Determinants and characteristics of help provision for elderly people living at home and in relation to quality of life (original) (raw)
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Journal of Health Social Care in the Community, 1996
The aim of this study was to investigate from the perspective of formal carers the care given to people aged 65 and over, who are cared for in their own homes by informal care. Thirty-three district nurses (DNs) and 20 home service assistants in a municipality with 13500 inhabitants (over 65 years old), were interviewed about the location of care recipients and 398 care recipients were located. Most of them were over 80 years old and had more than one disease (62%), mostly related to the circulatory system (27%). Dependence in three or more of the Katz ADL categories was seen in 30%, reduced mobility in 67%, reduced memory in 34% to a degree that restricted their everyday life and 34% of them could seldom or never be alone. Care had been given for three years or more for 57% of these people. The monitoring of the disabilities and reduced functional health status differed significantly between the diagnostic groups. Home help service was associated with the care recipients' ADL index but not with their need for continuous monitoring. The DNs' care did not relate to any of the variables. In conclusion, diagnoses, the care recipients ability to be alone and functional health status are important variables to include when assessing the demands for home care and when planning supplementary care for home care recipients and their informal caregivers.
Health & Social Care in the Community, 2007
The aim of this study was to investigate from the perspective of formal carers the care given to people aged 65 and over, who are cared for in their own homes by informal care. Thirty-three district nurses (DNs) and 20 home service assistants in a municipality with 13500 inhabitants (over 65 years old), were interviewed about the location of care recipients and 398 care recipients were located. Most of them were over 80 years old and had more than one disease (62%), mostly related to the circulatory system (27%). Dependence in three or more of the Katz ADL categories was seen in 30%, reduced mobility in 67%, reduced memory in 34% to a degree that restricted their everyday life and 34% of them could seldom or never be alone. Care had been given for three years or more for 57% of these people. The monitoring of the disabilities and reduced functional health status differed significantly between the diagnostic groups. Home help service was associated with the care recipients' ADL index but not with their need for continuous monitoring. The DNs' care did not relate to any of the variables. In conclusion, diagnoses, the care recipients ability to be alone and functional health status are important variables to include when assessing the demands for home care and when planning supplementary care for home care recipients and their informal caregivers.
Patterns of Informal Help and Caregiving in Sweden: A Thirteen-Year Perspective
Social Policy & Administration, 2009
This article analyses informal help and caregiving in Sweden with a focus on the scope and trends of change over time. The discussion is based on the results of three national surveys and of one survey conducted in the county of Stockholm. The results indicated that informal help and caregiving was common throughout the period under study. In the 1990s, the figures were fairly stable, while from the late 1990s to 2005 there seems to have been a dramatic increase in the prevalence of such support. Two interpretative perspectives are used to discuss this pattern. One locates its point of departure in recent welfare state changes and in the substitution argument, according to which cuts in welfare services put more pressure on people to provide informal help and care. The second perspective relates to the present debate on civil society and to its possible role in contemporary society. According to the civil society perspective, an increase in the prevalence of informal help and caregiving might be interpreted as an expression of growing civic involvement ‘in its own right’, without a straightforward and simple relationship to changes in the welfare state. It is argued in the article that the two frames of interpretation should not be viewed as mutually exclusive, but rather that they represent two partly complementary approaches to the understanding of the complex dynamics of unpaid work in contemporary Swedish society.
Scandinavian Journal of Public Health, 2021
Aims: All Swedish municipalities are legally obliged to provide publicly funded elder care to individuals in need. The Swedish Social Service Register collects data on such care. It is the only nationwide source of information on care home residency and use of home care but has rarely been used for research. This study aims to present the content and coverage of the Social Service Register and to provide guidance for researchers planning to use these data. Methods: For each month between 2013 and 2020, we examined which of Sweden’s 290 municipalities reported data to the Social Service Register. We calculated proportions of the population (restricted to ages 80–89 years to enable comparison) that were reported to the Social Service Register in each municipality and presented the types and amount of care recorded in the register. Results: The proportion of municipalities reporting to the Social Service Register increased from 82% to 98% during the study period but several municipalit...
