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Monetising the provision of informal long-term care by elderly people: estimates for European out-of-home caregivers based on the well-being valuation method
- Authors:
- SCHNEIDER Ulrike, KLEINDIENST Julia
- Journal article citation:
- Health and Social Care in the Community, 24(5), 2016, pp.e81-e91.
- Publisher:
- Wiley
Providing informal care can be both a burden and a source of satisfaction. To understand the welfare effect on caregivers, we need an estimate of the ‘shadow value’ of informal care, an imputed value for the non-market activity. The study used data from the 2006–2007 Survey of Health Ageing and Retirement in Europe which offers the needed details on 29,471 individuals in Austria, Belgium, the Czech Republic, Denmark, France, Germany, Italy, the Netherlands, Poland, Spain, Sweden and Switzerland. Of these, 9768 are unpaid non-co-resident caregivers. To estimate net costs, researchers followed the subjective well-being valuation method, modelling respondents' life satisfaction as a product of informal care provision, income and personal characteristics, then expressing the relation between satisfaction and care as a monetary amount. The study estimates a positive net effect of providing mode rate amounts of informal care, equivalent to €93 for an hour of care/week provided by a caregiver at the median income. The net effect appears to turn negative for greater high care burdens (over 30 hours/week). Interestingly, the effects of differences in care situation are at least an order of magnitude larger. The study also finds that carers providing personal care are significantly more satisfied than those primarily giving help with housework, a difference equivalent to €811 a year at the median income. The article makes two unique contributions to knowledge. The first is its quantifying a net benefit to moderately time-intensive out-of-home caregivers. The second is its clear demonstration of the importance of heterogeneity of care burden on different subgroups. Care-giving context and specific activities matter greatly, pointing to the need for further work on targeting interventions at those caregivers most in need of them. (Edited publisher abstract)
Sustainable care: theorising the wellbeing of caregivers to older persons
- Authors:
- KEATING Norah, MCGREGOR J. Allister, YEANDLE Sue
- Journal article citation:
- International Journal of Care and Caring, 5(4), 2021, pp.611-630.
- Publisher:
- Policy Press
The term ‘care crisis’ is invoked to denote chronic system failures and bad outcomes for the people involved. This paper presents a comprehensive wellbeing framework and illustrate its practicality with evidence of negative outcomes for those who provide care. This study finds evidence of substantial material and relational wellbeing failures for family carers and for care workers, while there has been little interest in carers’ views of their ability to live the life that they most value. Understanding and improving wellbeing outcomes for carers is an essential component of sustainable care, which requires the wellbeing of the different actors in care arrangements. (Edited publisher abstract)
Time use and experienced wellbeing of older caregivers: a sequence analysis
- Authors:
- FREEDMAN Vicki A., et al
- Journal article citation:
- Gerontologist, 59(5), 2019, pp.e441-e450.
- Publisher:
- Oxford University Press
Background and Objectives: The diminished wellbeing of caregivers is well documented, but studies typically draw upon coarse measures of time use and thus provide limited understanding of the role of specific care activities in the daily lives of care providers. This study uses time diary data to explore whether there are signature care patterns throughout the day and whether these care patterns have implications for caregivers’ experienced wellbeing. Research Design and Methods: Using a national sample of 511 time diaries from older caregivers in the Disability and Use of Time supplement to the Panel Study of Income Dynamics, this study examined minutes of care provided on the prior day, overall and for four broad care categories (household, personal care, transportation, and visiting), and patterns of care over the day, the latter based on sequence and cluster analysis. Results: Older caregivers spend on average 2.3 hr providing care to another adult on care days. Caregiving follows a roller-coaster pattern over the day, peaking at mealtimes. Sequence analysis suggests five distinctive caregiving patterns, which vary by both demographic characteristics of the caregiver (gender, work status) and care arrangement type (relationship to recipient, whether sole caregiver to recipient). The 40% who provide only marginal assistance of about 1 hr report lower experienced wellbeing than the 28% who provide sporadic assistance with a mix of activities for about 2 hr. Discussion and Implications: A substantial share of older caregivers provides only 1 hr of assistance on a given day but appears to be at risk for reduced wellbeing. Better understanding of the reason for their marginal involvement and reduced wellbeing is warranted. (Edited publisher abstract)
Psychological well-being over time among informal caregivers caring for persons with dementia living at home
- Authors:
- LETHIN Connie, et al
- Journal article citation:
- Aging and Mental Health, 21(11), 2017, pp.1138-1146.
