Family Caregivers of Adults Aged 80 and over: Caregiving as a Stress Process and a Disruption of Occupational Balance

Background: Population ageing increases reliance on family caregivers (FCGs) for very old adults (80+). While caregiving is often studied as a source of burden, its impact on caregivers’ daily life and occupational balance remains underexplored. This study aimed to explore how caregiving responsibilities shape the daily lives, occupational balance, and support needs of FCGs, using the Stress Process Model (SPM) and the concept of Occupational Balance (OB). Methods: A qualitative study was conducted in the PACA region (France) within the SCOPE project. Seventeen semi-structured interviews were analysed using thematic content analysis, with independent double coding by two researchers. Results: Six themes were identified: caregiving role and identity, consequences, occupational patterns, needs, proposed actions, and barriers and facilitators. Caregiving generated both primary stressors (physical and emotional demands) and secondary stressors (role conflicts, financial strain, and social isolation). It also led to occupational imbalance, characterized by reduced leisure, diminished self-care, and reorganization of daily routines. Working FCGs reported greater role strain and time constraints, whereas retired FCGs emphasized informational needs and adaptation strategies. Across both groups, caregivers’ needs were rarely formally assessed. Conclusions: These findings highlight that caregiving for very old adults profoundly reshapes caregivers’ daily lives through both stress-related mechanisms and disruptions in occupational balance. They underscore the need for tailored, context-sensitive support strategies, including systematic needs assessment and more structured, individualized coordination approaches such as case management.