scholarly journals Socioeconomic Inequality in Long-Term Care: A Comparison of Three Time Periods in the Netherlands

2020 ◽  
Vol 4 (Supplement_1) ◽  
pp. 725-725
Author(s):  
Jens Abbing ◽  
Bianca Suanet ◽  
Marjolein Broese van Groenou
Keyword(s):  
Long Term Care ◽  
Time Data ◽  
Term Care ◽  
Partner Status ◽  
Lower Socioeconomic ◽  
Longitudinal Aging Study Amsterdam ◽  
Aging Study ◽  
Longitudinal Aging Study ◽  
Over Time

Abstract This study aims at investigating to what extent inequalities in the use of formal, informal and privately paid care have changed over time. Data from the Longitudinal Aging Study Amsterdam (LASA) was used from three points in time (1995, 2005 and 2015) that capture distinct periods in the recent development of the Dutch long-term care system. In particular, the reforms of 2007 and 2015 might have impacted care uses. All participants (N = 1810) were living at home and between the age of 75 and 85 at measurement. The results indicate that, adjusted for health and partner status, formal, informal and privately paid care have decreased over time. Socioeconomic differences in informal care use have increased over time, but no change was found for privately paid or formal care use. These findings suggest that changes in the LTC system and long-term care resources in particular benefit lower socioeconomic groups.

scholarly journals Socio-economic inequality in long-term care: a comparison of three time periods in the Netherlands

2021 ◽  
pp. 1-21
Author(s):  
Jens Abbing ◽  
Bianca Suanet ◽  
Marjolein Broese van Groenou
Keyword(s):  
The Netherlands ◽  
Informal Care ◽  
Long Term Care ◽  
Economic Status ◽  
Time Data ◽  
Term Care ◽  
Care Givers ◽  
Longitudinal Aging Study Amsterdam ◽  
Over Time

Abstract As a result of the rapid ageing of societies, meeting the demands for long-term care has become increasingly difficult. In the Netherlands, informal care is recognised as a key element to compensate for cut-backs in formal care provision. Formal, informal and privately paid long-term care services, however, are not used equally across socio-economic status (SES) groups and whether these inequalities have been reduced or exacerbated over time has not been researched. This study investigates to what extent educational and income inequalities in the use of formal, informal and privately paid care have changed over time. Data from the Longitudinal Aging Study Amsterdam (LASA) was used from three points in time: 1995 (N = 787), 2005 (N = 550) and 2015 (N = 473). Participants were between 75 and 85 years of age and living independently. The results indicate that lower SES groups are consistently more likely to use formal and informal care, and less likely to use privately paid care compared to higher SES groups. An increase in inequality was only found in the use of informal care; while informal care use is stable among lower SES groups, it decreases steeply among higher SES groups. These findings highlight the importance of education for explaining variation and changes over time in care use. Governmental efforts to mobilise informal care-givers might be outweighed by trends towards less long-term care.

scholarly journals Frailty and Its Associated Risk Factors: First Phase Analysis of Multicentre Indonesia Longitudinal Aging Study

2021 ◽  
Vol 8 ◽  
Author(s):  
Siti Setiati ◽  
Czeresna Heriawan Soejono ◽  
Kuntjoro Harimurti ◽  
Noto Dwimartutie ◽  
I. G. P. Suka Aryana ◽  
...  
Keyword(s):  
Risk Factors ◽  
At Risk ◽  
Long Term Care ◽  
Functional Dependence ◽  
Community Dwelling ◽  
Term Care ◽  
Aging Study ◽  
History Of ◽  
Longitudinal Aging Study

Background: National long-term care development requires updated epidemiological data related to frailty. We aimed to find the prevalence of frailty and its associated factors among Indonesian elderly.Methods: We conducted first-phase cross-sectional analysis of Indonesia Longitudinal Aging Study (INALAS) data collected from community-dwelling outpatients aged 60 years and older without acute illness in nine geriatric service care centres. Descriptive, bivariate and multivariate analyses were conducted.Results: Among 908 elderly in this study, 15.10% were robust, 66.20% were pre-frail, and 18.70% were frail. Functional dependence was associated with frailty among Indonesian elderly (OR 5.97, 95% CI 4.04–8.80). Being depressed and at risk for malnutrition were also associated with frailty with OR 2.54, 95% CI 1.56–4.12, and OR 2.56, 95% CI 1.68–3.90, respectively. Prior history of fall (OR 1.77, 95% CI 1.16–2.72) and hospitalization (OR 1.46, 95% CI 0.97–2.20) in the previous 12 months were associated with frailty. There is also significant association between poly pharmacy and frailty (OR 2.42, 95% CI 1.50–3.91).Conclusion: Approximately one in five Indonesian community-dwelling elderly was frail. Frailty is associated with functional dependence, being at risk for malnutrition or being malnourished, depression, history of fall, history of hospitalization, and poly pharmacy. There may be bidirectional relationships between the risk factors and frailty. The development of long-term care in Indonesia should be considered, without forcing the elderly who need it.

