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Predicting transitions in the use of informal and professional care by older adults
- Authors:
- GEERLINGS Sandra, et al
- Journal article citation:
- Ageing and Society, 25(1), January 2005, pp.111-130.
- Publisher:
- Cambridge University Press
To prepare the care system for a rising population of older people it is important to understand what factors predict the use of care. This paper reports a study of transitions in use of informal and professional care using Andersen-Newman models of the predictive predisposing, enabling and need factors. It draws on Longitudinal Ageing Study Amsterdam data on care use and contextual factors. Data were collected at 3-yearly intervals from a random sex- and age-stratified population-based sample of adults aged 55-85. In summary, findings for those who initially did not receive care were that almost one-third received some kind 3 years later, most provided by informal carers. Need factors were important predictors of most transitions, and predisposing and enabling factors, such as age, partner status and income also played a role. On the relationship between informal and professional care, evidence was found for both 'compensatory processes (informal substitutes for professional care) and 'bridging processes' (informal care facilitates professional care). In view of the increasing discrepancy between the demand for professional care and supply, the significant impact of predisposing and enabling factors offers opportunities for intervention.
When your world gets smaller: how older people try to meet their social needs, including the role of social technology
- Authors:
- TEN BRUGGENCATE Tina, LUIJKX Katrien G., STURM Janienke
- Journal article citation:
- Ageing and Society, 39(8), 2019, pp.1826-1852.
- Publisher:
- Cambridge University Press
Social needs are important basic human needs. When social needs are not fulfilled, it can lead to mental and physical health problems. In an ageing society, meeting the social needs of older adults is important to sustain their wellbeing and quality of life. Social technology is used by younger people attempting to fulfil social needs. The aim of this study is to understand the social needs of older people and the role of social technology in fulfilling these needs. Using this information we will uncover opportunities for (technological) interventions. This study conducted a qualitative explorative field study by interviewing 19 community-dwelling older adults. The participants were selected by professional care-givers with the help of a list of criteria for people at risk of social isolation or loneliness. Semi-structured interviews were held, using a topic list covering the following topics: social networks, social support, connectedness, neighbourhood, activities and hobbies, as well as use of and experiences with social technology. After thematic analysis, inductive codes were attached to quotations relevant to the research question. The results were described in four sections: (a) social needs and relationships; (b) the influence of life history and personality; (c) possibilities and barriers to meet social needs; and (d) use of and attitude towards social technology. The results indicate that the group of participants is heterogeneous and that their social needs and the way they try to meet these are diverse. The Social Production Functions Theory of Successful Aging (SPF-SA) was found to be a useful basis for interpreting and presenting the data. Social needs such as connectedness, autonomy, affection, behavioural confirmation and status are important for the wellbeing of older people. Although the need for affection is most easy to fulfil for older people, it looks like satisfaction of the need for behavioural confirmation and status are in some cases preferred, especially by the male participants. Resources such as relationships, activities, personal circumstances and social technology can help meet social needs. Where there is a lack of (physical) resources such as health problems, reduced mobility, death of network members, fear of rejection and gossip, and poor financial circumstances, meeting social needs can be more difficult for some older people. Social technology now plays a modest role in the lives of older people and in fulfilling their social needs. Because of its potential and its role in the lives of younger people, social technology can be seen as a promising resource in the satisfaction of social needs. However, since it is yet unknown how and to what extent the use of social network technologies, such as Facebook, can be beneficial for older people, more research in this area is needed. The findings conclude that the world of older individuals is getting smaller. The loss of resources, e.g. the loss of one's health and mobility, may make it more difficult for an older person to connect with the world outside, which may result in a smaller social network. Therefore it is suggested that interventions to support older adults to meet their social needs may focus on two aspects: supporting and improving the world close by and bringing the world outside a little bit closer. (Edited publisher abstract)
Overcoming old in age-friendliness
- Authors:
- LINDENBERG J., WESTENDORP R.G.J.
- Journal article citation:
- Journal of Social Work Practice, 29(1), 2015, pp.85-98.
- Publisher:
- Taylor and Francis
- Place of publication:
- Philadelphia, USA
In this article, the authors explore views on an age-friendly space in the Netherlands by analysing the responses of older individuals (N = 54) in focus groups and by examining the perspectives around an age-friendly zone in the Netherlands, Parkstad Limburg. The authors found that a central issue in the wishes for living at a later age are adjustments to envisioned physical limitations that come with the ageing process; this includes adjustments to ensure safety, accessibility and mobility, in order to facilitate older individuals' efforts to stay engaged with the world around them. In their wishes, the older participants constructed ideal dwelling places that closely resembled a senior home, but at the same time they rejected wishing to live in a place that was identified as a senior home. The authors explain this paradox by the representation of such a space as being for old people, i.e. needy older individuals, which was not how the older participants wished to be identified. It is concluded that the conception of age-friendly environments will have to face the difficult challenge of overcoming the association with old age, while simultaneously taking into account adjustments that signify and relate to the ageing process and that seem inescapably tied to oldness. (Edited publisher abstract)
Individual determinants of task division in older adults' mixed care networks
- Authors:
- JACOBS Marianne T., et al
- Journal article citation:
- Health and Social Care in the Community, 22(1), 2014, pp.57-66.
