e\n \u003cp\u003e4.2%\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 85px;\" align=\"left\"\u003e\n \u003cp\u003eWants\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 27px;\" align=\"left\"\u003e\n \u003cp\u003e625\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 61px;\" align=\"left\"\u003e\n \u003cp\u003e17.2%\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 42.0208px;\" align=\"left\"\u003e\n \u003cp\u003e403\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 93px;\" align=\"left\"\u003e\n \u003cp\u003e28.3%\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 85px;\" align=\"left\"\u003e\n \u003cp\u003eNot relevant\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 27px;\" align=\"left\"\u003e\n \u003cp\u003e2937\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 61px;\" align=\"left\"\u003e\n \u003cp\u003e80.7%\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 42.0208px;\" align=\"left\"\u003e\n \u003cp\u003e960\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 93px;\" align=\"left\"\u003e\n \u003cp\u003e67.5%\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 312px;\" colspan=\"5\" align=\"left\"\u003e\n \u003cp\u003eParticipated in support group\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 85px;\" align=\"left\"\u003e\n \u003cp\u003eReceived\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 27px;\" align=\"left\"\u003e\n \u003cp\u003e44\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 61px;\" align=\"left\"\u003e\n \u003cp\u003e1.2%\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 42.0208px;\" align=\"left\"\u003e\n \u003cp\u003e36\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 93px;\" align=\"left\"\u003e\n \u003cp\u003e2.5%\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 85px;\" align=\"left\"\u003e\n \u003cp\u003eWants\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 27px;\" align=\"left\"\u003e\n \u003cp\u003e371\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 61px;\" align=\"left\"\u003e\n \u003cp\u003e10.2%\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 42.0208px;\" align=\"left\"\u003e\n \u003cp\u003e252\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 93px;\" align=\"left\"\u003e\n \u003cp\u003e17.7%\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 85px;\" align=\"left\"\u003e\n \u003cp\u003eNot relevant\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 27px;\" align=\"left\"\u003e\n \u003cp\u003e3221\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 61px;\" align=\"left\"\u003e\n \u003cp\u003e88.6%\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 42.0208px;\" align=\"left\"\u003e\n \u003cp\u003e1133\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 93px;\" align=\"left\"\u003e\n \u003cp\u003e79.7%\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 312px;\" colspan=\"5\" align=\"left\"\u003e\n \u003cp\u003eRelief care services\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 85px;\" align=\"left\"\u003e\n \u003cp\u003eReceived\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 27px;\" align=\"left\"\u003e\n \u003cp\u003e59\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 61px;\" align=\"left\"\u003e\n \u003cp\u003e1.6%\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 42.0208px;\" align=\"left\"\u003e\n \u003cp\u003e53\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 93px;\" align=\"left\"\u003e\n \u003cp\u003e3.7%\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 85px;\" align=\"left\"\u003e\n \u003cp\u003eWants\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 27px;\" align=\"left\"\u003e\n \u003cp\u003e555\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 61px;\" align=\"left\"\u003e\n \u003cp\u003e15.3%\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 42.0208px;\" align=\"left\"\u003e\n \u003cp\u003e408\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 93px;\" align=\"left\"\u003e\n \u003cp\u003e28.7%\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 85px;\" align=\"left\"\u003e\n \u003cp\u003eNot relevant\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 27px;\" align=\"left\"\u003e\n \u003cp\u003e3021\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 61px;\" align=\"left\"\u003e\n \u003cp\u003e83.1%\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 42.0208px;\" align=\"left\"\u003e\n \u003cp\u003e960\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 93px;\" align=\"left\"\u003e\n \u003cp\u003e67.6%\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 