Double-duty caregivers enduring COVID-19 pandemic to endemic: “It’s just wearing me down”
Open accessAbstract
The COVID-19 pandemic has considerably strained health care providers and family caregivers. Double-duty caregivers give unpaid care at home and are employed as care providers. This sequential mixed-method study, a survey followed by qualitative interviews, aimed to comprehensively understand the experiences of these Canadian double-duty caregivers amidst the pandemic and the transition to the endemic phase. The multi-section survey included standardized assessments such as the Double-duty Caregiver Scale and the State Anxiety Scale, along with demographic, employment-related, and care work questions. Data analysis employed descriptive and linear regression modeling statistics, and content analysis of the qualitative data. Out of the 415 respondents, the majority were female (92.5%) and married (77.3%), with 54.9% aged 35 to 54 years and 29.2% 55 to 64 years. 68.9% reported mental health decline over the past year, while 60.7% noted physical health deteriorated. 75.9% of participants self-rated their anxiety as moderate to high. The final regression model explained 36.8% of the variance in participants’ anxiety levels. Factors contributing to lower anxiety included more personal supports, awareness of limits, younger age, and fewer weekly employment hours. Increased anxiety was linked to poorer self-rated health, and both perceptions and consequences of blurred boundaries. The eighteen interviewees highlighted the stress of managing additional work and home care during the pandemic. They highlighted the difficulty navigating systems and coordinating care. Double-duty caregivers form a significant portion of the healthcare workforce. Despite the spotlight on care and caregiving during the COVID-19 pandemic, the vital contributions and well-being of double-duty caregivers and family caregivers have remained unnoticed. Prioritizing their welfare is crucial for health systems as they make up the largest care workforce, particularly evident during the ongoing healthcare workforce shortage.
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Double-duty caregivers are increasingly common within the health and social care workforce.
“Within the health and social care workforce itself, double-duty caregivers, paid providers who also deliver substantial unpaid care at home, are increasingly common [19,20,21].”
From Home care comparison (2026) · cites this paper as [21]
The 'Double-duty caregivers and the impacts of COVID-19' section defines double-duty caregivers as healthcare workers who provide unpaid care at home, and the Abstract says they form a significant portion of the healthcare workforce. Neither passage establishes that they are becoming more common; the Introduction's increase in caregiving hours concerns employed family caregivers generally, not the prevalence of double-duty caregivers. (LLM, conf=0.86)
Experimental — accuracy not yet measuredIn some continuing care settings in Alberta, more than half of staff also provide unpaid care at home.
“In some continuing care settings in Alberta, more than half of staff also provide unpaid care at home [21].”
From Home care comparison (2026) · cites this paper as [21]
The paper’s “Double-duty caregivers and the impacts of COVID-19” section defines healthcare workers who provide unpaid care at home and says at least one-third of employed health providers are family caregivers. It does not report that more than half of staff in any Alberta continuing care setting provide unpaid care at home; its Results describe a survey of double-duty caregivers, not a prevalence estimate for continuing care staff. (LLM, conf=0.83)
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References 95 · Cited by 11
Research works printed but not linked: 2
- [8]Banerjee S, MacDougall D. CADTH Health Technology Review. Interventions to address and prevent violence toward health care workers in the emergency department. [Internet]. Ottawa, ON: CADTH Health Technology Review; 2021 [cited 2022 Jul 12]. Available from: https://www.ncbi.nlm.nih.gov/books/NBK584543/pdf/Bookshelf_NBK584543.pdf 36170468
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- Authors
- Parmar, J., L’Heureux, T., Lobchuk, M., Penner, J., Charles, L., St. Amant, O., Ward-Griffin, C., & Anderson, S.
- Affiliations
- University of Alberta (CA)
- University of Manitoba (CA)
- Corresponding author
- Anderson, Sharon
- Venue
- PLOS ONE
- Publisher
- Public Library of Science (PLoS)
- Published
- 2024-04-16
- Volume
- 19
- Issue
- 4
- Pages
- e0298584
- ISSN
- 1932-6203 (ISSN-L)
- PMC
- PMC11020535
- OpenAlex
- W4394841180
- Cited by
- 11
- References
- 95
- Citations by year
- 2026: 2 · 2025: 3 · 2024: 6
- FWCI
- 5.51
- Type
- journal article
- Language
- en
- Open access
- gold
- doi.org
- Licence
- Locations
- PLoS ONE (publishedVersion, cc-by)
- PubMed Central (publishedVersion, cc-by)
- PubMed (publishedVersion)
- RePEc: Research Papers in Economics (submittedVersion)
- DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion, cc-by-sa)
- Funders
- Northern Alberta Academic Family Medicine Fund (R16P06)
- Topics
- Social Sciences › Psychology › Clinical Psychology › COVID-19 and Mental Health
- Health Sciences › Health Professions › Pharmacy › Nursing care and research
- Social Sciences › Sociology and Political Science › Work-Family Balance Challenges
- Keywords
- family caregivers, COVID-19 pandemic, caregiver anxiety, mental health, work-care balance, blurred boundaries, self-rated health, care worker shortage, home care, caregiver well-being, individual support
- MeSH terms
- COVID-19, Canada, Female, Health Personnel, Humans, Male, Caregivers, Pandemics
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