The influence of meso and macro factors on caregiving of older persons in Singapore: A narrative review

Studies on caregiving burden in Singapore typically focus on issues at a personal or micro level. There is a paucity of research focused at a meso or macro level on caregiving. The purpose of this narrative review is to explore the influence of meso and macro factors on caregiving by informal caregivers of older persons in Singapore. Studies were identified from sources such as CINAHL, PsycINFO, PubMed, Scopus, Web of Science, Google Scholar, as well as other websites for grey literature. Studies focusing on informal caregivers, defined as family, friends, or foreign domestic workers providing care to an older adult (60 and above) were included. Other inclusion criteria include: (a) studies focusing on meso factors (e.g., social norms, community resource, social network) and/or studies focusing on macro factors (e.g., caregiver support policies, workplace policies, care services policies, or caregiver payment policies), (b) studies with outcome measures on caregivers/caregiving such as burden, gains, or grief, and (c) in Singapore. A total of 43 studies were included in this review. A range of meso factors influencing caregivers/caregiving were identified. Examples include filial piety, norm of women as caregivers, interventions aimed at helping caregivers, and care services such as day cares. However, the influence of macro level factors (e.g., national level policies) was limited due to a relative paucity of research in this area. Areas for further research were also identified.