- Publisher:
- Wiley
Older adults in need of long-term care often receive help from both informal and formal caregivers. The division of tasks between these different types of caregivers may vary among such mixed care networks. Traditional models of task division suggest that formal and informal caregivers may either supplement each other or specialise in the care activities performed. This study explores division of Activities of Daily Living (ADL) andI Instrumental ADL (IADL) between informal and formal caregivers of older people in the Netherlands, using data collected in 2007 on 458 mixed care situations. Four types of task divisions of informal and formal care are distinguished: the complementation model [neither Activities of Daily Living (ADL) nor instrumental ADL (IADL) tasks shared, 14%], the supplementation model (both ADL and IADL tasks shared, 39%) and informal and formal specialisation (one type of task shared, one type of task not shared, 27% and 20% respectively). Analyses show that the intensity of care provision, the informal caregivers' motives and the presence of privately paid help – more than care receiver's health – are related to type of task division with formal care. For example, when the informal caregiver provides more hours of help and out of a strong personal bond, the likelihood of informal specialisation increases, whereas the likelihood of formal specialisation decreases. When privately paid help is present, the complementation model is more likely, whereas the supplementation model is less likely to be found. Results are discussed regarding the differential consequences for co-ordination and co-operation in mixed care networks. (Edited publisher abstract)
Major depressive disorder in late life: a multifocus perspective on care needs
- Authors:
- HOUTJES W., et al
- Journal article citation:
- Aging and Mental Health, 14(7), September 2010, pp.874-880.
- Publisher:
- Taylor and Francis
To gain insight into the needs of outpatients with late-life depression this study interviewed 99 outpatients aged 58-92 who were receiving treatment for major depressive disorder from six specialised mental health care facilities in the Netherlands. They were interviewed using the Dutch version of the Camberwell Assessment of Needs for the Elderly (CANE-NL) to identify met and unmet needs and the Montgomery-Asberg Depression Rating Scale to measure depression severity. The results showed that depression severity levels varied from remission (23%), mild (31%), moderate (31%), to severe depression (15%). The average number of needs reported was 8.86, comprising 6.5 met needs and 2.3 unmet needs. Most of the unique variance in depression severity was explained by psychological unmet needs, more in particular by needs representing psychological distress. The environmental, social or physical unmet needs showed less or no meaningful predictive value for variance in depression severity. The article concludes that systematic needs assessment may be a necessary complement to medical examination and a prerequisite for the development of tailored treatment plans for older people with depression.
Care and support for older adults in the Netherlands living independently
- Authors:
- VERVER Didi, et al
- Journal article citation:
- Health and Social Care in the Community, 26(3), 2018, pp.e404-e414.
- Publisher:
- Wiley
The growth in the numbers of older adults needing long‐term care has resulted in rising costs which have forced the Dutch government to change its long‐term care system. Now, the local authorities have greater responsibility for supporting older adults and in prolonging independent living with increased support provided by the social network. However, it is unclear whether these older adults have such a network to rely upon. The objective of this study was to gain insight into the providers of formal and informal care to older adults, and to assess possible differences between older adults who are frail and those who are not. In addition, their care and support needs were investigated. Data was collected from a quantitative survey using a cross‐sectional design in different regions of the Netherlands from July until September 2014 (n = 181). Frailty was measured using the Tilburg Frailty indicator. To analyse the data chi‐square tests, crosstabs and odds ratios were used for dichotomous data and the Mann–Whitney U‐Test for nominal data. The number of formal care providers involved was significantly higher (median = 2) for those deemed frail than for those not deemed frail (median = 1), U = 2,130, p < .005. However, more than one‐third of the respondents deemed frail did not get the care or support they needed (33.7%). There was a significant positive association between being frail and having an informal care provider (χ2 = 18.78, df = 1, p < .005). However, more than one‐third of those deemed frail did not have an informal care provider (36.8%). One‐third of older adults deemed to be frail did not have their needs sufficiently addressed by their care network. For a substantial part of this group of older adults, the informal network seems to be unable to support them sufficiently. Additional attention for their needs and wishes is required to implement the policy reforms successfully. (Edited publisher abstract)
The care needs of older patients with bipolar disorder
- Authors:
- DAUTZENBERG Geraud, et al
- Journal article citation:
- Aging and Mental Health, 20(9), 2016, pp.899-907.
