Informal Caregiving in Germany: Burden, Support Needs, and Implications for Public Health

Background

Around 5 million people in Germany provide informal care. Caregiving can cause substantial psychological, physical, financial, and time-related burden. However, support services are often underused yet. Evidence remains limited on which informal caregivers (IC) are particularly burdened and which support needs are insufficiently met. This study examined determinants of perceived caregiving burden and support needs among IC in Germany.

Methods

We conducted a cross-sectional questionnaire survey among IC in Germany (n = 3,267). Data included information on the caregiving situation, use of support services, unmet needs, and perceived caregiving burden measured with the Burden Scale for Family Caregivers (BSFC-s). Multivariable regression analyses identified factors associated with perceived burden. Open-text responses were analyzed using qualitative content analysis. Recommendations for action were derived together with experts.

Results

In the fully adjusted model, higher perceived caregiving burden was associated with higher care level (b = 0.57), more care-dependent persons (b = 0.93), formal service use (b = 0.52), and greater care intensity (all p < 0.01). Providing psychological support showed one of the strongest associations with burden (b = 2.83, p < 0.01). IC mainly used financial and in-kind benefits, while counselling services and health education were unknown to the majority. Qualitative findings further highlighted insufficient information on available services and benefit entitlements.

Conclusions

IC with intensive and complex care responsibilities experience particularly high burden. Public health interventions should prioritize proactive information, targeted counselling, and accessible support services for high-burden caregiver groups. These findings provide an evidence base for needs-oriented service planning and prevention strategies.

Key messages

• Caregiving burden is highest among informal caregivers with intensive and complex responsibilities, highlighting the need for targeted support.

• Support for informal caregivers must become more accessible, as counselling and health education services remain unknown to many.