Care and support for older adults in The Netherlands living independently

Abstract

The growth in the numbers of older adults needing long-term care has resulted in rising costs which have forced the Dutch government to change its long-term care system. Now, the local authorities have greater responsibility for supporting older adults and in prolonging independent living with increased support provided by the social network. However, it is unclear whether these older adults have such a network to rely upon. The objective of this study was to gain insight into the providers of formal and informal care to older adults, and to assess possible differences between older adults who are frail and those who are not. In addition, we investigated their care and support needs. We used data from a quantitative survey using a cross-sectional design in different regions of the Netherlands from July until September 2014 (n = 181). Frailty was measured using the Tilburg Frailty indicator. To analyse the data chi-square tests, crosstabs and odds ratios were used for dichotomous data and the Mann-Whitney U-Test for nominal data. The number of formal care providers involved was significantly higher (median = 2) for those deemed frail than for those not deemed frail (median = 1), U = 2,130, p < .005. However, more than one-third of the respondents deemed frail did not get the care or support they needed (33.7%). There was a significant positive association between being frail and having an informal care provider (χ = 18.78, df = 1, p < .005). However, more than one-third of those deemed frail did not have an informal care provider (36.8%). One-third of older adults deemed to be frail did not have their needs sufficiently addressed by their care network. For a substantial part of this group of older adults, the informal network seems to be unable to support them sufficiently. Additional attention for their needs and wishes is required to implement the policy reforms successfully.

Fragilidad y su correlación con calidad de vida y utilización de los servicios de salud en personas mayores que viven en la comunidad

“…La prevalencia de fragilidad es variada a nivel mundial ya que depende de varios factores como, por ejemplo, definición de fragilidad, tipo de muestra e instrumento de medición que se emplee. Si se hace una búsqueda de estudios similares a este, es decir, resultados de investigación que han medido la fragilidad multidimensional con el instrumento TFI en PM que viven en la comunidad, los porcentajes varían entre 51% a 58% [30][31][32][33][34] ; en consecuencia, el porcentaje de fragilidad encontrado en este estudio concuerda con lo encontrado en la literatura internacional. Dentro de las limitaciones de esta investigación se encuentra que no se pueden establecer causalidad entre las variables en estudio por el tipo de diseño del mismo.…”

Psychometric evaluation of the German version of a social support scale of FAFHES (Family Functioning, Family Health and Social Support)

“…These families might have fewer people in their neighbourhood whom they can ask for help. Social support networks often consist of healthcare professionals, family members and spouses or partners .…”

“…These families might have fewer people in their neighbourhood whom they can ask for help. Social support networks often consist of healthcare professionals, family members and spouses or partners (22,55). The factor analysis revealed a three-factor solution according to the social support theoretical framework by Kahn and Antonucci (36), with the dimensions of affirmation, affect and concrete aid and to the FAFHES social support scale (21,35).…”

Community care for severely frail older people: Developing explanations of how, why and for whom it works

“…The realist programme theories overlap but tend to happen in sequence (see Figure 1 Our study suggests that the first phases of trust development and risk minimisation at home, which encompass a full consideration of the social and physical environment within which people live, are central to the added value of the CWT compared to other services. This allows the Team coordinators to become familiar with and support severely frail older patients; they then begin to play a key role in their informal care networks (Verver, Merten, Robben, & Wagner, 2018). Berkman and Glass (2000) hypothesised causal pathways through which social networks impact on health outcomes.…”