Do characteristics of family members influence older persons’ transition to long-term healthcare services?

Abstract

Background Future demographic and economic changes warrant a better understanding of older persons’ need for health-related long-term care services (LTC). LTC uptake among older people is likely to be influenced by the presence or absence of family members, but there is scarce research on the role played by partners with different caregiving potential. There is even less research on the contributions of adult children and their caregiving potential. The current study examines the extent to which transitions into LTC in older men and women differ according to the presence and caregiving potential of partners and children. Methods Linked registry data for Norway on older persons (aged 65+), their partners, and their adult children are used to examine how characteristics of these family members influence transitions into LTC from 2010 to 2016, using logistic discrete-time hazard regression models. We observed around 215,000 transitions to LTC, corresponding to around 26.3% of individuals and 5.4% of the total person-years (4.0 million). Caregiving potential is measured in terms of employment, income, health and educational attainment for partners and education and geographical proximity for children. Results Personal, partner and child(ren)’s resources are all associated with older persons’ LTC uptake. Unpartnered and/or childless older people are more likely to use LTC than those with partners and/or child(ren). Older persons with resourceful partners and children are the least likely to transition into LTC. The geographical proximity of adult children appears to have only a minor influence on LTC use among older people. Conclusions Population ageing and strained public resources will likely challenge the future provision of formal old-age care. The role of family networks in the future provision of formal old-age care is expected to become progressively important in the years to come. Inequalities in the health, care and welfare of older persons with and without resourceful family members are likely to increase.

Factors determining assistance needs for social voluntary services among home-based elderly in Chinese urban areas: a cross-sectional study

“…Another surprising nd was that elderly people with more children had elevated demand. This nding was contrary to an extensive body of literature that suggested that more children are associated with stronger family support [48, 49,50,51]. It may be expected that more children may be able to fully meet the needs of the elderly [50], but this is not always the case.…”

“…Based on the ndings of Suitor et al [52], offspring's perceptions of parental favoritism may exacerbate tensions among various family members, and may indirectly affect quality of care provided to parents. Another study indicated that the elderly quality of care depends more on whether children are resourceful, rather than numerous [51]. Likewise, volunteers must not ignore the assistance needs of the elderly with many children.…”

The effect of age on specialized palliative care use in the last year of life for patients who die of cancer: A nationwide study from Norway

“…Sex differences in patient preferences for palliative care have been documented [17]. A contributing explanation may also be that men with female partners use fewer services because women take on a larger care burden for a sick partner, similar to what is observed in the use of long-term care [18].…”

The association between financial support of adult children to their parents and informal care provision in China and its differences in household registration, residence arrangement and community-based care services: 2008 ~ 2018

“…In Germany, long-term care policies provide cash benefits, which made family caregivers reduce the time of home care, increase labor supply, and pay more formal care for older people [18]. Long-term healthcare services have reduced informal care from family members in the Nordic countries, such as Norway and Sweden, but population ageing and strained public resources will likely challenge the future provision of formal oldage care [19]. In contrast, other studies estimate a complementary effect, which found that formal care increases the provision of informal care [20].…”

“…Household registration in China determines eligibility for various welfare benefits, such as education, health insurance, pension insurance, housing and employment, which has led to a huge difference in social welfare and economic status between urban and rural residents [37]. Co-residence represents an important source of informal care, and elderly people living alone are much more likely to rely on formal care, while those who live with adult children receive more informal care [19]. Currently, China has vigorously developed community-based care services such as housekeeping services, rehabilitation care and spiritual comfort services in order to make up for the lack of informal care.…”