- Publisher:
- Taylor and Francis
Objectives: To investigate informal caregivers’ psychological well-being and predicted increase in psychological well-being, when caring for persons with dementia (PwDs) living at home, related to caregiver, PwD and formal care (FC) factors. Method: A cohort study at baseline and 3 months’ follow-up in eight European countries. Caregivers included (n = 1223) were caring for PwDs aged ≥ 65 years at home. Data on caregivers, PwDs and FC were collected using standardised instruments. Regression analysis of factors associated with caregiver psychological well-being at baseline and 3 months later was performed. Results: Factors associated with caregiver psychological well-being at baseline were positive experience of caregiving, low caregiver burden, high quality of life (QoL) for caregivers, male gender of PwD, high QoL of PwD, few neuropsychiatric symptoms and depressive symptoms for the PwD. At follow-up, caregivers with increased psychological well-being experienced of quality of care (QoC) higher and were more often using dementia specific service. Predicting factors for caregivers’ increased psychological well-being were less caregiver burden, positive experience of caregiving, less supervision of the PwD and higher caregiver QoL, if PwD were male, had higher QoL and less neuropsychiatric symptoms. Furthermore, higher QoC predicted increased caregivers’ psychological well-being. Conclusion: Informal caregiving for PwDs living at home is a complex task. The authors' study shows that caregivers’ psychological well-being was associated with, among other things, less caregiver burden and higher QoL. Professionals should be aware of PwD neuropsychiatric symptoms that might affect caregivers’ psychological well-being, and provide proper care and treatment for caregivers and PwDs. (Edited publisher abstract)
Do caregiving burden and satisfaction predict loneliness in older care recipients?
- Author:
- IECOVICH Esther
- Journal article citation:
- Aging and Mental Health, 20(4), 2016, pp.441-449.
- Publisher:
- Taylor and Francis
Objectives: The goal of this study was to assess the extent to which caregiving burden and satisfaction of primary family caregivers in Israel predict loneliness among their older care recipients. Method: The study included a convenience sample of 325 dyads of respondents. The short version of Zarit Caregiving Burden Interview and Lawton Caregiving Appraisal measures were used to assess caregiving burden and satisfaction; the de Jong Gierveld Loneliness Scale was used to assess care recipient's loneliness. Results: The results showed that greater caregiving burden was significantly correlated with increased loneliness, whereas greater caregiving satisfaction was significantly correlated with lower levels of loneliness. Conclusion: The literature has broadly addressed the association between caregiving burden and satisfaction and the caregivers’ well-being, whereas this association with regard to care recipients’ well-being has been barely examined. The multivariate analyses showed that caregiving burden was insignificant in explaining loneliness, whereas greater caregiving satisfaction was found significant in explaining lower levels of loneliness. The results and implications for further research and practice are discussed. (Publisher abstract)
Family caregivers for seniors in rural areas
- Author:
- MONAHAN Deborah J.
- Journal article citation:
- Journal of Family Social Work, 16(1), 2013, pp.116-128.
- Publisher:
- Taylor and Francis
- Place of publication:
- Philadelphia, USA
In this article, the demographic characteristics of family caregivers for seniors in rural communities are assessed to examine whether their circumstances could facilitate or impede their well-being. Services available in rural communities for family members providing ongoing care to frail seniors is examined, particularly those that provide health and social services. How families access these services and whether there are specific barriers in service provision are analysed based on current social work practice and the research literature. Trends for future services are identified as well as whether these trends support new roles for social workers in rural settings. (Publisher abstract)
Wellbeing depends on social relationship characteristics: comparing different types and providers of support to older adults
- Authors:
- MERZ Eva-Maria, HUNHOLD Oliver
- Journal article citation:
- Ageing and Society, 30(5), July 2010, pp.843-857.
- Publisher:
- Cambridge University Press
Data from 1,146 older people, from the (2002) second wave, of the ‘German Ageing Survey’ is used to explore different types of support, the providers, and the wellbeing of people over 65-years of age in Germany. Emphasis is given to wellbeing differences associated with kin (family member) or non-kin providers, emotional and instrumental types of support and the quality of the relationships with kin and non-kin. Emotional support from kin and instrumental support from non-kin were positively associated with wellbeing. Emotional support from non-kin providers did not associate with wellbeing whereas instrumental support from kin providers had a negative association with one aspect of wellbeing. High relationship quality from either kin or non-kin positively related to wellbeing, agreeing with the authors’ expectations that a good relationship would buffer negative impacts of both kin/non-kin instrumental supports. The authors conclude that when family carer relationships are of high quality, the challenges, frailties and decreasing capabilities associated with ageing can be met with support without compromising wellbeing.
