The Impact of Long-Term Care Needs on the Socioeconomic Deprivation of Older People and Their Families: Results from Mixed-Methods Scoping Review

Casanova, Georgia; Martarelli, Rossella; Belletti, Francesco; Moreno-Castro, Carolina; Lamura, Giovanni

doi:10.3390/healthcare11182593

Cited by 2 publications

(2 citation statements)

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“…Material and social deprivation have both been identified as relevant risks posed by informal care provision or having to shoulder the cost of home care. This also confirms the validity of Erikson's multidimensional poverty concept [54] in an LTC context, as Casanova et al [48] have recently proposed, which considers material and social deprivation not as separate aspects but as mutually impacting aspects of impoverishment linked to caring. However, the risk of SED for families providing informal care is a dynamic phenomenon influenced by social and historical changes that determine its characteristics.…”

Section: Discussionsupporting

confidence: 84%

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The Risk of Household Socioeconomic Deprivation Related to Older Long-Term Care Needs: A Qualitative Exploratory Study in Italy and Spain

Casanova,

Fernández-Salido,

Moreno-Castro

2023

Sustainability

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Background: Older individuals with long-term care (LTC) needs represent a risk factor for poverty and socioeconomic deprivation (SED) for households. This challenge threatens the overall sustainability of health and social care systems. Spain and Italy have a robust family-based care regime with a high level of informal long-term care. Aims: This qualitative study aims to provide empirical evidence of the socioeconomic risks for Spanish and Italian households related to long-term care needs by identifying the phenomenon’s main characteristics and suggestions for innovative policies and solutions. In particular, this qualitative study examines the opinions of experts and stakeholders from both countries to: (a) explore the relationship between LTC needs and household SED risk in Spain and Italy; (b) identify key associations between words and concepts, highlighting their specific characteristics in both countries; and (c) perform an in-depth analysis of the interviewees’ views on designing innovative policies to support households, aimed at coping with the SED risk arising from the challenges posed by meeting the LTC needs of older people and their relatives Methods: National experts and stakeholders were involved in interviews and focus groups in both countries. A linguistic and content analysis of the transcriptions produced was performed and supported by T-LAB. Results: The SED risk for households was confirmed in both countries. Informal carers, often women, contend with a higher risk of material and social deprivation. To improve the coordination and integration strategy of public LTC, policies should contrast the SED risk of households. Moreover, an innovative integrated welfare model should consider valorizing different existing resources (e.g., informal care, neighbors, and NGOs). Conclusions: Long-term care policies aimed at promoting ageing need to pay more attention to such a risk as a structural component to be addressed and tackled with more specific and effective strategies.

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Section: Discussionsupporting

confidence: 84%

“…A recent literature review [48] identifies several gaps in the literature by studying the relationship between LTC needs and socioeconomic deprivation (SED) household risk.…”

Section: Related Literaturementioning

confidence: 99%

The Risk of Household Socioeconomic Deprivation Related to Older Long-Term Care Needs: A Qualitative Exploratory Study in Italy and Spain

Casanova,

Fernández-Salido,

Moreno-Castro

2023

Sustainability

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The care of non-institutionalized ADL-dependent people in the Orcasitas neighborhood of Madrid (Spain) during the Covid-19 pandemic and its relationship with social inequalities, intergenerational dependency and survival

Martín Moreno,

Martínez Sanz,

Martín Fernández

et al. 2024

Front. Public Health

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BackgroundMortality among people with dependency to perform basic activities of daily living (ADL) is higher than that of non-dependent people of the same age. Understanding the evolutionary course and factors involved in non-institutionalized ADL dependency, including the influence of the family structure that supports this population, would contribute to improved health planning.MethodsA longitudinal study carried out in the ADL-dependent population of the Orcasitas neighborhood, Madrid (Spain), between June 2020, when the nationwide COVID-19 lockdown ended, and June 2023. A total of 127 patients participated in the study, 78.7% of whom were women and 21.3% were men. Risk analysis was performed via odds ratios (OR) and hazard ratios (HR). Survival analysis was performed using Cox regression.ResultsA total of 54.33% of the ADL-dependent persons did not live with their adult children and 45.67% did, being associated living independently with economic capacity and the married marital status but not with the dependency level. In women, being married increased the probability of living independently of their adult children (OR = 12.632; 95% CI = 3.312–48.178). Loss of mobility (OR = 0.398; 95% CI = 0.186–0.853), economic capacity of the dependent (HR = 0.596; 95% CI = 0.459–0.774), and living independently and having better economic capacity (HR = 0.471; 95% CI = 0.234–0.935) were associated with 3-year survival. Those who lived with their adult children had a worse autonomy profile and higher mortality (HR = 1.473; 95% CI = 1.072–2.024). Not being employed, not being married, and not owning a home were significantly associated with being an essential family caregiver. Caregivers were mostly women (OR = 1.794; 95% CI = 1.011–3.182).ConclusionAmong ADL-dependent persons, economic capacity influenced the ability to living independently and affected survival after 3 years. Loss of mobility (wheelchair use) was a predictor of mortality. Social inequalities promote that adult children end up as essential family caregivers. This generates reverse dependency and maintains a vulnerability that is transmitted from generation to generation, perpetuating social and gender inequalities. Dependent parent care in this cohort maintained an archaic pattern in which the eldest daughter cared for her parents. This study made it possible to show that ADL dependence is accompanied by complex interrelationships that must be considered in socio-health planning.

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The Impact of Long-Term Care Needs on the Socioeconomic Deprivation of Older People and Their Families: Results from Mixed-Methods Scoping Review

Cited by 2 publications

References 70 publications

The Risk of Household Socioeconomic Deprivation Related to Older Long-Term Care Needs: A Qualitative Exploratory Study in Italy and Spain

The Risk of Household Socioeconomic Deprivation Related to Older Long-Term Care Needs: A Qualitative Exploratory Study in Italy and Spain

The care of non-institutionalized ADL-dependent people in the Orcasitas neighborhood of Madrid (Spain) during the Covid-19 pandemic and its relationship with social inequalities, intergenerational dependency and survival

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