Journal of Nutrition Health & Aging, 2016
Objectives: Study formal and informal care of community-living older people in the Swedish National study of Aging and Care (SNAC). Design: Cross-sectional, population based cohort. Setting: Three areas in Sweden: Municipality of Nordanstig, Stockholm and Skåne County. Participants: 3,338 persons ≥72 years. Measurements: Patterns and amounts of informal and formal care by cognition and area of residence. Results: 73% received no care; 14% formal care; and 17% informal care (7% received both). In the whole study population, including those who used no care, individuals in small municipalities received 9.6 hours of informal care/month; in mid-size municipalities, 6.6; and in urban areas, 5.6. Users of informal care received 33.1 hours of informal care/month in small municipalities, 54.6 in mid-size municipalities and 36.1 in urban areas. Individuals with cognitive impairment received 14.1 hours of informal care/month, 2.7 times more than people with no/slight impairment. In the whole study population, individuals in small municipalities received an average of 3.2 hours of formal care/month; in mid-size municipalities 1.4; and in urban areas, 2.6. Corresponding figures for formal care users were 29.4 hours in small municipalities, 13.6 in mid-size municipalities and 16.7 in urban areas. Formal care users received 7.1 hours, and informal care users, 5.9 hours for each hour/month received by people in the study population as a whole. Conclusions: More informal than formal care was provided. Informal care is more frequent in small municipalities than urban areas and for those with than without cognitive impairment. The relationship between data on the whole population and the data on users or care indicates that population-based data are needed to avoid overestimates of care.
Scandinavian Journal of Public Health
Background: Will being a caregiver further impact the health of a group already at risk of adverse health due to old age? This study aimed to answer the questions whether short- and long-term healthcare consumption and mortality differ between informal caregivers and non-caregivers and between high-burden and low-burden informal caregivers. Method: The study population consisted of 423 caregivers and 3444 controls from the Swedish national general population study ‘Good Aging in Skåne’. Caregivers were divided into those reporting high and low caregiver burden and information on caregiver status was collected from questionnaires. Data for mortality and healthcare consumption (inpatient and outpatient visits) were obtained from The National Board of Health and Welfare. Mortality was tested with Cox regression models and healthcare consumption with logistic regression models, adjusted for sociodemographic covariates, Activities of daily living (ADL) and number of chronic diseases. Res...
The Shifting Balance of Long-Term Care in Sweden
The Gerontologist, 2002
Purpose: This study describes the Swedish debate on the role of family and state in care of elderly persons. It provides empirical evidence on the shifting balance of family, state, and market in the total panorama of elderly care. Design and Methods: Secondary analysis of older (1954) and more recent data sources (1994 and 2000) is used to assess living arrangements and care patterns for persons 75 years or older living in the community. Results: Total spending on aged adults has stagnated, and institutional care is shrinking in absolute and relative terms, but public Home Help for elders in the community is decreasing even more. Family members increasingly shoulder the bulk of care, but privately purchased care also seems to expand. This study calculates how public and informal care changed between 1994 and 2000: Informal care is estimated to have provided 60% of all care to elders in the community in 1994 and 70% in 2000. Implications: The results parallel a crisis of legitimacy of public elderly care in Sweden. They also call into question various metaphors used to describe patterns of care.
Determinants of home care utilization among the Swedish old: nationwide register-based study
European Journal of Ageing, 2021
Since the 1990s, Sweden has implemented aging-in-place policies increasing the share of older adults dependent on home care instead of residing in care homes. At the same time previous research has highlighted that individuals receive home care at a higher age than before. Consequently, services are provided for a shorter time before death, increasing reliance on family and kin as caregivers. Previous studies addressing how homecare is distributed rely primarily on small surveys and are often limited to specific regions. This study aims to ascertain how home care services are distributed regarding individual-level factors such as health status, living arrangements, availability of family, education, and socioeconomic position. To provide estimates that can be generalized to Sweden as a whole, we use register data for the entire Swedish population aged 65 + in 2016. The study's main findings are that home care recipients and the amount of care received are among the oldest old wi...
Scandinavian Journal of Social Welfare, 1993
Whether an individual receives home care services depends on two factors: the functional disability of the care recipient and the caregiver's gender, when the living arrangements of the care recipient are controlled. Data from this longitudinal study of social networks and home care organization in 3 municipalities in Sweden show that care recipients with a severe disability received more home care services than others. In cases where the main caregiver lives together with the care recipient, the public services are adjusted to the family situation and are independent of the functional disability of the care recipient. Care recipients who live with the primary caregiver receive less formal help than do care recipients who live alone. When the primary caregiver does not live together with the care recipient, the public services are adjusted to the functional disability of the care recipient and are independent of the primary caregiver's gender. Care recipients supported by a ...