Help from spouse and from children among older people with functional limitations: comparison of England and Finland

2011 ◽  
Vol 32 (6) ◽  
pp. 905-933 ◽  
Author(s):  
JENNI BLOMGREN ◽  
ELIZABETH BREEZE ◽  
SEPPO KOSKINEN ◽  
PEKKA MARTIKAINEN
Keyword(s):  
Older People ◽  
Informal Care ◽  
Functional Limitations ◽  
Community Dwelling ◽  
Formal Sector ◽  
Low Education ◽  
Formal Services ◽  
Nationally Representative ◽  
Generous Welfare

ABSTRACTFuture increases in need of old-age care warrant research on receipt of informal care among older people in different policy and cultural contexts. Separating informal care into help provided by spouse and by children may shed more light on dynamics of informal help, important in alleviating the demands on the formal sector. Using nationally representative data from England and Finland, we performed logistic regression analyses to study receipt of help from spouse and children among community-dwelling persons 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. In the context of a generous welfare state, children may function more as active agents bridging the gap between their parents and formal services.

Pain and symptoms of depression in older adults living in community and in nursing homes: the role of activity restriction as a potential mediator and moderator

2014 ◽  
Vol 26 (10) ◽  
pp. 1679-1691 ◽  
Author(s):  
Almudena López-Lopez ◽  
José L. González ◽  
Miriam Alonso-Fernández ◽  
Noelia Cuidad ◽  
Borja Matías
Keyword(s):  
Older Adults ◽  
Depressive Symptoms ◽  
Nursing Homes ◽  
Older People ◽  
Pain Intensity ◽  
Nursing Home Residents ◽  
Well Being ◽  
Community Dwelling ◽  
Activity Restriction

ABSTRACTBackground:Chronic pain is likely to lead to depressive symptoms, but the nature of this relationship is not completely clear. The aim of the present study is to analyze the role of activity restriction in the pain-depression relationship in older people, and to test the hypothesis that this role is more relevant in community-dwelling older people than in nursing home residents.Method:Depressive symptoms, pain intensity, and activity restriction were measured in a sample of 208 older adults with osteoarthritis, 102 living in nursing homes (NH), and 106 in the community. Analyses were carried out using moderation and moderated mediation analyses approach, treating activity restriction as a confounder.Results:Results showed a significant confounding effect of activity restriction, interaction effect between pain intensity and activity restriction on depression, and modifying effect of pain intensity on depression by adding activity restriction into the model. These results suggest a potential mediating and moderating effects of activity restriction. Moreover, analyses suggest that, surprisingly, the strength of the mediation could be higher in nursing homes.Conclusions:Overall, it may be that what is really important to emotional well-being is not so much pain itself, but rather the way in which the pain alters older people's lives. The greater strength of the mediation in NH might be understood within the scope of self-determination theory. Generally speaking, the NH context has been considered as a coercive setting, promoting non-autonomous orientation. In this context, when events are objectively coercive, people may lack perceived autonomy and hence be at greater risk of depression.

scholarly journals Overlooked and undervalued: the caring contribution of older people

2014 ◽  
Vol 41 (5) ◽  
pp. 397-419 ◽  
Author(s):  
Fiona Carmichael ◽  
Marco G. Ercolani
Keyword(s):  
Health Care ◽  
Older People ◽  
Personal Care ◽  
Data Set ◽  
Content Type ◽  
The People ◽  
Ordered Logistic Regression ◽  
Allocation Of Time ◽  
Nationally Representative

Purpose – Older people are often perceived to be a drain on health care resources. This ignores their caring contribution to the health care sector. The purpose of this paper is to address this imbalance and highlight the role of older people as carers. Design/methodology/approach – The study uses a unique data set supplied by a charity. It covers 1,985 caregivers, their characteristics, type and amount of care provided and the characteristics and needs of those cared-for. Binary and ordered logistic regression is used to examine determinates of the supply of care. Fairlie-Oaxaca-Blinder decompositions are used to disentangle the extent to which differences in the supply of care by age are due to observable endowment effects or coefficient effects. Nationally representative British Household Panel Survey data provide contextualization. Findings – Older caregivers are more intensive carers, caring for longer hours, providing more co-residential and personal care. They are therefore more likely to be in greater need of assistance. The decompositions show that their more intensive caring contribution is partly explained by the largely exogenous characteristics and needs of the people they care for. Research limitations/implications – The data are regional and constrained by the supplier's design. Social implications – Older carers make a significant contribution to health care provision. Their allocation of time to caregiving is not a free choice, it is constrained by the needs of those cared-for. Originality/value – If the burden of care and caring contribution are measured by hours supplied and provision of intimate personal care, then a case is made that older carers experience the greatest burden and contribute the most to the community.

