Introduction
The world’s population is ageing, resulting in a global demographic shift. WHO estimates that by 2050, 2.1 billion people globally will be over the age of 60 years, and those aged 80+ years will triple by this time, reaching 426 million.1 Notably, ageing is associated with gradual decline in physical and mental health which introduce challenges related to health and social care, particularly given that a large majority of the population continues to live longer with more comorbidities.2 These age-related changes in health, combined with a growing ageing population has and will continue to strain healthcare systems, shifting care responsibilities to unpaid carers who are known to enhance the quality of life of their care recipient(s). In Canada, provincial healthcare spending does not currently account for the increase in population ageing3 and there is a lack of services needed to support an ageing population.4 He et al5 explain inadequacies in long-term care among all countries globally, a finding that puts increased burden on unpaid care. These rising healthcare demands, coupled with governments’ withdrawal from publicly provided health and social services, have led to an increased demand for unpaid care, often provided by family and friends.6 Unpaid care is the provision of care to an older and/or dependent person by someone who shares some form of familial or social relationship.6 Those providing this unpaid care often manage it while working in the paid labour force and are often called carer-employees (CEs).7 Occupying the dual role of unpaid carer and paid employee can impact labour force participation and wages among CEs.8 In addition to labour force implications, CEs also incur several health-related impacts as a result of occupying this dual role. Research by Yang et al9 found several mental health impacts that CEs experience as a direct result of their caregiving duties, including anxiousness, depressive feelings and irritability. This finding is confirmed by Gaugler et al,10 who state that conflict between work and caregiving duties is the strongest predictor of caregiver physical and mental health. These labour force and health impacts incurred by CEs has drawn attention to the role of the workplace in promoting caregiver-friendly workplace policies (CFWPs). CFWPs are sometimes called family friendly policies and address necessary organisational changes in policy and/or programmes, practice or work culture aimed towards reducing work-family conflict and increasing support for CEs.11 12
Rationale
The goal of this scoping review is to determine the availability of CFWPs between 1 May 2019 and 31 May 2023. This scoping review provides an update on CFWPs since the previous scoping review was conducted by a similar group supervised by Dr Allison Williams in 2021.11 The 2021 scoping review was preceded by the initial scoping review, published under Dr Allison Williams’ supervision in 2018.13 Continued follow-up reviews are necessary to determine how broader social and cultural changes impact CFWPs. The scoping review published in 202111 noted changes in the availability and climate surrounding CFWPs when compared with the scoping review conducted in 2018.13
Moreover, the proposed scoping review seeks to address limitations of the previous reviews to ensure comprehensive findings on the research topic. Specifically, a wider database search will be performed to better capture the availability of CFWPs. The goal here is to bridge the gap in the peer-reviewed literature on CFWPs identified in previous scoping reviews, while capturing a better understanding of CFWPs availability across the globe. The same research questions used in the previous scoping reviews will guide this review, aiming to address ‘(1) how workplaces are supporting the growing number of CEs through workplace culture and policy, compared with 5 years ago and (2) identify and prioritise actions that will improve workplace support for CEs’ (p. 4).11 This is guided by the main objective of determining the current state of CFWPs internationally, as well as the factors contributing to the development of these programmes and/or policies.
The scoping review methodology has proved effective (as determined in previous research by the same group) for exploring and summarising the growth of CFWPs internationally. This scoping review adopts terminology that reflects the broad parameters of what is considered CFWPs and CEs. Previous reviews have detailed the multiplicity of terms that are used to describe CFWPs and have adopted the formal definition by Kelly et al,12 which defines CFWPs as ‘deliberate organisational changes—in policies, practices or target culture—to reduce work-family conflict and/or support employees’ lives outside of work’ (p. 310). In the context of this review, CFWPs will serve as a placeholder term for terminology related to workplace/organisational policy. Similarly, the term CE speaks to a range of terms surrounding CEs (carer-workers, working carers, etc). More specifically, a CE would refer to an individual that participates in both paid employment and unpaid care for another adult with a health condition or disability.11 This scoping review will offer valuable insights into how wider social and cultural issues work to shape CFWPs, and identify leading workplaces that provide CFWPs, as well as labour sectors that require improvement. Specifically, this review will account for the broader social changes informing CFWPs, as determined via content analysis, to explain how these factors influence CFWPs. Explaining how overarching social and cultural changes are reflected in changes to or implementation of CFWPs can provide insights into the forces that will continue to shape CFWPs in the future. Comparative analysis between the previous published scoping reviews will allow for further conclusions, with respect to the changing landscape of CFWPs over time.
