Health economist Yvonne Krabbe-Alkemade, together with her colleagues, is pleading for a cultural shift: men must structurally step up in supporting people with dementia.
Explosive increase in care demand
The statistics are telling. While the Netherlands currently has an estimated 310,000 people with dementia, this number will grow to more than 610,000 in the coming decades. Consequently, the impact of dementia will affect an increasingly large group within society.
Simultaneously, professional care is grappling with major personnel shortages, and government policy is steering towards "aging in place" (living at home longer). This means that family and loved ones must not only do more, but we will also increasingly lean on people's social networks: neighbors, friends, and volunteers. Informal care (mantelzorg) often arises not from free choice, but from necessity and emotional connection; precisely for this reason, the system is extra vulnerable.
While this shift to informal support is essential to absorb the rising demand for care, it immediately exposes a major vulnerability: informal care is currently provided very unequally. Of the informal caregivers for people with dementia, 73 percent are women. Women not only provide informal care more often, but they also develop dementia more frequently themselves and make up a large proportion of professional healthcare staff.
In ongoing research, Yvonne Krabbe-Alkemade, Fatima Amankour, Klarita Gërxhani, France Portrait, and Marieke van Wieringen are examining the consequences of this care burden for women and exploring possibilities to distribute support around dementia care more fairly in the future.
Woman sacrifice career and health
This unequal distribution has significant consequences. Female informal caregivers give up their career opportunities more often, work fewer hours, and consequently accrue less pension. When faced with a lack of time due to caregiving, women primarily spend less time on personal needs and paid work, whereas men mainly reduce household tasks. Additionally, women experience stress, anxiety, and depression more often than male informal caregivers.
There is also a difference in the type of care provided: men who provide informal care tend to focus more on logistical and financial tasks, while women take on the intensive, daily physical care and emotional support. Although there is some movement visible in how care tasks are divided, the pattern remains stubborn, and extra effort is needed to achieve real change.
The calculation: 580,000 extra men needed
The researchers made a telling calculation for the year 2050. If the care for people with dementia continues to be organized in the same way and remains primarily on women's shoulders, over half a million extra female informal caregivers will be needed in 25 years.
That is societally and economically unfeasible. To reach a truly balanced distribution by 2050, an estimated 580,000 male informal caregivers would need to be added, compared to 170,000 women.
Solutions: Volunteers and Expectations
How do we make that distribution fairer? The VU researchers point to two important tracks:
- Stimulating voluntary commitment, especially among men: Because informal care is often not a choice, but volunteering is, there is a significant opportunity here to distribute the pressure more evenly. Volunteering, neighborly help, and low-threshold social support can absorb part of the current imbalance. Especially now that policy leans more heavily on social networks, it is necessary to stimulate social support in a broad sense and give men a larger role in this.
- The role of professionals: Unconscious biases also play a role in nursing homes and home care. Care professionals approach female family members for caregiving tasks more often than men. By breaking through these patterns of expectation, men can be better involved in care.
In the coming period, the research team will further investigate which incentives can effectively motivate men to take on more care tasks. Additionally, they are researching the impact on (healthcare) professionals who provide informal care alongside their jobs, and how the combination of work and informal care can be better facilitated.
Read the full research publication here (in Dutch).