scholarly journals Limitations in Physical Activities and Loneliness: The Role of Guilt for Perceiving Oneself as a Burden

2021 ◽  
Vol 5 (Supplement_1) ◽  
pp. 457-457
Author(s):  
María del Sequeros Chaparro ◽  
Isabel Cabrera ◽  
Carlos Vara-García ◽  
José Adrián Fernandes-Pires ◽  
Samara Barrera-Caballero ◽  
...  
Keyword(s):  
Older Adults ◽  
Regression Analysis ◽  
Daily Life ◽  
Functional Limitations ◽  
Linear Regression Analysis ◽  
Physical Activities ◽  
Community Dwelling ◽  
Gender And Age ◽  
The Relationship

Abstract Loneliness is a prevalent problem associated with negative health consequences for older adults, such as greater cognitive decline. Limitations to perform physical activities have been associated with greater loneliness in older adults. This association could be moderated by maladaptive social cognition or feelings, such as guilt associated with perceiving oneself as a burden. The objective of this study was to analyze the moderating effect of guilt associated with perceiving oneself as a burden in the relationship between limitations in physical activities and loneliness. Participants were 195 community-dwelling people 60 years or older not showing explicit cognitive or functional limitations that prevent activities of daily life, but who may present limitations in some physical activities (e.g., walking a kilometer or more). A linear regression analysis was conducted for testing the interaction between limitations in physical activities and guilt for perceiving oneself as a burden in loneliness, controlling for gender and age. The interaction between limitations in physical activities and guilt for perceiving oneself as a burden was the only significant predictor of loneliness and the model explained 18.30% of the variance. Limitations in physical activities influenced loneliness when people have high levels of guilt for perceiving oneself as a burden. This study suggests that guilt for perceiving oneself as a burden may play an important role in the association between limitations in some physical activities and loneliness.

scholarly journals 306Association between polypharmacy and mortality in the community-dwelling older population: a data linkage study

2021 ◽  
Vol 50 (Supplement_1) ◽  
Author(s):  
Johan Van der Heyden ◽  
Finaba Berete ◽  
Brecht Devleesschauwer ◽  
Karin De Ridder ◽  
Olivier Bruyère ◽  
...  
Keyword(s):  
Older People ◽  
Functional Limitations ◽  
Critical Evaluation ◽  
Community Dwelling ◽  
Health Care Use ◽  
Mortality Data ◽  
Health Interview Survey ◽  
Health Interview ◽  
Interview Survey ◽  
The Impact

Abstract Background Literature findings on the association between polypharmacy and mortality in older people are not consistent. Appropriate tools, making use of linkages, are helpful to investigate this further. Methods Data of participants of the Belgian Health Interview Survey 2013 aged ≥ 65 years (n = 1950) were linked with billing data and 5 year’s mortality follow-up information. Polypharmacy was defined as concomitant use of ≥ 5 medicines in the past 24 hours or ≥ 5 recent prescriptions of reimbursed medicines. The impact of polypharmacy on mortality was assessed through mortality rate ratios (MRR) from a Poisson regression model adjusting for gender, age, multimorbidity, functional limitations and health care use, and including interactions. Results The prevalence of polypharmacy was 38,3%. Age and disability status were effect modifiers in the association between polypharmacy and mortality. Whereas polypharmacy was significantly associated with mortality among people aged 65-79 years (MRR 2.52; 95% CI 1.67-3.80), this was not so for the 80 + (MRR 1.46; 95% CI 0.93-2.29). Polypharmacy was a mortality predictor among people with no/moderate functional limitations (MRR 2,29; 95% CI 1.61-3.25), but not for those with severe functional limitations (MRR 1,22; 95% CI 0.67-2.34). Conclusions By linking health interview survey, billing and mortality data further insights can be gained on the association between polypharmacy and mortality. Key messages A critical evaluation of polypharmacy in older people below 80 years and in people without severe functional limitations may reduce mortality in these population groups.