312px;\" colspan=\"5\" align=\"left\"\u003e\n \u003cp\u003eCare allowance\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 85px;\" align=\"left\"\u003e\n \u003cp\u003eReceived\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 27px;\" align=\"left\"\u003e\n \u003cp\u003e24\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 61px;\" align=\"left\"\u003e\n \u003cp\u003e0.7%\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 42.0208px;\" align=\"left\"\u003e\n \u003cp\u003e19\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 93px;\" align=\"left\"\u003e\n \u003cp\u003e1.3%\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 85px;\" align=\"left\"\u003e\n \u003cp\u003eWants\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 27px;\" align=\"left\"\u003e\n \u003cp\u003e478\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 61px;\" align=\"left\"\u003e\n \u003cp\u003e13.3%\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 42.0208px;\" align=\"left\"\u003e\n \u003cp\u003e324\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 93px;\" align=\"left\"\u003e\n \u003cp\u003e22.9%\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 85px;\" align=\"left\"\u003e\n \u003cp\u003eNot relevant\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 27px;\" align=\"left\"\u003e\n \u003cp\u003e3104\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 61px;\" align=\"left\"\u003e\n \u003cp\u003e86.1%\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 42.0208px;\" align=\"left\"\u003e\n \u003cp\u003e1073\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 93px;\" align=\"left\"\u003e\n \u003cp\u003e75.8%\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n \u003c/table\u003e\n \u003c/div\u003e\n \u003cp\u003eFour out of ten expressed a need for information about available eldercare services in the municipality. Respondents also needed more information about caregiver support, a caregiver contact, and relief services. However, few expressed a need for support groups (10%) or for care allowance (13%). These numbers were higher among respondents who had provided personal care during the last six months (see Table\u0026nbsp;\u003cspan class=\"InternalRef\"\u003e3\u003c/span\u003e). Among personal care providers, demand for municipal support was substantially higher across all categories, highlighting the greater strain experienced by intensive caregivers.\u003c/p\u003e\n\u003c/div\u003e"},{"header":"Discussion","content":"\u003cp\u003e A majority reported having provided help or care to older parents in the last six months. Most common was assistance with digital technology (reported by two in three). Other frequently reported tasks included house maintenance, transport, grocery shopping, managing finances, and household chores. Additionally, for each of the following tasks, approximately a third reported having performed them: accompanying parents to medical appointments or care services, supporting activities outside the parent\u0026rsquo;s home, and maintaining phone contact with public offices and services on behalf of the parent. Personal care for parents was rarer, with similar numbers as in earlier Norwegian studies (Rom\u0026oslash;ren \u003cspan citationid=\"CR31\" class=\"CitationRef\"\u003e2004\u003c/span\u003e; Gautun and Hagen \u003cspan citationid=\"CR6\" class=\"CitationRef\"\u003e2010\u003c/span\u003e; Gautun and Bratt \u003cspan citationid=\"CR3\" class=\"CitationRef\"\u003e2023\u003c/span\u003e). However, approximately one in three reported supervision of a parent because of physical illness or injury, a similar number reported supervision because the parent had felt insecure; and nearly two out of ten due to cognitive impairment or dementia. We found only moderate differences between daughters and sons in help provided to parents, though daughters provided more help to mothers than sons did. Daughters also reported more personal care for both mothers and fathers.