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Formal and informal care: trajectories of home care use among Danish older adults
- Authors:
- KJAER Agnete Aslaug, SIREN Anu
- Journal article citation:
- Ageing and Society, 40(11), 2020, pp.2495-2518.
- Publisher:
- Cambridge University Press
To adjust future care policies for an ageing population, policy makers need to understand when and why older adults rely on different sources of care (e.g. informal support versus formal services). However, previous scholars have proposed competing conceptualisations of the link between formal and informal care, and empirical examinations have often lacked a dynamic approach. This study applied an analytical method (sequence analysis), allowing for an exploratory and dynamic description of care utilisation. Based on 15 years of data from 473 community-dwelling older individuals in Denmark, this study identified four distinct clusters of care trajectories. The probability of belonging to each cluster varied with predisposing factors (such as age and gender), needs factors (such as dependence in activities of daily living and medical conditions) and enabling factors (such as co-habitation and contact with adult children). A key finding was that trajectories characterised by sporadic use of informal care were associated with low needs and strong social relations, whereas trajectories characterised by reliance on formal care were associated with high needs and limited contact with children. Taken together, the findings provide new evidence on the associations between care use and multiple determining factors. The dynamic approach to studying care use reveals that sources of individual care utilisation change over time as the individual and societal determinants change. (Edited publisher abstract)
The importance of the size of the social network and residential proximity in the reception of informal care in the European Union
- Authors:
- RODRIGUEZ Mercedes, RECOVER M. Angeles Minguela, BALLESTA Jose A. Camacho
- Journal article citation:
- European Journal of Social Work, 21(5), 2018, pp.653-664.
- Publisher:
- Taylor and Francis
This paper explores which factors affect the reception of informal care among those dependent people aged 65 and over in Europe, starting from the so-called Behavioural Model of Health Service Use introduced by Andersen. The data employed are drawn from the fourth wave of the Survey of Health, Ageing, and Retirement. The final sample consists of a total of 17,284 older dependent people of which 4529 (26.2%) received informal care. The main novelty is the incorporation of different characteristics of the social network of the individual (presence of children, size and residential proximity) among the factors that enable the reception of informal care. In particular the two latter aspects are combined in one sole indicator of distance to the social network. In addition to ‘traditional factors’ like age or degree of dependency, all the characteristics of the social network are found to influence the likelihood of receiving informal care. This reveals the need for taking into consideration the role played by social networks when governments design care programmes, especially in the current scenario of rising demand for care. (Publisher abstract)
An assessment of the relationship between informal caring and quality of life in older community-dwelling adults: more positives than negatives?
- Authors:
- RATCLIFFE Julie, et al
- Journal article citation:
- Health and Social Care in the Community, 21(1), 2013, pp.35-46.
- Publisher:
- Wiley
This study used the Index of Capability (ICECAP-O) instrument to measure the quality of life of a representative sample of the older South Australian population according to carer status. A survey including the ICECAP-O instrument, carer status and several socio-demographic questions was administered in 2009 to 789 individuals aged 65 years or older in their own homes. A total of 671 individuals characterised themselves as a non-carer and 115 individuals characterised themselves as an informal carer. In general, carers exhibited relatively high quality of life as measured by the ICECAP-O, with carers having comparable mean ICECAP-O scores to non-carers in the general population. The results indicated statistically significant variations in overall ICECAP-O scores according to age, with younger participants tending to have slightly higher scores on average. Average ICECAP-O scores were noticeably lower for carers who were separated or divorced and for carers who lived alone. The authors concluded that the provision of informal care may be associated with a positive impact upon quality of life for many caregivers, which may mediate the negative aspects arising from the burden associated with informal care-giving.
Helpful citizens and caring families: patterns of informal help and caregiving in Sweden in a 17-year perspective
- Authors:
- JEGERMALM Magnus, GRASSMAN Eva Jeppsson
- Journal article citation:
- International Journal of Social Welfare, 21(4), October 2012, pp.422-432.
- Publisher:
- Wiley
This article reports on an analysis of informal help and caregiving in Sweden with a focus on patterns of change over 17 years. In particular, it examines whether there has been a change in the extent of caregiving, the type of caregivers, and the relationship between the caregivers and the recipients of help. The discussion is based on results from a national survey repeated 4 times between 1992 and 2009. The survey asked whether the respondent regularly helped someone with whom they did not live (relatives, neighbours, co-workers or friends) with activities such as housework, transport, or gardening. In order to discuss how the trends can be understood in the Swedish context, the findings are analysed using 2 interpretative perspectives: the welfare state and impact of recent changes; and civil society and its possible and changing role. The findings indicate that in the 1990s the figures were stable, but from the late 1990s to 2009, there was a dramatic increase in the extent of informal help giving. Concerning types of helpers, the patterns implied involvement not only from family members, but also from other types of helpers.
Help from spouse and from children among older people with functional limitations: comparison of England and Finland
- Authors:
- BLOMGREN Jenni, et al
- Journal article citation:
- Ageing and Society, 32(6), August 2012, pp.905-933.
- Publisher:
- Cambridge University Press
This study, using nationally representative data from England and Finland, investigated receipt of help from spouse and children among community-dwelling people aged 70+ years with functional limitations. In both countries, women and those with more functional limitations had higher odds of receiving spousal and filial help. In England, but not in Finland, those receiving formal public help had lower odds of receiving spousal help than those with no formal help. Those with low education received more filial help in England, but no association was found between formal and filial help. In Finland, the effect of education was not significant but those receiving formal help had higher odds of also receiving filial help. The results suggest that in a liberal market-led state, the role of children may be to help their parents living alone and with low financial resources. The authors concluded that, in the context of a generous welfare state, children may function more as active agents bridging the gap between their parents and traditional services.
