Distributed Care, Not Solo Sacrifice or Full Delegation: Shared Caregiving Arrangements and Caregiver Wellbeing
Abstract
Among adults coordinating care for an aging parent, those in a distributed-care arrangement — an explicit, agreed division of caregiving tasks among two or more family members, supplemented by some paid support — reported lower caregiving strain (28%) and higher relationship satisfaction with the care recipient (7.3/10) at a one-year follow-up than adults who provided solo, largely unshared care (36% strain, 6.0/10 satisfaction) or adults who fully delegated care to paid providers with minimal personal involvement (33% strain, 5.7/10 satisfaction).
1. Introduction
Family caregiving for aging parents is often discussed as a choice between two extremes: one family member takes on the caregiving role largely alone, or the family delegates care entirely to outside providers. We looked at a middle arrangement, an explicit, agreed division of caregiving responsibilities across multiple family members combined with some paid support, and asked how it relates to caregiver wellbeing and relationship quality with the care recipient, next to the two more common setups.
2. Method (Summary)
We surveyed 298 adults who had coordinated care for a parent aged 70 or older for at least one year. Respondents were classified by care arrangement: solo (one family member provided the substantial majority of care with little formal sharing), full-delegation (care was primarily provided by paid professionals, with occasional family visits but no regular hands-on caregiving from family), or distributed (an explicit division of specific caregiving tasks — e.g., scheduling visits, running errands, and regular check-in calls — across two or more family members, combined with some paid support). Caregiving strain was measured with a standard self-report scale and expressed as the percentage of respondents scoring in the upper third of the scale; relationship satisfaction with the care recipient was assessed with a standard 10-point satisfaction scale. Both were collected at a one-year follow-up.
3. Findings
The distributed-care group reported the lowest caregiving strain (28%) and the highest relationship satisfaction with the care recipient (7.3/10). The solo-care group reported the highest strain (36%) and intermediate relationship satisfaction (6.0/10), with many respondents describing resentment toward other family members alongside continued closeness with the parent. The full-delegation group reported intermediate strain (33%) but the lowest relationship satisfaction (5.7/10), with respondents in this group most often citing guilt and a sense of reduced closeness despite lower day-to-day workload.
4. Discussion
Distributed care likely lowers strain relative to solo care simply by spreading the load across more than one person, but the relationship-satisfaction gap over full delegation points to something more specific: dividing tasks explicitly lets family members stay meaningfully involved without any one person absorbing the full burden, which preserves the relational side of caregiving that full delegation seems to lose. The full-delegation group's relatively poor relationship-satisfaction outcome, despite lower strain than solo care, suggests caregiver strain and relationship quality are not the same target, and a distributed arrangement may be better positioned to serve both. Solo care and full delegation, despite sitting at near-opposite ends of how much hands-on labor a family member does, produced similarly modest outcomes on both strain and relationship satisfaction in this sample. Each arrangement's downside seems to offset its own upside: solo caregivers keep more direct relational contact with the parent but carry more day-to-day workload, while caregivers who fully delegate carry less workload but describe guilt and reduced closeness. That trade-off may be what keeps the two arrangements in a broadly comparable range on both measures, even though the underlying caregiving experience differs substantially between them.
5. Limitations and Future Directions
Family composition (e.g., number of siblings, geographic proximity) was not controlled for and likely constrains which arrangement is feasible in the first place, independent of its effects. Care recipients' own perspective on relationship quality was not collected, only the caregiver's. A planned follow-up will survey care recipients directly and track families longitudinally as care needs change over time.
Editorial Note
This report underwent CfAHC's Rapid Review Protocol, including AI-assisted literature cross-checking and a two-reviewer human sign-off.