A journey without maps—Understanding the costs of caring for dependent older people in Nigeria, China, Mexico and Peru

Mayston, Rosie; Lloyd‐Sherlock, Peter; Gallardo, Sara; Wang, Hong; Huang, Yueqin; de, Verónica Montes; Ezeah, Peter; Guerra, Mariella; Sosa, Ana Luisa; Liu, Zhaourui; Uwakwe, Richard; Guerchet, Maëlenn; Prince, Martin

doi:10.1371/journal.pone.0182360

Cited by 42 publications

(66 citation statements)

References 26 publications

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“…The results suggest that in an effort to improve adaptation to heavy stressors of families of patient with dementia, future interventions should target improving different sources of support, especially FA and kin support. Several studies have shown that in families in which adult children are primary caregivers, adult children will have difficulty balancing the physical and financial needs of multiple roles, 17,19 which affected family relationships and FA. Studies of Zairt and Bangerter have also shown that most of the families have conflicts related to caregiving.…”

Section: Discussionmentioning

confidence: 99%

“…So, we also confirmed that FA and kin support were mediators through our research at the same time. As many studies have shown, the heavy burden of stressor in families of patients with dementia led to conflicts among family members and relatives, [16][17][18][19] which reduced the FA and kin support. And the support influenced family adaptation in turn.…”

Section: Effect Of Community Support and N-social Supportmentioning

confidence: 99%

“…8 If they cannot adapt to this situation, it will lead to depression, 13,14 sleep disturbance, even thoughts of suicide, 15 family conflicts [16][17][18][19] , and economic vulnerability. [18][19][20] These outcomes of family maladaptation threaten life quality of patients with dementia and even have the possibility to start up a vicious circle. 18,19 Social support (broad sense) is not only family coping resource, but coping result during family adaptation process as well.…”

Section: Introductionmentioning

confidence: 99%

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Effect of Different Sources Support on Adaptation in Families of Patient With Moderate-to-Severe Dementia in China

Wang

et al. 2019

Am J Alzheimers Dis Other Demen

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Purpose: To examine the support from different sources of Chinese families of patients with moderate-to-severe dementia that most heavily influences the family adaptation and the influence pathway. Method: Two hundred and three families participated in this study. Chinese versions of instruments were used. Structural equation modeling was applied to confirm the effect pathway. Results: More family support, kin support, community support, and social support (narrow sense) were related to greater levels of family adaptation. Family support was the most heavy influence factor (total effect = 0.374), followed by kin support (0.334), social support (0.137), and community support (0.121). Family support and kin support were direct influence factors, while the other 2 were not. Conclusion: All support will promote family adaptation, especially family support and kin support. Interventions improving support from different sources, especially family support and kin support, will promote adaptation in Chinese families of patients with moderate-to-severe dementia.

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Section: Discussionmentioning

confidence: 99%

Section: Effect Of Community Support and N-social Supportmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Effect of Different Sources Support on Adaptation in Families of Patient With Moderate-to-Severe Dementia in China

Wang

et al. 2019

Am J Alzheimers Dis Other Demen

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“…At the incidence wave survey, assets were similarly distributed between households selected for ‘care’ and ‘no care’ groups [ 24 ]. The accompanying qualitative case studies enabled us to explore mechanisms underlying any observed associations between care dependence and household impoverishment, including factors that support economic resilience [ 24 , 25 ].…”

Section: Introductionmentioning

confidence: 99%

A cohort study of the effects of older adult care dependence upon household economic functioning, in Peru, Mexico and China

