overcare

Overcare is a pattern of caregiving or medical management that provides more intervention, protection, or monitoring than is necessary or beneficial for the recipient. It can occur in family settings, primary care, hospitals, and long-term care. While preventive care is valuable, overcare is associated with diminished autonomy and increased dependency, and it can entail overtreatment or excessive safeguarding that may cause harm.

Contexts and manifestations include elder care with excessive safety measures, pediatric or disability support that overprotects, and chronic disease management with unnecessary tests or aggressive treatment beyond guidelines or patient preferences.

Causes and drivers include cultural emphasis on safety, caregiver anxiety and burnout, lack of shared decision-making, medical culture favoring comprehensive testing, and payment structures that reward volume over value.

Consequences and indicators include reduced independence, caregiver burden, higher costs, and potential harm from unnecessary procedures. Indicators include deviation from evidence-based guidelines, persistent surveillance with unclear benefit, and misalignment between patient goals and care.

Responses focus on patient-centered care and shared decision-making, adherence to guidelines and goal-concordant planning, advance care planning, caregiver education and respite services, and policies that align incentives with appropriate, value-based care.