Care Plateaus, Peaks, and Loops: Insights on Stress from Family Carers for Older Adults

Alexa Carson and Ito Peng recently published an article in International Journal of Environmental Research and Public Health based on findings from the Canada team’s research for the Care Economies in Context project. Carson and Peng find that caregiver stress is not always accumulative. Some people experience “plateaus and peaks” that correspond with moments of crisis and transition. Others experience “loops” where they come back to caregiving after a period of time without caregiving stress, typically when a second or third family member needs care. This article adds nuance to the stress process model using life course and intersectional analysis, highlighting the important role of socioeconomic status, gender, and complex care needs in shaping carer stress. 

Alexa Carson is a Postdoctoral Fellow at the Centre for Global Social Policy. She has a PhD in Sociology from the University of Toronto (2026) and was the Lead Research Assistant for the Canada team with the Care Economies in Context Project from 2022-2024. Ito Peng is the Canada Research Chair in Global Social Policy, Professor of Sociology and Public Policy at the Department of Sociology and the School of Public Policy and Governance, and the Director of the Centre for Global Social Policy. Professor Peng is the Project Director for the Care Economies in Context project, and was previously the Project Director for the Gender, Migration and the Work of Care project.

Citation

Carson, A., & Peng, I. (2026). Care Plateaus, Peaks, and Loops: Insights on Stress from Family Carers for Older Adults. International Journal of Environmental Research and Public Health, 23(10), 1271. https://doi.org/10.3390/ijerph23101271 

Abstract

With an aging demographic and increasingly stretched care services in many countries, the issue of unpaid care for older adults is a growing concern for families and policy makers alike. Empirical evidence highlights how unpaid caregiving can be a stressful and challenging experience. In this paper, we draw from and build on the stress process model, which conceptualizes caregiver well-being and mental health as outcomes of primary and secondary stressors within social context, as well as relational framing from intersectional life course theory and feminist political economics. Based on 57 in-depth interviews with unpaid caregivers for older adults across Canada, we articulate two non-mutually exclusive themes that add nuance to understandings of caregiver stress. First, many caregivers describe their caregiving in “plateaus and peaks,” with minimal stress much of the time and spikes in stress at moments of crisis and transition. However, there are outlier cases of chronically stressed carers, with evidence that gender, socioeconomic status and complex care situations inequitably shape caregiver experiences. Second, some care journeys involve “loops,” with care for one senior ending, followed by care for another beginning shortly thereafter, a novel articulation of multiple care which was found to influence caregiver decisions and meaning-making about care.