Determinants of home-based formal help in community-dwelling older people in Finland

Abstract

Knowledge of the determinants of use of formal home-based services among older people is of particular importance for predicting the need for and cost of care in the future. The aim of this study was to estimate the frequency of formal and informal help among community-dwelling older people and to assess the determinants of home-based formal help, with a special emphasis on the frequency of help from spouse, from children and other relatives and friends. We used nationally representative cross-sectional data from 1,166 communitydwelling Finnish persons aged 70-99. Determinants of formal help were assessed with logistic regression models. Receiving formal help was most strongly related to need factors such as age and functional capacity. Adjusted for need factors, receiving help from spouse or living with someone else than the spouse decreased the odds of receiving formal help. In contrast, the more frequently the children helped, the larger were the odds of receiving formal home-based help. Help from other informal sources did not affect receipt of formal help. Our results thus suggest that intra-household help from spouse or from other co-residents may partly offset expected cost increases in the formal care sector brought about by an aging population. The results further suggest that help from children and help from formal sources is likely to be concomitant and that children may act as agents seeking formal help also in a welfare state based on the universal and equal care services.

Paid and unpaid support received by co-resident informal caregivers attending to community-dwelling older adults in Spain

“…Consistent with previous studies from the United Kingdom (Bywaters and Harris 1998), men receive more external paid support than do women. Unlike previous results from North America (Hong 2010), but in agreement with previous results for Finland (Blomgren et al 2008), the results suggest (P value \ 0.1) that spouses have a lower probability of receiving paid support than distant relatives in Spain. This is accounted for by the lower degree of commitment and intimacy of distant relatives in comparison to spouses (Allen et al 1999).…”

“…In contrast with the Blomgren et al (2008) study of formal help in Finland, no need factors were linked to paid support to informal caregivers in the models. This difference can be explained because Blomgren et al also included public, volunteer and private organisations, while this study only considered private paid work.…”

Should the provision of home help services be contained?: Validation of the new preventive care policy in Japan

“…Similar to previous studies, we found that people who had no primary caregiver, or whose primary caregiver came from outside the household, were more likely to choose home help, while those whose primary caregiver lived in the same household were more likely to go to day care [25,26]. However, even after controlling for these variables, home help service users were found to have a lower risk of functional decline than day care service users.…”

Formal and informal care for disabled elderly living in the community: an appraisal of French care composition and costs

“…Others have studied factors associated with the type of care received [23][24][25]. Knowledge of the characteristics that determine the use of care is essential to designing health policies that fit society's needs [26]. In France, the publicly financed assistance is only conceived as residual of the former assistance delivered by the families.…”