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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.
Is social exclusion still important for older people?
- Author:
- KNEALE Dylan
- Publisher:
- Age UK
- Publication year:
- 2012
- Pagination:
- 124p.
- Place of publication:
- London
Social exclusion among older people has received little attention, despite the fact that older people are at high risk of social isolation and loneliness, as well as exhibiting substantial inequalities in income and housing. The study analysed data from the English Longitudinal Study of Ageing (ELSA), collected in 2002 and 2008, to examine how patterns of social exclusion have changed. Social exclusion was measured across 7 domains including exclusion from social relationships, local amenities, financial products, civic activities and access to information, decent housing and public transport, cultural activities, and common consumer goods. The report discusses: how social exclusion can be measured among older people; factors associated with the risk of being socially excluded in 2008; how exclusion status changes over time for individuals; and the impact social exclusion has on people’s lives. The findings show that levels of social exclusion rose slightly between 2002 and 2008 among people aged 50 and above. In 2002, 54.4% were not excluded on any domain, reducing to 52.3% in 2008. The report highlights how an older person’s demographic, socioeconomic and health characteristics are associated with whether or not they are socially excluded. The policy implications of these findings are discussed.
The baby boomers’ intergenerational relationships
- Authors:
- FINGERMAN Karen L., et al
- Journal article citation:
- Gerontologist, 52(2), April 2012, pp.199-209.
- Publisher:
- Oxford University Press
The Baby Boom generation are now entering late life. Increases in life expectancy over the past century have precipitated changes in family ties, and Baby Boomers may be torn between helping young adult children and ageing parents. This review article considers both these aspects of intergenerational relationships of Baby Boomers in the context of changing marital dynamics. Three major studies are described: the Within Family Differences Study (WFDS) of mothers aged 65–75 and their multiple grown children (primarily Baby Boomers) ongoing since 2001; the Family Exchanges Study (FES) of Baby Boomers aged 42–60, their spouses, parents, and multiple grown children ongoing since 2008; and the Longitudinal Study of Generations (LSoG) of 351 3-generation families started when the Baby Boomers were teenagers in 1971. These studies show that the Baby Boomers in midlife navigate complex intergenerational patterns. The WFDS finds ageing parents differentiate among Baby Boomer children in midlife, favouring some more than others. The FES shows that the Baby Boomers are typically more involved with their children than with their aging parents. The LSoG documents how divorce and remarriage dampen intergenerational obligations in some families. These studies provide insights into the nature of intergenerational ties and caregiving in the future.
Caregiver confidence: does it predict changes in disability among elderly home care recipients?
- Authors:
- LI Lydia W., MCLAUGHLIN Sara J.
- Journal article citation:
- Gerontologist, 52(1), February 2012, pp.79-88.
- Publisher:
- Oxford University Press
Caregivers who are confident in their care recipients’ functional capacity may be less likely to offer assistance and more likely to encourage the recipient to perform tasks independently. The aim of this study was to determine whether caregiver confidence in their care recipients’ functional capabilities predicts changes in the performance of activities of daily living (ADL) among elderly home care recipients over time. The sample included 5,138 elderly recipients of home and community-based long-term care in Michigan. ADL performance was assessed multiple times over a 2-year period. Caregiver confidence was measured at baseline with a single item. Multilevel modelling was used to estimate the effect of caregiver confidence on changes in ADL performance over time, controlling for baseline self-efficacy and ADL performance. The findings showed that elders whose caregivers were confident in their capacity for greater functional independence experienced greater improvement in ADL performance than those whose caregivers were not confident. Elders in dyads in which both members expressed confidence experienced more improvement in ADL performance than those in dyads in which either 1 or both members lacked confidence.
Race and cognitive decline among community-dwelling elders with mild cognitive impairment: findings from the Memory and Medical Care Study
- Authors:
- LEE Hochang B., et al
- Journal article citation:
- Aging and Mental Health, 16(3), April 2012, pp.372-377.
- Publisher:
- Taylor and Francis
This paper considers the relationship between race and cognitive decline in elders with dementia. Previous studies have reported inconsistent findings on the relationship between race and cognitive decline, and suggested it might differ across the level of cognitive impairment. This study aimed to investigate the relationship between race and cognitive decline in community-dwelling elders with mild cognitive impairment (MCI). The findings are taken from the Memory and Medical Care Study, a prospective observational cohort study that examined variations in the practice of caring for cognitively impaired elders living in the community. This study included 133 participants who were diagnosed with MCI; 112 (76.7%) of the participants were female, and 59 (44.4%) were black. The main outcome measure was the Telephone Interview for Cognitive Status (TICS) score over 3 years. The findings showed that the 3-year decline in mean TICS score was significantly higher among African Americans than non-African Americans. The article concludes that the rate of cognitive decline in MCI appears to be faster in African Americans than non-African Americans in the community. Diagnosis of MCI among African American elders could lead to early interventions to prevent or delay cognitive decline in the future.
Prevalence and risk factors of depressive symptoms in latest life-results of the Leipzig Longitudinal Study of the Aged (LEILA 75+)
- Authors:
- LUPPA Melanie, et al
- Journal article citation:
- International Journal of Geriatric Psychiatry, 27(3), March 2012, pp.286-295.
- Publisher:
- Wiley
As depressive symptoms are common in oldest age and associated with broad categories of risk factors, latest-life depression represents an important public health issue. The aim of this study was to determine the age-specific and gender-specific prevalence rates and risk factors of depressive symptoms of the oldest old people. The data was derived from the Leipzig Longitudinal Study of the Aged (LEILA 75+), a population-based study on the epidemiology of dementia and mild cognitive impairment (MCI). A sample of 1006 individuals aged 75 years and older were interviewed on socio-demographic, clinical and psychometric variables. Of the overall sample, 38.2% were classified as depressed. Analysis revealed that the following variables were significantly associated with depressive symptoms: divorced or widowed marital status; low educational level; poor self-rated health status; functional impairment; multi-domain MCI, stressful life events; and poor social networks.