\u003c/p\u003e \u003cdiv id=\"Sec14\" class=\"Section2\"\u003e \u003ch2\u003eA considerable potential for expanding family-provided care for older people\u003c/h2\u003e \u003cp\u003eIn recent years, older people\u0026rsquo; relatives have faced increasing pressure to provide more help and care. Central authorities, local authorities, and eldercare services now all exert such pressure on family members (Jakobsson et al. \u003cspan citationid=\"CR19\" class=\"CitationRef\"\u003e2016\u003c/span\u003e; Norwegian Ministry of Health and Care Services \u003cspan citationid=\"CR26\" class=\"CitationRef\"\u003e2018\u003c/span\u003e, \u003cspan citationid=\"CR25\" class=\"CitationRef\"\u003e2023\u003c/span\u003e). However, little has been known about the realism of these appeals. Surveys show the population believes public eldercare services should bear the primary responsibility for providing care to older people (Lingsom \u003cspan citationid=\"CR21\" class=\"CitationRef\"\u003e1989\u003c/span\u003e; Herlofson et al. \u003cspan citationid=\"CR13\" class=\"CitationRef\"\u003e2019\u003c/span\u003e). This view aligns with the legal obligation of public authorities in Norway to provide care and support to care-needing adults. However, health authorities increasingly signal that demographic changes will widen the gap between supply and demand for public health and care services (Norwegian Ministry of Health and Care Services \u003cspan citationid=\"CR25\" class=\"CitationRef\"\u003e2023\u003c/span\u003e). Authorities are now preparing the population for an emerging reality in which older people will have access to more limited public eldercare services. Our analyses indicate that citizens are increasingly aware of this shift in eldercare provision and its implications for family responsibility. Seven of ten respondents expressed willingness to increase help and care to parents should public services prove insufficient. A similar number reported that other family members would increase contributions. More than half of the respondents stated that both they and other family members would increase their assistance to parents. These responses were strikingly similar across daughters and sons.\u003c/p\u003e \u003cp\u003eThe sociologist Hagestad (\u003cspan citationid=\"CR9\" class=\"CitationRef\"\u003e1999\u003c/span\u003e) has described the family as an \"omnibus institution,\" meaning that the family steps in to fulfil caregiving needs that the welfare state fails to address. Previous research, as well as the current study, confirms this observation about family's adaptive caregiving role. The welfare state contributes with medical and personal care, while next of kin provide substantial practical help and support. Most respondents in the current study are willing to contribute more if needed.\u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec15\" class=\"Section2\"\u003e \u003ch2\u003eWilling to make significant life adjustments to offer extra care\u003c/h2\u003e \u003cp\u003eAmong respondents willing to increase help and care for a parent, a quarter indicated they would take short unpaid leave to facilitate such assistance, while others indicated they would reduce working hours (15%) or take extended unpaid leave for up to a year (5%). One in ten were willing to move in with their parents, and approximately one in ten would consider early retirement. Nearly 60% would not make such adjustments. Sons were more likely to reduce working hours or retire early, while daughters were more inclined to take short unpaid leave, extended leave, or move in with a parent.\u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec16\" class=\"Section2\"\u003e \u003ch2\u003eDeveloping policies to facilitate family care\u003c/h2\u003e \u003cp\u003eThe willingness to reduce work to facilitate helping and caring for parents comes at a cost \u0026ndash; even for society at large. If caregivers choose to reduce their working hours or take early retirement to provide care for older relatives, this could conflict with society\u0026rsquo;s growing need for people of working age remaining in full employment. The increasing demand for caregivers to provide more care while continuing to work underscores the need for a collaboration between authorities responsible for eldercare policy and those overseeing labour market policies (Gautun and Bratt \u003cspan citationid=\"CR4\" class=\"CitationRef\"\u003e2024\u003c/span\u003e). Different authorities ought to collaborate in developing policies that facilitate the ability to balance the roles of full-time employees and caregivers. Specifically, labour policies need to prevent employees from retiring permanently due to caregiving. This would be possible by establishing a legal right for caregivers who take early retirement for caregiving to return to full-time employment if the caregiving period ends prior to the general retirement age.