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Caring in Silence: Exploring the Lived Experiences of Employed Informal Caregivers of Older Persons in Iran
Fereshteh Mohammadzadeh Yazd1, Rahimah Ibrahim2, Puvaneswaran Kunasekaran1
1Malaysian Research Institute on Ageing, Universiti Putra Malaysia, Serdang, 43400, Selangor, Malaysia.
Employed informal caregivers in Iran navigate caregiving responsibilities within a context of absent formal support infrastructure, rigid cultural expectations, and economic constraints. This study explored their lived experiences, focusing on work-care balance, stress management, and interactions with support structures. A qualitative descriptive study was conducted using semi-structured in-depth interviews with five employed female informal caregivers of older persons (aged 65 and above) in urban Iran. Interviews were conducted in Persian via Zoom between January and March 2025, lasting 60 to 120 min. Data were analyzed using Reflexive Thematic Analysis, informed by Role Theory and Lazarus and Folkman's Stress and Coping Theory. Six themes emerged: (1) onset and context of caregiving, (2) work-care role balance, (3) stress and coping strategies, (4) social and workplace support, (5) personal and cultural experiences, and (6) advice and future perspectives. Findings reveal a distinctive "triple burden" where structural barriers (absent caregiver leave policies, inadequate insurance coverage, limited respite services), cultural expectations (filial piety norms, gendered care obligations), and economic pressures (inability to reduce work hours, high caregiving costs) converge to create unsustainable caregiving conditions. Participants sacrificed sleep, personal relationships, and career advancement while experiencing chronic exhaustion, workplace discrimination, and social isolation. Coping strategies proved insufficient without formal support structures. Unlike developed countries with established support systems, Iranian caregivers operate within institutional silence where caregiving remains an exclusively private burden. Urgent policy reforms are needed: caregiver leave policies, subsidized respite services, insurance coverage for home care, workplace accommodations, and culturally sensitive counseling programs.
Employed informal caregivers in Iran navigate caregiving responsibilities within a context of absent formal support infrastructure, rigid cultural expectations, and economic constraints. This study explored their lived experiences, focusing on work-care balance, stress management, and interactions with support structures. A qualitative descriptive study was conducted using semi-structured in-depth interviews with five employed female informal caregivers of older persons (aged 65 and above) in urban Iran. Interviews were conducted in Persian via Zoom between January and March 2025, lasting 60 to 120 min. Data were analyzed using Reflexive Thematic Analysis, informed by Role Theory and Lazarus and Folkman's Stress and Coping Theory. Six themes emerged: (1) onset and context of caregiving, (2) work-care role balance, (3) stress and coping strategies, (4) social and workplace support, (5) personal and cultural experiences, and (6) advice and future perspectives. Findings reveal a distinctive "triple burden" where structural barriers (absent caregiver leave policies, inadequate insurance coverage, limited respite services), cultural expectations (filial piety norms, gendered care obligations), and economic pressures (inability to reduce work hours, high caregiving costs) converge to create unsustainable caregiving conditions. Participants sacrificed sleep, personal relationships, and career advancement while experiencing chronic exhaustion, workplace discrimination, and social isolation. Coping strategies proved insufficient without formal support structures. Unlike developed countries with established support systems, Iranian caregivers operate within institutional silence where caregiving remains an exclusively private burden. Urgent policy reforms are needed: caregiver leave policies, subsidized respite services, insurance coverage for home care, workplace accommodations, and culturally sensitive counseling programs.
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