scholarly journals POLYPHARMACY IN DIABETIC PEOPLE: EVIDENCE FROM THE ENGLISH LONGITUDINAL STUDY OF AGEING (ELSA)

2019 ◽  
Vol 3 (Supplement_1) ◽  
pp. S482-S483
Author(s):  
Yun-Ting Huang ◽  
Paola Zaninotto ◽  
Andrew Steptoe ◽  
Li Wei
Keyword(s):  
Risk Factors ◽  
Older People ◽  
Significant Risk ◽  
Cross Sectional Study ◽  
Health Condition ◽  
Cross Sectional ◽  
Nationally Representative ◽  
English Longitudinal Study

Abstract Diabetes among older people is becoming more common worldwide, and usually accompanied by polypharmacy. However, the role of polypharmacy in older people with diabetes remains uncertain. A nationally representative cross-sectional study, ELSA 2012/2013, was used and 7729 participants aged 50-109 were investigated. Polypharmacy was defined as taking five to nine long-term used medications daily for chronic diseases or chronic symptoms, while using ten or more medications was excessive polypharmacy. The presence of illness was defined as either self-reported diagnosis or being prescribed specific medications for the condition. Data showed the prevalence of polypharmacy was 21.4%, and only 3% was excessive polypharmacy. 51.6% of diabetic people reported polypharmacy and 10.2% excessive polypharmacy. These rates were significantly higher than the 16.4% polypharmacy and 1.8% excessive polypharmacy among people without diabetes (p < 0.001). Among people with three or more comorbidities, polypharmacy was present in 61.5% of people with diabetes, compared with 36.0% in people without diabetes. Significant risk factors for polypharmacy were diabetes (Relative-risk ratios/RRR=4.06, 95% CI 3.38, 4.86), older age (RRR=1.02, 95% CI 1.01, 1.03), male (RRR=0.64, 95% CI 0.55, 0.75), more comorbidity (RRR=2.46, 95% CI 2.30, 2.62), living with a partner (RRR=1.20, 95% CI 1.01, 1.42), and less wealth (RRR=0.93, 95% CI 0.87, 0.98). However, age, cohabitation, and wealth were not significantly related to excessive polypharmacy. Diabetes and the number of comorbidities were predominant risk factors for excessive polypharmacy. Current evidences confirmed both health condition and socioeconomic status were associated with medication use in older adults.

scholarly journals Informal and paid care for Brazilian older adults (National Health Survey, 2013)

2017 ◽  
Vol 51 (suppl 1) ◽  
Author(s):  
Maria Fernanda Lima-Costa ◽  
Sérgio Viana Peixoto ◽  
Deborah Carvalho Malta ◽  
Célia Landmann Szwarcwald ◽  
Juliana Vaz de Melo Mambrini
Keyword(s):  
Older Adults ◽  
Informal Care ◽  
National Health ◽  
Health Survey ◽  
Population Aging ◽  
Functional Limitations ◽  
Sociodemographic Factors ◽  
National Health Survey ◽  
Community Dwelling ◽  
Term Care

ABSTRACT OBJECTIVE To describe the prevalence and sociodemographic factors associated with informal and paid care for Brazilian older adults with functional limitations. METHODS Of the 23,815 participants of the National Health Survey aged 60 or older, 5,978 reported needing help to perform activities of daily living and were included in this analysis. The dependent variable was the source of care, categorized as exclusively informal (unpaid), exclusively formal (paid), mixed or none. The socio-demographic variables were age (60-64, 65-74, ≥ 75 years old), gender and number of residents in the household (1, 2, ≥ 3). The multivariate analysis was based on binomial and multinomial logistic regressions. RESULTS Informal care predominated (81.8%), followed by paid (5.8%) or mixed (6.8%) and no care (5.7%). The receipt of care from any source increased gradually with the number of residents in a same household, regardless of age and gender (OR = 4.85 and 9.74 for 2 and ≥ 3, respectively). Age was positively associated with receiving any care while the male gender showed a negative association. The number of residents in the household showed the strongest association with informal care (OR = 10.94 for ≥ 3 residents), compared with paid (OR = 5.48) and mixed (OR = 4.16) care. CONCLUSIONS Informal care is the main source of help for community-dwelling older adults with functional limitations. In a context of rapid population aging and decline in family size, the results reinforce the need for policies to support long-term care for older Brazilians.

