Optimizing Caregiving Systems: A Strategic Analysis of Family, Government, and Institutional Interactions

As global populations age rapidly, caregiving for the elderly has emerged as a critical challenge, particularly due to the fragmented roles played by families, governments, and institutions. This paper reconceptualizes caregiving as a strategic decision-making process rather than a purely emotional or moral undertaking. Through a thematic synthesis of 16 game-theoretic empirical studies, it identifies systemic inefficiencies rooted in coordination failures, free-riding behaviour, and asymmetrical burdens—particularly along gender and cultural lines. The study divides its literature analysis into two domains: intra-family role allocation and the influence of governmental and institutional policy. It finds that caregiving within families often functions as a non-cooperative public goods game, while government interventions are frequently either overly generalized or narrowly targeted, leading to suboptimal support. To address these strategic mismatches, the paper proposes a cooperative game-theoretic model integrating Lagrangian optimization for efficiency with Shapley Value allocation for fairness. This model formalizes caregiving as a shared burden between families, institutions, and governments, and identifies optimal strategies for cost-sharing and stable cooperation. The paper thus contributes a new conceptual and prescriptive framework to optimize caregiving systems under growing demographic and economic pressure.