Six-month trajectories of self-reported depressive symptoms in long-term care

2015 ◽  
Vol 28 (1) ◽  
pp. 71-81 ◽  
Author(s):  
Jane McCusker ◽  
Martin G. Cole ◽  
Philippe Voyer ◽  
Johanne Monette ◽  
Nathalie Champoux ◽  
...  
Keyword(s):  
Depressive Symptoms ◽  
Long Term Care ◽  
Secondary Analysis ◽  
Depression Scale ◽  
Depression Symptom ◽  
Term Care ◽  
Symptom Trajectory ◽  
Over Time

ABSTRACTBackground:Depression is a common problem in long-term care (LTC) settings. We sought to characterize depression symptom trajectories over six months among older residents, and to identify resident characteristics at baseline that predict symptom trajectory.Methods:This study was a secondary analysis of data from a six-month prospective, observational, and multi-site study. Severity of depressive symptoms was assessed with the 15-item Geriatric Depression Scale (GDS) at baseline and with up to six monthly follow-up assessments. Participants were 130 residents with a Mini-Mental State Examination score of 15 or more at baseline and of at least two of the six monthly follow-up assessments. Individual resident GDS trajectories were grouped using hierarchical clustering. The baseline predictors of a more severe trajectory were identified using the Proportional Odds Model.Results:Three clusters of depression symptom trajectory were found that described “lower,” “intermediate,” and “higher” levels of depressive symptoms over time (mean GDS scores for three clusters at baseline were 2.2, 4.9, and 9.0 respectively). The GDS scores in all groups were generally stable over time. Baseline predictors of a more severe trajectory were as follows: Initial GDS score of 7 or more, female sex, LTC residence for less than 12 months, and corrected visual impairment.Conclusions:The six-month course of depressive symptoms in LTC is generally stable. Most residents who experience a more severe symptom trajectory can be identified at baseline.

Modeling trajectories of long-term care needs at old age: A Japanese-Swedish comparison

2017 ◽  
Vol 3 (1) ◽  
pp. 79 ◽  
Author(s):  
Marten Lagergren ◽  
Noriko Kurube ◽  
Yasuhiko Saito
Keyword(s):  
Long Term Care ◽  
Transition Probabilities ◽  
Functional Limitations ◽  
Matrix Multiplication ◽  
National Study ◽  
Initial State ◽  
Term Care ◽  
Future State ◽  
Over Time

A simulation model has been developed, which looks at the future state of functional limitations and provision of long-term care from the individual’s point of view and compares the prospects of Japanese and Swedish old persons. The model calculates the distribution on level of functional limitations combined with level of long-term care (LTC) for a 78-year-old man or woman after 3, 6, 9, 12 and 15 years given the initial state expressed in those terms. Longitudinal data for the model has been taken from the Nihon University Japanese Longitudinal Study of Aging (NUJLSOA) study, two waves three years apart, and the Swedish National Study of Aging and Care (SNAC) study, baseline and three-year follow up. Transition probabilities are calculated by relating individual states between waves. Changes over time are then calculated in the model by matrix multiplication using the Markov assumption. The results are in most respects similar for Japan and Sweden. A difference is that institutional care in Sweden is a much more definite stage reflecting differences in end-of-life care policy. Future state and mortality depends to a great degree on the initial state, both in terms of dependency and level of LTC. Thus, 78-year-old people who have no functional dependency and no LTC have a much higher probability of surviving the coming 10–15 years than people of the same age who already are dependent and in need of LTC services. Not a few of the initially independent 78-year-old persons will retain that state even after 15 years. However, the effect of the initial state seems to decrease over time.

Trends in the informal and formal home-care use of older adults in the Netherlands between 1992 and 2012

2015 ◽  
Vol 36 (9) ◽  
pp. 1870-1890 ◽  
Author(s):  
JOUKJE C. SWINKELS ◽  
BIANCA SUANET ◽  
DORLY J. H. DEEG ◽  
MARJOLEIN I. BROESE VAN GROENOU
Keyword(s):  
Logistic Regression ◽  
Home Care ◽  
Informal Care ◽  
Long Term Care ◽  
Substitution Effect ◽  
Large Decrease ◽  
Term Care ◽  
Multi Level ◽  
Over Time

ABSTRACTThis study investigates trends in, and the interdependence of, the use of informal and formal home care of community-dwelling older people over the last two decades in the context of governmental reform of long-term care services and modernisation of informal relationships. Seven observations of the Longitudinal Aging Study Amsterdam covering the time span between 1992 and 2012 were analysed using multi-level logistic regression analysis. The sample entailed 9,585 observations from 3,574 respondents, aged between 65 and 85 years and living independently at each time of measurement. Measures included formal and informal care use, health, physical and cognitive limitations, socio-demographics, partner status, social network, privately paid help and sense of mastery. Results showed that between 1992 and 2012, formal home-care use increased slightly while there was a large decrease in the use of informal care. Multivariate multi-level logistic regression analyses showed a substitution effect between formal and informal care use which decreased over time. Analyses also showed improved cognitive functioning, increased partner availability and social network size, as well as increased use of privately paid care over time. Nevertheless, these positive trends did not explain the large decrease in informal care use. The results regarding informal care use suggest a societal trend of weakened informal solidarity, reflecting increased individualisation and increased availability of formal home care. The decreased substitution effect suggests that, in agreement with current reforms of long-term care, complementary or supplementary forms of care use may be more common in the near future.

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