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Caregiving after domestic abuse: Cumulative health toll impacts 1 in 20 mid-age women

One in twenty middle-aged women providing informal care for a family member or friend has also experienced intimate partner violence (domestic abuse).

These women have twice the normal odds of experiencing depressive symptoms and stress – and they also have worse physical health than other women.

Having better personal resources like resilience and social support reduced the associations with poor health.

What is this research about?

Women caregivers play an important, but undervalued role socially and economically. Caregiving takes a toll and is linked to poor health for the caregiver. Research on the impact of caregiving usually focuses on current relationship dynamics rather than looking at how past experiences affect a woman’s capacity to provide care and remain healthy. The researchers noted that a large number of participants in the Australian Longitudinal Study on Women’s Health (Also known as Women’s Health Australia) who were caregivers had also experienced domestic abuse. However, no research had ever been undertaken on how a history of abuse might also impact their health.

What did the researchers do?

The number of women acting as informal caregivers peaks as women enter middle age and their elderly family members require support. The researchers followed 8453 Women’s Health Australia participants aged between 45 and 65. They investigated the physical, mental, depressive and stress outcomes in women who had a history of intimate partner violence and/or caregiving.

What did the research find?

Thirteen per cent of the women had a history of intimate partner violence and 32 per cent of the women identified as caregivers. Nearly one in 20 women had experienced both.

Both caregiving and domestic abuse lead to worse physical health, increased depressive symptoms and higher stress in women.

When the researchers compared the two very different, very stressful, life events, they found the impact on the women’s health was almost the same, even though one was perpetrated against the individual (violence) and one was undertaken with a degree of personal control (caregiving). When women had both a history of domestic abuse and caregiving the impact on their health was cumulative. Their scores for stress, depressive symptoms and physical health were twice as bad as those for domestic abuse or caregiving alone.

The association between poor health, caregiving and the experience of domestic violence was reduced when women had better personal resources like resilience and social support to draw on for support.

How can you use this research?

Domestic violence is associated with poor personal resources in women – things like financial stress, lower education levels and poor social support – and this lack of resources remains a factor for women years after the violence stops. The findings highlight how important it is for clinicians to ask about the life experiences of patients experiencing poor health. To better support women with complex histories, we need to provide better referral pathways and services to help augment their personal resources.


Pablo Ferreira, Deborah Loxton, Leigh R. Tooth, Intimate personal violence and caregiving: Influences on physical and mental health in middle-aged women, Maturitas, August 2017, (102) 34–40. DOI: 10.1016/j.maturitas.2017.05.001