\u003c/p\u003e \u003cp\u003eShifting governments have emphasized the need for support for family caregivers of older relatives (Norwegian Ministry of Health and Care Services \u003cspan citationid=\"CR26\" class=\"CitationRef\"\u003e2018\u003c/span\u003e, \u003cspan citationid=\"CR25\" class=\"CitationRef\"\u003e2023\u003c/span\u003e). In 2023, the government launched a four-year \"Stay Safe at Home\" reform, recommending that municipalities provide various types of caregiver support (Norwegian Ministry of Health and Care Services \u003cspan citationid=\"CR25\" class=\"CitationRef\"\u003e2023\u003c/span\u003e). Only a minority of respondents had received this caregiver support from their municipality. Four in ten indicated they needed information on available eldercare services. Respondents also need more information on caregiver support, caregiver contact, and relief services. However, few expressed need for support groups or care allowance.\u003c/p\u003e \u003cp\u003eOur survey demonstrates the necessity of enhanced municipal support tailored to caregivers. However, limited resources and personnel shortages in municipalities may motivate authorities to deprioritise caregiver support. That could easily be counterproductive. Implementing low-resource initiatives for family caregivers can be a low-cost measure benefitting expanded family caregiving and reducing the need for costly eldercare services or institutional care.\u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec17\" class=\"Section2\"\u003e \u003ch2\u003eImplications of not having children\u003c/h2\u003e \u003cp\u003eOne group of older people is not covered by our research nor by initiatives to mobilise family members as caregivers: childless older people. Statistics from Statistics Norway shows that one in four older individuals (aged 67 and older) living alone lack family nearby, defined as within a 30-minute driving distance (Haugen \u003cspan citationid=\"CR12\" class=\"CitationRef\"\u003e2025\u003c/span\u003e). Some of these individuals are childless, and also have no other family members who might provide help and care (Haugen \u003cspan citationid=\"CR12\" class=\"CitationRef\"\u003e2025\u003c/span\u003e). A particularly vulnerable group of childless older adults that has received little attention is older immigrants living alone. In total, 32% of older adults with an immigrant background (aged 67 and above) live alone (Statistics Norway 2025\u003csup\u003e1\u003c/sup\u003e). This group includes men who never married and established a family. Research shows that individuals with an immigrant background are less likely to use health and care services (Syse and T\u0026oslash;nnessen \u003cspan citationid=\"CR33\" class=\"CitationRef\"\u003e2022\u003c/span\u003e). Childless older immigrants is especially at risk of having their needs for eldercare services unmet. Authorities planning to involve family members to provide help and care to older people also need to develop plans for how to address the needs of the older people who have no family to help them, so that ageing in place is realistic even for the childless older people.\u003c/p\u003e \u003c/div\u003e"},{"header":"Conclusion","content":"\u003cp\u003eAn ageing in place policy mounts pressure on families to offer additional care for older people. This study reveals significant potential for expanding family-provided care for older people in Norway. The findings emphasize the need for enhanced municipal support tailored to caregivers. Implementing low-resource initiatives for family caregivers could serve as a cost-effective strategy, fostering increased family caregiving while reducing reliance on costly eldercare services and institutional care.\u003c/p\u003e"},{"header":"References","content":"\u003col\u003e\u003cli\u003e\u003cspan\u003eBlix BH, \u0026Aring;gotnes G (2023) Aging Successfully in the Changing Norwegian Welfare State: A Policy Analysis Framed by Critical Gerontology. 