- Publisher:
- Taylor and Francis
Objectives: With ageing, bipolar disorder evolves into a more complex illness, with increasing cognitive impairment, somatic comorbidity, and polypharmacy. To tailor treatment of these patients, it is important to study their needs, as having more unmet needs is a strong predictor of a lower quality of life. Method: Seventy-eight Dutch patients with bipolar I or II disorder aged 60 years and older in contact with mental health services were interviewed using the Camberwell Assessment of Need in the Elderly (CANE) to assess met and unmet needs, both from a patient and a staff perspective. Results: Patients (mean age 68 years, range 61–98) reported a mean of 4.3 needs compared to 4.4 reported by staff, of which 0.8 were unmet according to patients and 0.5 according to staff. Patients frequently rated company and daytime activities as unmet needs. More current mood symptoms were associated with a higher total number of needs. Less social participation was associated with a higher total number of needs and more unmet needs. Conclusion: Older bipolar patients report fewer needs and unmet needs compared to older patients with depression, schizophrenia, and dementia. A plausible explanation is that older bipolar patients had higher Global Assessment of Functioning scores, were better socially integrated, and had fewer actual mood symptoms, all of which correlated with the number of needs in this study. The results emphasise the necessity to assess the needs of bipolar patients with special attention to social functioning, as it is suggested that staff fail to recognise or anticipate these needs. (Edited publisher abstract)
Care workers in long-term care for older people: challenges of quantity and quality
- Author:
- CHEN Lisa Henglien
- Journal article citation:
- European Journal of Social Work, 17(3), 2014, pp.383-401.
- Publisher:
- Taylor and Francis
This article, drawing on a qualitative study in England, the Netherlands and Taiwan, explores how countries with very different care systems address the challenge of securing sufficient numbers of care workers with appropriate skills in ageing care. The analysis exposes the salient features of care systems, ageing-care markets and the ageing-care workforce in the three countries. To support the analysis, examples of how the countries attempt to recruit and retain ageing-care workers are provided. Key findings are that to secure an adequate number of skilled ageing-care workers, job satisfaction, coherence between care and labour policies and equal working conditions across sectors are vital. A quality ageing-care worker requires regular professional supervision and support, resources for ongoing training and career development opportunities. Most importantly, securing a sufficient number of ageing-care workers and ensuring they have appropriate skills are not isolated challenges but are interlinked and require collaboration between a range of care actors. (Publisher abstract)
Lack of motivation for treatment associated with greater care needs and psychosocial problems
- Authors:
- STOBBE Jolanda, et al
- Journal article citation:
- Aging and Mental Health, 17(8), 2013, pp.1052-1058.
- Publisher:
- Taylor and Francis
One hundred and forty one outpatients with severe mental illness (SMI), aged 55 and older, participated in a study to compare the care needs and severity of psychosocial problems between those who were and were not motivated for treatment. Participants were from an area of The Netherlands. Needs were measured using the Camberwell Assessment of Needs for the Elderly, and psychosocial problems with the Health of the Nation Outcome Scale 65+. Motivation for treatment was assessed using a motivation-for-change scale. Parametric and non-parametric tests were used to analyse differences between motivated and non-motivated patients. Explorative logistic regression analyses were used to establish, which unmet needs were associated with motivation. Less-motivated patients had greater unmet care needs and more psychosocial problems than those who were motivated. Logistic regression analyses showed that lack of motivation was associated with greater unmet needs regarding daytime activities, psychotic symptoms, behavioral problems, and addiction problems. Lack of treatment motivation was associated with more unmet needs and more severe psychosocial problems. Further research will be needed to identify other factors associated with motivation in older people with SMI and to investigate whether this group of patient benefits from interventions such as assertive outreach, integrated care or treatment-adherence therapy. (Edited publisher abstract)
Successful ageing amongst older people needing care: international comparisons seeking solutions
- Author:
- CHEN Henglien Lisa
- Journal article citation:
- Social and Public Policy Review, 3(1), 2009, Online only
- Publisher:
- University of Plymouth
- Place of publication:
- Plymouth
Quality of life is one of the main concerns in long-term care amongst ageing populations in many countries. This paper explores the way that long-term care of older people is organised between the East and West, and considers how three countries (England, the Netherlands and Taiwan) may learn from one another in their search for solutions. The research was designed to include the views and experiences of all the actors in the three examples of welfare systems concerning the demand and supply of care resources and the impact of policy upon the provision of social inclusion in long-term care services. Most service users in the research supported the view that improvement in social well-being would increase their quality of life.