Comparison of the Quality of Informal Care of Community-Dwelling Taiwanese Older People

2017 ◽  
Vol 25 (5) ◽  
pp. 375-382
Author(s):  
Chia-Yi Chiao ◽  
Yen-Ju Lin ◽  
Chiu-Yueh Hsiao
Keyword(s):  
Older People ◽  
Informal Care ◽  
Community Dwelling

Welfare states do not crowd out the family: evidence for mixed responsibility from comparative analyses

2005 ◽  
Vol 25 (6) ◽  
pp. 863-882 ◽  
Author(s):  
ANDREAS MOTEL-KLINGEBIEL ◽  
CLEMENS TESCH-ROEMER ◽  
HANS-JOACHIM VON KONDRATOWITZ
Keyword(s):  
Welfare State ◽  
Older People ◽  
Welfare States ◽  
Welfare Regimes ◽  
Opportunity Structures ◽  
The Social ◽  
The Family ◽  
Formal Services ◽  
Stratified Sample

This paper discusses the informal and formal provision of help and support to older people from a comparative welfare state perspective, with particular reference to the relationships between inter-generational family help and welfare state support. While the ‘substitution’ hypothesis states that the generous provision of welfare state services in support of older people ‘crowds out’ family help, the ‘encouragement’ hypothesis predicts a stimulation of family help, and the ‘mixed responsibility’ hypothesis predicts a combination of family and formal help and support. The paper reports findings from the Old Age and Autonomy: The Role of Service Systems and Inter-generational Family Solidarity (OASIS) research project. This created a unique age-stratified sample of 6,106 people aged 25–102 years from the urban populations of Norway, England, Germany, Spain and Israel. The analyses show that the total quantity of help received by older people is greater in welfare states with a strong infrastructure of formal services. Moreover, when measures of the social structure, support preferences and familial opportunity structures were controlled, no evidence of a substantial ‘crowding out’ of family help was found. The results support the hypothesis of ‘mixed responsibility’, and suggest that in societies with well-developed service infrastructures, help from families and welfare state services act accumulatively, but that in familistic welfare regimes, similar combinations do not occur.

scholarly journals Projecting future demand for informal care among older people in China: the road towards a sustainable long-term care system

2018 ◽  
Vol 14 (1) ◽  
pp. 61-81 ◽  
Author(s):  
Bo Hu
Keyword(s):  
Older People ◽  
Informal Care ◽  
Long Term Care ◽  
Term Care ◽  
Monte Carlo Simulation Technique ◽  
Modelling Framework ◽  
Nationally Representative ◽  
The Government ◽  
Care System

AbstractThe long-term care system in China relies heavily on informal care provided by family members. This study makes projections on the demand for informal care among Chinese older people between 2015 and 2035 and quantifies the level of long-term care resources needed to meet their needs. The data come from longitudinal information in a nationally representative sample, China Health and Retirement Longitudinal Survey 2011 and 2013. The macrosimulation approach (PSSRU model) and the Markov approach are integrated into one Bayesian modelling framework. The Monte Carlo simulation technique is used to capture parameter uncertainty. We project that the demand for informal care will increase from 41.3 million people (95% CI: 39.9–42.7) in 2015 to 82.6 million people (95% CI: 78.3–86.9) in 2035. The long-term care system faces unbalanced pressure of demand for informal care from different groups of older people. The projected demand is sensitive to changes in older people’s disability trajectory and the availability of formal care provided by the government, but less sensitive to an increase in singleton households in the future. We discuss possible policy measures to alleviate the mounting pressure on the demand for informal care.

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