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Report Generation in R\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eZhu H (2024) kableExtra: Construct Complex Table with kable and Pipe Syntax, R package version 1.4.0\u003c/span\u003e\u003c/li\u003e\u003c/ol\u003e"},{"header":"Footnotes","content":"\u003col\u003e\u003cli\u003e\u003cspan\u003e Statistics provided by Magnus Haug, Senior Advisor, Section for Population Statistics Norway (January 3, 2025)\u003c/span\u003e\u003c/li\u003e\u003c/ol\u003e"}],"fulltextSource":"","fullText":"","funders":[{"identity":"3f6fdef8-5402-4b0c-9ea4-9461b06cead6","identifier":"10.13039/501100005416","name":"Norges Forskningsråd","awardNumber":"344102","order_by":0}],"hasAdminPriorityOnWorkflow":false,"hasManuscriptDocX":true,"hasOptedInToPreprint":true,"hasPassedJournalQc":"","hasAnyPriority":true,"hideJournal":true,"highlight":"","institution":"OsloMet – Oslo Metropolitan University","isAcceptedByJournal":false,"isAuthorSuppliedPdf":false,"isDeskRejected":"","isHiddenFromSearch":false,"isInQc":false,"isInWorkflow":true,"isPdf":false,"isPdfUpToDate":true,"isWithdrawnOrRetracted":false,"journal":{"display":true,"email":"[email protected]","identity":"researchsquare","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":true,"externalIdentity":"","sideBox":"","snPcode":"","submissionUrl":"/submission","title":"Research Square","twitterHandle":"researchsquare","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"","reportingPortfolio":"","inReviewEnabled":false,"inReviewRevisionsEnabled":true},"keywords":"ageing in place, family caregivers, adult-child caregivers, caregiver support services, informal care capacity","lastPublishedDoi":"10.21203/rs.3.rs-6882140/v1","lastPublishedDoiUrl":"https://doi.org/10.21203/rs.3.rs-6882140/v1","license":{"name":"CC BY 4.0","url":"https://creativecommons.org/licenses/by/4.0/"},"manuscriptAbstract":"\u003cp\u003eAs ageing in place becomes a central component of eldercare strategies, family members of older adults face mounting pressure to provide more care for older people. By analysing data from Norway, this paper explores the potential for expanding family care for older relatives living in their own homes. We address the following questions: (1) To what extent do adult children provide help and care for their ageing parents? (2) Is there potential for expanding family care? (3) Do caregivers need municipal support aimed at supporting family caregivers? In March 2025, we surveyed a nationwide sample of 3,673 respondents aged 45 to 67, each with at least one parent residing in their own home. We analyse the data using descriptive statistics, Confirmatory Factor Analysis and Structural Equation Modelling. Respondents provided various types of practical and administrative help. Seven in ten respondents indicated a willingness to extend care if public care services inadequately meet parents' needs as frailty increases. An equal proportion indicated that other family members would increase care. Four in ten were willing to make one or more significant life adjustments to offer extra care: taking short unpaid leave, reducing working hours, moving in with their parents, opting for early retirement, and/or taking extended unpaid leave, such as for a year. Respondents expressed a need for enhanced municipal support tailored to caregivers. We conclude that implementing low-resource initiatives for family caregivers could be a cost-effective strategy, enabling increased family caregiving while reducing reliance on costly eldercare services and institutional care.\u003c/p\u003e\n\u003cp\u003e\u003cbr\u003e\u003c/p\u003e","manuscriptTitle":"Enabling Ageing in Place: The Potential for Expanded Family Care","msid":"","msnumber":"","nonDraftVersions":[{"code":1,"date":"2025-06-16 07:55:07","doi":"10.21203/rs.3.rs-6882140/v1","editorialEvents":[{"type":"communityComments","content":0}],"status":"published","journal":{"display":true,"email":"[email protected]","identity":"researchsquare","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":true,"externalIdentity":"","sideBox":"","snPcode":"","submissionUrl":"/submission","title":"Research Square","twitterHandle":"researchsquare","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"","reportingPortfolio":"","inReviewEnabled":false,"inReviewRevisionsEnabled":true}}],"origin":"","ownerIdentity":"3267c6cd-a2b8-40b9-b18d-bfba19035ce1","owner":[],"postedDate":"June 16th, 2025","published":true,"recentEditorialEvents":[],"rejectedJournal":[],"revision":"","amendment":"","status":"posted","subjectAreas":[{"id":49965596,"name":"Sociology"}],"tags":[],"updatedAt":"2025-06-16T07:55:08+00:00","versionOfRecord":[],"versionCreatedAt":"2025-06-16 07:55:07","video":"","vorDoi":"","vorDoiUrl":"","workflowStages":[]},"version":"v1","identity":"rs-6882140","journalConfig":"researchsquare"},"__N_SSP":true},"page":"/article/[identity]/[[...version]]","query":{"redirect":"/article/rs-6882140","identity":"rs-6882140","version":["v1"]},"buildId":"8U1c8b4HqxoKbykW_rLl7","isFallback":false,"isExperimentalCompile":false,"dynamicIds":[84888],"gssp":true,"scriptLoader":[]}