Caregiving in the Pacific Rim: a comparison of Asian and non-Asian caregiving experiences
- Authors:
- ARNBERGER Pam, CHANG Nathan, MENSENDIER Martha
- Journal article citation:
- Asia Pacific Journal of Social Work and Development, 19(2), December 2009, pp.38-51.
- Publisher:
- Taylor and Francis
Surveys of informal carers in California and Hawaii in 2002 and 2007 respectively were combined and analysed to see if there is a uniquely Asian model of caregiving. Differences between Asian and non-Asian carers exist; there were more Asian male carers, Asian carers had significantly higher socio-economic status measured by education and income, fewer of the Asian carers were born in the United States and were more likely to be caring for parents and in-laws than carers from other ethnicities who were more likely to be spouses or friends. With over half of carers unemployed, Asian carers had more likely given up work, rather than be retired or alter their work status. Asian carers provided care for longer periods, were more likely to have help, less likely to admit caregiving was affecting family life and emotional stress. Asian carers, while respecting their caregiving traditions, experience difficulties in adapting them into their lives. Asians are less likely to feel they are setting an example to family and experience fewer rewards. A unique style of Asian caregiving is identified, but to assume that all Asian carers are managing and the best cost effectiveness is achieved by making dramatic sacrifices such as giving up skilled work is incorrect. Research to determine areas of needed assistance and to develop culturally sensitive policies to encourage Asian carers to utilise available support is suggested.
The inter-relationship between formal and informal care: a study in France and Israel
- Authors:
- LITWIN Howard, ATTIAS-DONFUT Claudine
- Journal article citation:
- Ageing and Society, 29(1), January 2009, pp.71-91.
- Publisher:
- Cambridge University Press
This study examined whether formal care services delivered to frail older people's homes in France and Israel substitute for or complement informal support. The two countries have comparable family welfare systems but many historical, cultural and religious differences. Data for the respondents aged 75 or more years at the first wave of the Survey of Health, Ageing and Retirement in Europe (SHARE) were analysed. Regressions were examined of three patterns of care from outside the household: informal support only, formal support only and both formal and informal care, with the predictor variables including whether informal help was provided by a family member living in the household. The results revealed that about one-half of the respondents received no help at all (France 51%, Israel 55%), about one-tenth received care from a household member (France 8%, Israel 10%), and one-third were helped by informal carers from outside the household (France 34%, Israel 33%). More French respondents (35%) received formal care services at home than Israelis (27%). Most predictors of the care patterns were similar in the two countries. The analysis showed that complementarity is a common outcome of the co-existence of formal and informal care, and that mixed provision occurs more frequently in situations of greater need. It is also shown that spouse care-givers had less formal home-care supports than either co-resident children or other family care-givers. Even so, spouses, children and other family care-givers all had considerable support from formal home-delivered care.
Older people – recipients but also providers of informal care: an analysis among community samples in the Republic of Ireland and Northern Ireland
- Authors:
- MCGEE Hannah M., et al
- Journal article citation:
- Health and Social Care in the Community, 16(5), September 2008, pp.548-553.
- Publisher:
- Wiley
Data on both the provision and receipt of informal care among populations of older adults are limited. Patterns of both informal care provided and received by older adults in the Republic of Ireland (RoI) and Northern Ireland (NI) were evaluated. A cross-sectional community-based population survey was conducted. Randomly selected older people (aged 65+, n = 2033, mean age (standard deviation): 74.1 years (6.8), 43% men, 68% response rate) provided information on the provision and receipt of care, its location, and the person(s) who provided the care. Twelve per cent of the sample (251/2033) identified themselves as informal caregivers (8% RoI and 17% NI). Caregivers were more likely to be women, married, have less education and have less functional impairment. Forty-nine per cent reported receiving some form of care in the past year. Care recipients were more likely to be older, married, have more functional impairment, and poorer self-rated health. Receiving regular informal care (help at least once a week) from a non-resident relative was the most common form of help received. Five per cent (n = 102/2033) of the sample reported both providing and receiving informal care. Levels of informal care provided by community-dwelling older adults were notably higher than reported in single-item national census questions. The balance of formal and informal health and social care will become increasingly important as populations age. It is essential, therefore, to evaluate factors facilitating or impeding informal care delivery.
Care provision for African American elders: family attitudes and strategies
- Author:
- STEWART Pearl
- Journal article citation:
- Journal of Intergenerational Relationships, 6(1), 2008, pp.61-81.
- Publisher:
- Routledge
- Place of publication:
- Philadelphia
This study uses a qualitative method and a Kinscripts perspective to examine in detail the attitudes towards caring for their elderly members of a large, extended African American family originating in rural North Carolina. Forty-eight interviews with family members aged 15 to 80 revealed a continued strong commitment to providing care for older people at home, which pre-dates slavery and has its roots in West African culture. There is an emphasis on spreading tasks across a broad range of family members rather than relying on a primary carer, with the majority of older people continuing to live in their own homes. (Copies of this article are available from: Haworth Document Delivery Centre, Haworth Press Inc., 10 Alice Street, Binghamton, NY 13904-1580).
Supporting older families: making a real difference
- Author:
- MAGRILL Dalia
- Publisher:
- Mental Health Foundation
- Publication year:
- 2005
- Pagination:
- 107p.
- Place of publication:
- London
Older families are a priority group for support, but it is important that their needs are linked in to the mainstream agendas of services for people with learning disabilities, older people and carers generally. It is important that we make sure that older families have their needs met now, and are supported to remain together for as long as they wish whilst planning for the future with confidence. However, it is equally important that we get things right for older families now so that others who are growing older do not face the same anxieties, uncertainty and fears that so many older family carers have lived with for decades.