Older caregivers’ responsibilities and strategies for their cohabiting partners living at home—a qualitative systematic literature review
Bibliographic record
Abstract
Background: Ageing-in-place policies have increasingly shifted elder care responsibilities onto family members. Among older cohabiting couples, one's partner's illness significantly impacts the other's daily life and well-being. Aim: To explore the responsibilities and strategies of caregiving partners in older cohabiting couples from the perspectives of cohabiting caregivers. Methods: A qualitative systematic literature review was conducted across seven databases, following PRISMA guidelines and registered in PROSPERO (CRD42025632103). Sixty-five studies were included based on predefined inclusion and exclusion criteria using Covidence. Quality was assessed using the Critical Appraisal Skills Programme (CASP) checklist for qualitative studies. Data were synthesised through descriptive numerical summaries and thematic analysis. Results: The studies, conducted in 20 countries, primarily used individual interviews for data collection. Three overarching themes emerged: (1) strategies directed towards the partner, (2) strategies to maintain personal identity and space, and (3) strategies for navigating formal care systems. Cohabiting caregivers often assumed daily responsibilities despite emotional and physical strain. They relied on both informal and formal support to care for their partner and preserve time for themselves. However, formal care involvement led to issues such as broken agreements and inadequate services. Conclusion: Older cohabiting caregivers constantly balance and adapt their caregiving roles in relation to their partner, themselves, and formal care providers. This shift in responsibility results in an often invisible, morally-driven labour that remains under-recognised in Ageing-in-place policies. The study highlights the need for policy frameworks and interventions that acknowledge caregivers' moral labour, enhance the quality of formal care, and support caregiver autonomy. Clinical trial registration: https://www.crd.york.ac.uk/PROSPERO/view/CRD42025632103, identifier (CRD42025632103).
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.038 | 0.066 |
| Meta-epidemiology (narrow) | 0.001 | 0.001 |
| Meta-epidemiology (broad) | 0.003 | 0.003 |
| Bibliometrics | 0.017 | 0.016 |
| Science and technology studies | 0.003 | 0.002 |
| Scholarly communication | 0.003 | 0.005 |
| Open science | 0.002 | 0.004 |
| Research integrity | 0.002 | 0.001 |
| Insufficient payload (model declined to judge) | 0.003 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".