Health: support provided and received in advanced old age

Abstract

While research focuses mainly on support provided to the elderly, this paper deals with the very old as a support provider to his family as much as a care recipient from both his family and a formal network. We hypothesize that elders with declining health will try to maintain the provision of services, even when they require and receive help.A total of 340 octogenarians from the Swiss Interdisciplinary Longitudinal Study on the Oldest Old (SWILSOO) were interviewed up to five times over five years (N=1225 interviews). A multilevel model was applied to assess the effects of health, controlled for socio-demographic and family network variables, on the frequency of services that the old persons provided to their family and received from their family and formal networks. Health is operationalized in three statuses: ADL-dependent, ADL-independent frail, and robust.While the recourse to the informal network increased progressively with the process of frailty, the recourse to the formal network drastically increased for ADL-dependent individuals. Being ADL-dependent seriously altered the capacity to provide services, but ADL-independent frail persons were providers with the same frequency as the robust oldest old, showing their ability to preserve a principle of reciprocity in their exchanges with their family network. This continuity of roles may help frail persons to maintain their self-esteem and well-being.

Long‐Term Effect on Mortality of a Home Intervention that Reduces Functional Difficulties in Older Adults: Results from a Randomized Trial

“…Control‐oriented strategies enable continued engagement in everyday activities, which may have some physiological and psychosocial benefits. Although pathophysiological mechanisms are unclear, 21 the findings of the current study are consistent with recent evidence on the dynamic interaction between frailty and living environments 22 …”

“…Although pathophysiological mechanisms are unclear, 21 the findings of the current study are consistent with recent evidence on the dynamic interaction between frailty and living environments. 22 There are other competing explanations than the benefits conferred by ABLE. Findings may be a result of attrition bias or selective mortality in the intervention group such that the highest-risk patients died early, leaving a remaining pool of lower risk patients.…”

Equidad en el apoyo social recíproco y satisfacción vital en personas mayores

“…La proporción relativa de intercambios equitativos y no equitativos se mantiene en las redes de apoyo emocional en los diferentes estados civiles y situaciones parentales, así como en los intercambios de ayuda instrumental con los hermanos y con los vecinos. Estos hallazgos ponen de relieve que los intercambios de apoyo dentro y fuera de la familia tienen en la reciprocidad un eje fundamental (Armi, Guilley, & Lalive d'Epinay, 2008;Johar, Maruyama, & Nakamura, 2015;McMunn, Nazroo, Wahrendorf, Breeze, & Zaninotto, 2009;Shaw, 2005) y van en la línea de los trabajos que defienden el papel de la reciprocidad en la continuidad de las relaciones (Fyrand, 2010). A lo largo de la vida, la reciprocidad igualaría los desequilibrios de los intercambios de ayuda presentes y anteriores, asegurando la continuidad en las relaciones íntimas, particularmente entre esposos y entre padres mayores e hijos adultos (Ikkink & van Tilburg, 1999).…”

The interface between formal and informal support in advanced old age: A 10-year study

“…In the cases of adjustment, the reduction of the informal services was probably a sign that an elderly parent who had become more severely impaired needed professional care which could no longer be provided by the relatives. Indeed, the informal network tends to continue caring for old persons as long as it is capable of doing so, with formal networks coming into play essentially when professional skills are necessary (Armi et al 2007). The introduction of formal networks may then lighten the task of the caregivers or redirect them to other forms of care.…”