Supporting an informal care group - social contacts and communication as important aspects in the psychosocial well-being of informal caregivers of older patients in Belgium
- Author:
- JANSEN Leontien
- Journal article citation:
- Health and Social Care in the Community, 30(4), 2022, pp.1514-1529.
- Publisher:
- Wiley
Background: Increasingly, informal caregivers in Belgium care in group for an older patient. This study aimed to decrease the caregiver burden and to increase the well-being of caregivers and patients by supporting the needs of informal care groups of older patients (≥70 years). Method: Through an online self-management tool, the groups were supported to make informed choices concerning the care for the older patient, taking into account the standards, values, concerns and needs of every caregiver and patient. A pre-post study was performed. Results: Although patients and caregivers considered the self-management tool as useful and supportive, no clear evidence for decreased caregiver burden was found. There was a positive trend in group characteristics such as the distribution of tasks, communication and prevalence of conflicts. Caregivers also stated that they took more time for themselves, had less feelings of guilt and experienced less barriers to ask help. Conclusion: Tailor-made support of informal care groups starts with facilitating and guiding a process to achieve consent within the group to optimise the care for the patient and also for the caregivers. With a shared vision and supported decisions, caregivers can enter into conversations with the professional caregiver to coordinate adjusted support regarding the care needs. (Edited publisher abstract)
What are the consequences of caring for older people and what interventions are effective for supporting unpaid carers? A rapid review of systematic reviews
- Authors:
- SPIERS Gemma F, et al
- Journal article citation:
- BMJ Open, 11(9), 2021, Online only
- Publisher:
- BMJ Publishing Group
Objectives: To identify and map evidence about the consequences of unpaid caring for all carers of older people, and effective interventions to support this carer population. Design: A rapid review of systematic reviews, focused on the consequences for carers of unpaid caring for older people, and interventions to support this heterogeneous group of carers. Reviews of carers of all ages were eligible, with any outcome measures relating to carers’ health, and social and financial well-being. Searches were conducted in MEDLINE, PsycInfo and Epistemonikos (January 2000 to January 2020). Records were screened, and included systematic reviews were quality appraised. Summary data were extracted and a narrative synthesis produced. Results: Twelve systematic reviews reporting evidence about the consequences of caring for carers (n=6) and assessing the effectiveness of carer interventions (n=6) were included. The review evidence typically focused on mental health outcomes, with little information identified about carers’ physical, social and financial well-being. Clear estimates of the prevalence and severity of carer outcomes, and how these differ between carers and non-carers, were absent. A range of interventions were identified, but there was no strong evidence of effectiveness. In some studies, the choice of outcome measure may underestimate the full impact of an intervention. Conclusions: Current evidence fails to fully quantify the impacts that caring for older people has on carers’ health and well-being. Information on social patterning of the consequences of caring is absent. Systematic measurement of a broad range of outcomes, with comparison to the general population, is needed to better understand the true consequences of caring. Classification of unpaid caring as a social determinant of health could be an effective lever to bring greater focus and support to this population. Further work is needed to develop and identify suitable interventions in order to support evidence-based policymaking and practice. (Edited publisher abstract)
Health, well‐being, and social support in older Australian lesbian and gay care‐givers
- Authors:
- ALBA Beatrice, et al
- Journal article citation:
- Health and Social Care in the Community, 28(1), 2020, pp.204-215.
- Publisher:
- Wiley
Informal care‐givers play an important role in society, and many of the people who provide this care are lesbian women and gay men. Being a care‐giver is known to be associated with poorer health and well‐being, and lesbian and gay care‐givers report experiences of stigma and discrimination in the care‐giving context. This study involved a survey of 230 lesbian women and 503 gay men aged 60 years and over living in Australia, of which 218 were care‐givers. This study compared care‐givers to non‐caregivers on a range of health and well‐being measures, including psychological distress, positive mental health, physical health and social support. While this study found no significant differences between these two groups, this study further compared care‐givers who were caring for an LGBTI person to those who were caring for a non‐LGBTI person. Among the lesbian women, care‐givers of an LGBTI person reported feeling less supported in their carer role and reported lower levels of social support more generally. They were also lower on positive mental health and physical health indicators. Among the gay men, care‐givers of an LGBTI person also reported feeling less supported in their carer role, but there were no differences in reported levels of social support more generally or health and well‐being compared to those caring for a non‐LGBTI person. Overall, results from this study suggest that older lesbian and gay care‐givers may be facing some challenges related to their well‐being and feeling supported, especially if they are caring for another LGBTI person. (Edited publisher abstract)