The determinants of receiving social care in later life in England

ABSTRACTDemographic change and policy changes in social care provision can affect the type of social care support received by older people, whether through informal, formal state or formal paid-for sources. This paper analyses the English Longitudinal Study of Ageing data (wave 4) in order to examine the relationship between demographic and socio-economic characteristics, and the receipt of support from different sources by older people who report difficulty with daily activities. The research outlines three key results with implications for the future organisation of social care for older people. Firstly, the number of instrumental activities of daily living (IADLs) an older person reports having difficulty with, followed by the number of activities of daily living (ADLs) are the strongest determinants of receiving support from any source. Secondly, there are significant gender differences in the factors associated with receiving support from different sources; for example, physical health is a strong determinant of informal support receipt by men, while mental health status is a strong determinant of informal support receipt by women. Finally, the research shows that different kinds of impediments in everyday life are associated with receiving support from different sources. This ‘link’ between particular types of difficulties and support receipt from particular sources raises questions about the way social care provision can or should be organised in the future.

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Unmet need for social care among older people

Ageing and Society ◽

10.1017/s0144686x17001118 ◽

2017 ◽

Vol 39 (4) ◽

pp. 657-684 ◽

Cited By ~ 7

Author(s):

ATHINA VLACHANTONI

Keyword(s):

Older People ◽

Activities Of Daily Living ◽

Family Environment ◽

Daily Living ◽

Social Care ◽

Economic Status ◽

Unmet Need ◽

Later Life ◽

Individual Characteristics ◽

Older Individuals

ABSTRACTUnderstanding the nature and extent of unmet need for social care among older people is a critical policy priority in the United Kingdom and beyond, as national governments juggle the provision of adequate social care for a growing older population with competing funding priorities. Several factors can heighten the experience of unmet need among older people, for instance their family environment, and their health and socio-economic status. This paper contributes empirical evidence on the patterns of unmet need for social care among older people in England today, focusing on the individual characteristics associated with experiencing unmet need in relation to mobility tasks, activities of daily living (ADLs) and instrumental activities of daily living (IADLs). The results show that about 55 per cent of older individuals with an ADL difficulty had unmet need, compared to 24 per cent of those with an IADL difficulty and 80 per cent of those with a mobility difficulty. Characteristics reflecting greater vulnerability were more strongly associated with the risk of experiencing unmet need for ADLs, and such vulnerability was greater for particular ADLs (e.g. bathing), and for a higher number of ADLs. The findings reaffirm the complexity of conceptualising and empirically investigating unmet need in later life, and add to our understanding of the challenges of providing adequate and appropriate social care to older people.

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DEPENDENCY IN ACTIVITIES OF DAILY LIVING: THE ROLE OF MULTIDIMENSIONAL FRAILTY AND PROTECTIVE FACTORS

Innovation in Aging ◽

10.1093/geroni/igz038.2367 ◽

2019 ◽

Vol 3 (Supplement_1) ◽

pp. S635-S636

Author(s):

G A Rixt Zijlstra ◽

Anne van der Vorst ◽

Linda P M Op het Veld ◽

Nico De Witte ◽

Jos M G A Schols ◽

...

Keyword(s):

Physical Activity ◽

Older Adults ◽

Older People ◽

Protective Factors ◽

Activities Of Daily Living ◽

Daily Living ◽

Community Dwelling ◽

Frail Older People ◽

The Relationship

Abstract Most older adults prefer to “age in place” and maintain independent regarding activities of daily living (ADL). Dependency in ADL might be caused by frailty. This study explored the relationship between multidimensional frailty and ADL dependency, and if protective factors, derived from a systematic literature review, moderate this relationship. A longitudinal study with a 24-month follow-up was performed among 1,027 community-dwelling older adults. Multidimensional frailty was assessed with the Tilburg Frailty Indicator, and ADL dependency with the Groningen Activity Restriction Scale. Other measures included socio-demographic characteristics and seven protective factors against ADL dependency, such as physical activity and non-smoking. Logistic regression analyses showed that frail older people had a twofold risk of developing ADL dependency in comparison to non-frail older people after 24 months (OR = 2.12, 95% CI = 1.50-3.00). Analyses with interaction terms indicated that the selected protective factors against ADL dependency did not signiﬁcantly moderate this relationship. Nonetheless, higher levels of physical activity and having suﬃcient ﬁnancial resources decreased the risk of becoming ADL dependent in the overall sample (OR = 0.67, 95% CI = 0.46-0.98 and OR = 0.49, 95% CI = 0.35-0.71, respectively). In conclusion, multidimensional frail older people are at higher risk of developing ADL dependency and the studied factors against ADL dependency did not signiﬁcantly moderate this relationship. To develop prevention strategies for ADL dependency and facilitate aging in place, future studies might explore the relationship between each specific frailty domain and ADL dependency, and the role of (other) moderating factors.

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Activities of Daily Living and Categorization Skills of Elderly with Cognitive Deficit: A Preliminary Study

Brain Sciences ◽

10.3390/brainsci11020213 ◽

2021 ◽

Vol 11 (2) ◽

pp. 213

Author(s):

Dulce Romero-Ayuso ◽

Cristian Cuerda ◽

Carmen Morales ◽

Ricardo Tesoriero ◽

José Matías Triviño-Juárez ◽

...

Keyword(s):

Cognitive Impairment ◽

Older People ◽

Activities Of Daily Living ◽

Daily Living ◽

Deductive Reasoning ◽

Personal Autonomy ◽

Assessment Process ◽

Digital Version ◽

Routine Tasks

Cognitive dysfunction affects the performance of Activities of Daily Living (ADL) and the quality of life of people with these deficits and their caregivers. To the knowledge of the authors, to date, there are few studies that focus on knowing the relationship between personal autonomy and deductive reasoning and/or categorization skills, which are necessary for the performance of the ADL. The aim of this study was to explore the relationships between ADL and categorization skills in older people. The study included 51 participants: 31 patients with cognitive impairment and 20 without cognitive impairment. Two tests were administered to assess cognitive functions: (1) the Montreal Cognitive Assessment (MoCA); and (2) the digital version of Riska Object Classification test (ROC-d). In addition, the Routine Tasks Inventory-2 (RTI-2) was applied to determine the level of independence in activities of daily living. People with cognitive impairment performed poorly in categorization tasks with unstructured information (p = 0.006). Also, the results found a high correlation between cognitive functioning and the performance of ADLs (Physical ADL: r = 0.798; p < 0.001; Instrumental ADL: r = 0.740; p < 0.001), a moderate correlation between Physical ADLs and categorization skills (unstructured ROC-d: r = 0.547; p < 0.001; structured ROC-d: r = 0.586; p < 0.001) and Instrumental ADLs and categorization skills in older people (unstructured ROC-d: r = 0.510; p < 0.001; structured ROC-d: r = 0.463; p < 0.001). The ROC-d allows the assessment of categorization skills to be quick and easy, facilitating the assessment process by OT, as well as the accuracy of the data obtained.

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