Guerchet¹,

Guerra²,

Huang³

et al. 2018

PLoS ONE

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BackgroundWhile links between disability and poverty are well established, there have been few longitudinal studies to clarify direction of causality, particularly among older adults in low and middle income countries. We aimed to study the effect of care dependence among older adult residents on the economic functioning of their households, in catchment area survey sites in Peru, Mexico and China.MethodsHouseholds were classified from the evolution of the needs for care of older residents, over two previous community surveys, as ‘incident care’, ‘chronic care’ or ‘no care’, and followed up three years later to ascertain economic outcomes (household income, consumption, economic strain, satisfaction with economic circumstances, healthcare expenditure and residents giving up work or education to care).ResultsHousehold income did not differ between household groups. However, income from paid work (Pooled Count Ratio pCR 0.88, 95% CI 0.78–1.00) and government transfers (pCR 0.80, 95% CI 0.69–0.93) were lower in care households. Consumption was 12% lower in chronic care households (pCR 0.88, 95% CI 0.77–0.99). Household healthcare expenditure was higher (pCR 1.55, 95% CI 1.26–1.90), and catastrophic healthcare spending more common (pRR 1.64, 95% CI 1.64–2.22) in care households.ConclusionsWhile endogeneity cannot be confidently excluded as an explanation for the findings, this study indicates that older people’s needs for care have a discernable impact on household economics, controlling for baseline indicators of long-term economic status. Although living, typically, in multigenerational family units, older people have not featured prominently in global health and development agendas. Population ageing will rapidly increase the number of households where older people live, and their societal significance. Building sustainable long-term care systems for the future will require some combination of improved income security in old age; incentivisation of informal care through compensation for direct and opportunity costs; and development of community care services to support, and, where necessary, supplement or substitute the central role of informal caregivers.

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“…Consistent with our current findings, a recent systematic review of qualitative studies from LMICs showed that loneliness was often characterised by older people as loss: of physical functioning, independence, close confidantes, social participation and sense of belonging within families and societies [20,22,23]. Results from the 10/66 DRG INDEP study and a recent study in Ghana carried out among dependent older people suggest that changing societal expectations (greater female participation in paid employment, longer periods of education for young people) were putting a strain on social norms of intergenerational reciprocity [45,46].…”

Section: Discussionmentioning

confidence: 99%

Loneliness among older adults in Latin America, China, and India: prevalence, correlates and association with mortality

Gao

Prina

Prince

et al. 2020

Preprint

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BackgroundResearch carried out in high income countries suggests that loneliness may be a common experience among older adults living in these settings. Loneliness is correlated with poor socioeconomic status, living alone, being widowed and is associated with adverse health outcomes, including mortality. There is still a lack of evidence about the epidemiology of loneliness among older adults living in low- and middle-income countries. This study was designed to explore prevalence and correlates of self-reported loneliness and to investigate whether loneliness predicts mortality in Latin America, China and India. MethodsThe study investigated population-based cross-sectional (2003-2007) and longitudinal surveys (follow-up 2007-2010) from the 10/66 Dementia Research Group project carried out among 16685 older adults in urban and rural catchment areas in Cuba, Dominican Republic, Puerto Rico, Venezuela, Peru, Mexico, China and India. Poisson regression and Cox regression analyses were conducted to analyse correlates of loneliness and its association with mortality. ResultsThe standardised prevalence of loneliness varied between 25.3% and 32.4% in Latin America and was 18.3% in India. China showed a low prevalence of loneliness (3.8%). In pooled meta-analyses, there was robust evidence to support an association between loneliness and mortality across Latin America (HR=1.13, 95% CI 1.01-1.26, I2=10.1%) and China (HR=1.58, 95% CI 1.03-2.41), but there were no associations in India. ConclusionsOur findings suggest potential cultural variances may exist in the concept of loneliness in older age. The effect of loneliness upon mortality is consistent across different cultural settings excluding India. Loneliness should therefore be considered as a potential dimension of public health among older populations.

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A journey without maps—Understanding the costs of caring for dependent older people in Nigeria, China, Mexico and Peru

Cited by 42 publications

References 26 publications

Effect of Different Sources Support on Adaptation in Families of Patient With Moderate-to-Severe Dementia in China

Effect of Different Sources Support on Adaptation in Families of Patient With Moderate-to-Severe Dementia in China

A cohort study of the effects of older adult care dependence upon household economic functioning, in Peru, Mexico and China

Loneliness among older adults in Latin America, China, and India: prevalence, correlates and association with mortality

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