By Ruru Ping (Hitotsubashi University)

In the US and the UK, a growing body of time-use research (e.g., Freedman, et al., 2019; Urwin, et al., 2023) has shown that informal caregiving does not affect all caregivers in the same way; how caregivers structure daily life matters. But what happens in a very different context — one with strong family caregiving norms and universal public long-term care coverage?

In our newly published study in The Journals of Gerontology: Series B, my colleagues Dr. Bo Hu, Dr. Takashi Oshio, and I examined this question using nationally representative panel data from Japan. By focusing on daily time-use patterns rather than caregiving hours alone, our findings reveal a striking paradox at the heart of family caregiving.

Beyond Care Hours: Four Time-use Patterns

We identified four distinct caregiver profiles based on how they allocate their daily time across sleep, work, housework, childcare, long-term care, and physical exercise:

1. Full-time workers providing minimal care: Primarily employed men caring for their parents.
2. Marginal caregivers: Typically older women balancing part-time work, housework, and light care.
3. Dual caregivers: Primarily younger women managing the “sandwich” responsibilities of both childcare and long-term care.
4. Intensive caregivers: Mostly single women providing high-intensity personal care, often to co-residing family members with severe needs.

Notably, household living standards did not differ across these groups. In Japan, intensive caregiving is not simply a last resort driven by financial constraints. Even with access to a universal system of affordable formal care, many families still choose to provide high-intensity care themselves.

A Paradox of Mental Health: Distress vs. Well-being

Our study adopts a “dual view” of mental health, measuring both psychological distress and subjective well-being. Using panel data from 2017 to 2020, our regression analyses found that marginal and intensive caregivers were more likely than full-time workers to experience psychological distress. Paradoxically, intensive caregivers also reported higher subjective well-being, including greater life satisfaction and happiness.

These findings challenge traditional frameworks. Becker’s time allocation theory and much of the existing research in Western societies typically interpret caregiving through the lens of “opportunity costs” (such as forgone leisure or employment), and therefore a trade-off that may reduce well-being. However, our findings suggest that in Japan, the deep-seated meaning and social expectations attached to caregiving fundamentally reshape how this time costs translate into subjective well-being. Although the time costs remain, these cultural sources of fulfilment allow a sense of well-being to persist, even when caregiving is physically exhausting and psychologically taxing.

The Role of Gender Expectations

Given the strong expectation in Japanese culture that women assume primary caregiving responsibilities, we looked closer at how male and female caregivers allocate their time differently, and how those differences were associated with their mental health. Our findings revealed a striking contrast in how gender roles relate to mental health:

• For women: Female caregivers dedicated more time to household production and caregiving. Those who fulfilled societal expectations through substantial caregiving reported higher life satisfaction and a greater sense of meaningfulness.
• For men: The experience was almost the opposite. Men reported greater happiness when working long hours in labour market. When men deviated from the “breadwinner” role to take on greater household responsibilities with minimal labour market participation, their mental health often suffered.

Implications for Caregiver Policy

As populations age globally, informal caregiving can be expected to remain indispensable. Our study highlights several implications for policymaking:

• Tailored support: Caregiver support should be tailored to daily time-use patterns, not just care intensity.
• Dual focus: Psychological distress and subjective well-being should be addressed simultaneously; helping a caregiver manage stress should not mean diminishing the sense of purpose they find in their role.
• The “marginal risk”: Marginal caregivers, not only intensive ones, represent a subgroup at risk of distress due to role fragmentation and lack of social recognition.
• Cultural context: Even generous formal care systems cannot fully substitute family care when caregiving carries deep social and emotional meaning.

Suggested citation:

Ping, R. (2026, 18 January) The Paradox of Caregiving: How Daily Time Use Shapes Well-Being in Japan. GOLTC Blog, Global Observatory of Long-Term Care, Care Policy and Evaluation Centre, London School of Economics and Political Science. https://goltc.org/publications/the-paradox-of-caregiving-how-daily-time-use-shapes-well-being-in-japan/