Age, ageing and subjective wellbeing in later life
- Authors:
- JIVRAJ Stephen, et al
- Publisher:
- University of Manchester. Cathie Marsh Centre for Census and Survey Research
- Publication year:
- 2012
- Pagination:
- 12p.
- Place of publication:
- Manchester
There has been a shift from measuring successful ageing as the absence of physical and mental health conditions towards assessing subjective wellbeing. There are 3 broad approaches to measuring subjective wellbeing: eudemonic; evaluative; and affective. This paper examines age-related changes in subjective wellbeing in later life using multiple measures that cover the 3 dimensions of wellbeing. The study uses data from 5 waves of the English Longitudinal Study of Ageing (ELSA) over an 8 year period. ELSA is a panel study of people aged 50 and over which began in 2002 and has continued to track the same individuals every 2 years. Multilevel linear growth curve models are used to examine the cross-sectional effects of age and the longitudinal effects of ageing on quality of life, depressive symptomatology and life satisfaction in later life. The findings show that older individuals have a better subjective wellbeing than those that are younger for each wellbeing measure, except at the oldest age for quality of life. Nonetheless, deterioration in wellbeing is greater at older ages, even when adjusting for age-related changes in later life, including widowhood, retirement and declining health. The results suggest that although older people enjoy higher levels of subjective wellbeing than their younger counterparts, they experience sharper declines, especially at the oldest ages.
Are we using support workers effectively? The relationship between patient and team characteristics and support worker utilisation in older people’s community-based rehabilitation services in England
- Authors:
- MORAN Anna, et al
- Journal article citation:
- Health and Social Care in the Community, 20(5), September 2012, pp.537-549.
- Publisher:
- Wiley
Support workers are utilised to increase the flexibility and efficiency of the health and social care workforce. The aim of this study was to explore the relationship between support worker utilisation and patient- and team-level characteristics in community-based rehabilitation services (CBRS). A prospective longitudinal study of 20 older people’s CBRS across England was conducted. Between January and September 2009, 462 Whole Time Equivalent Staff and 1913 patients participated in the study. Patient dependency, health status, and demographic data were collected alongside detailed staff activity data for patients during the recruitment period. The analyses aimed to determine the relationship between the proportion of direct care delivered by support workers team and patient variables. The findings showed that support workers delivered up to 36% of direct patient care and spent less mean time per patient contact (36.0 mins) than qualified professionals (75.8 mins). Less-dependent and female patients had a greater proportion of support worker input, with a 4.9% increase in face-to-face support worker time. Other factors associated with support worker input included the referral source, intensity of care, usual living arrangements and proportion of support staff in a team. The results suggest that a targeted deployment of support workers based on patient characteristics may facilitate more effective use of qualified practitioner time for more complex, dependent patients.
Cohort differences in the availability of informal caregivers: are the boomers at risk?
- Authors:
- RYAN Lindsay H., et al
- Journal article citation:
- Gerontologist, 52(2), April 2012, pp.177-188.
- Publisher:
- Oxford University Press
With the projected increases in both the numbers of older adults and their life expectancies, the demand for formal and informal care among aging adults is expected to grow. The purpose of this study was to explore the potential informal care resources of the baby boomer (BB) cohort (born 1946-1964). Specifically, the study compares the age-related changes in the availability of a spouse or adult child of BBs to previous cohorts of older adults at population level. Population data from the U.S. Census and from the Health and Retirement Study (HRS) were used to identify a cohort similar to the BBs on marital status and fertility rates. The Depression and WWII parents (DWPs) cohort was identified as a proxy for the BBs in old age. Longitudinal data from the DWP cohort and the parents of BBs (PBB) cohort in the HRS was examined for differences in the time-varying likelihoods of being married and of having an adult child living within 10 miles. Analyses revealed that the availability of family changes over time and that the DWP cohort was significantly less likely to have a spouse or a grown child living nearby. The article concludes that as BBs enter into late life they may have lower likelihoods of access to either a spouse or adult children.
Prognostic factors, course, and outcome of depression among older primary care patients: the PROSPECT study
- Authors:
- BOGNER Hillary R., et al
- Journal article citation:
- Aging and Mental Health, 16(4), May 2012, pp.452-461.
- Publisher:
- Taylor and Francis
Major depression describes a clinically diverse set of people; while some patients may respond quickly to treatment, others may have a slower road to recovery. The aim of this study was to examine whether there are patterns of evolving depression symptoms among older primary care patients that are related to prognostic factors and long-term clinical outcomes. The study used data from the PROSPECT study, a multi-site, collaborative study of depression treatment in primary care settings for elderly patients. Primary care practices were randomly assigned to usual care or to an intervention consisting of a depression care manager offering algorithm-based depression care. For this study, 599 adults aged 60 years and older meeting criteria for major depression or clinically significant minor depression were randomly selected. Analysis revealed 3 patterns of change in depression symptoms over 12 months: high persistent course (19.1%); high declining course (14.4%); and low declining course (66.5%). Being in the intervention condition was more likely to be associated with a course of high and declining depression symptoms than high and persistent depression symptoms. Patients with a course of high and persistent depression symptoms were much more likely to have a diagnosis of major depression at 24 months compared with patients with a course of low and declining depression symptoms.