Care Configurations and Unmet Care Needs in Older Men and Women

Abstract

Older adults frequently experience adverse consequences as the result of unmet care needs, including not getting dressed and going without food when hungry. Previous studies have noted that characteristics of the caregiver network may be associated with unmet needs. Using National Health and Aging Trends Study data, I modeled the association between care configurations and unmet needs for men and women. In generalized linear models, formal care was not associated with unmet need among women or men. Compared with recipients of spousal care, men receiving care from one nonspousal caregiver, and men and women receiving care from any other configuration, had higher odds of unmet needs. The level of difficulty with daily tasks was strongly associated with unmet needs. These findings support monitoring older adults not receiving spousal care, increasing access to formal care, and regularly assessing level of difficulty with daily tasks in clinical and research settings.

Associations between care network types and psychological well-being among Dutch older adults

“…Longitudinal studies are required to examine how changes in care network types, attitudes and evaluations impact on each other and on psychological well-being. Another limitation concerns the use of a general one-item indicator of unmet needs instead of a more comprehensive measure that specifies what type of help is lacking (for example, Potter, 2017). This may have given more insight into how informal and formal care may supplement or complement each other on care tasks, as well as to what degree these specific needs of help impact well-being differently.…”

“…A difference between the type of help received and the type of help needed may result from care recipients' hesitance to ask for the care that they need; however, it may also arise from restrictions, on the side of the providers, to help out in the way that one prefers. Generally, the use of informal care (in particular, from spouses and adult children) lowers the level of unmet needs (Casado et al, 2011;Potter 2017), whereas the use of formal care increases the level of unmet needs (Li, 2006;Bien et al, 2013). Yet, Djundadeva et al (2014) showed that some parents reported receiving too little or too much help from adult children.…”

“…Yet, Djundadeva et al (2014) showed that some parents reported receiving too little or too much help from adult children. For some, the use of formal care was not related to unmet need (Potter, 2017). Also, the use of privately paid care was associated with fewer unmet needs than the use of publicly provided care (Rogero-García and Rosenberg, 2011), implying that paying for care oneself makes it easier to get the care that is needed.…”

“…There is related evidence, for example, feeling that one is a burden to relatives contributes to a lower level of well-being (Cahill et al, 2009). There is also evidence which demonstrates that, in particular, the use of privately paid care increases a feeling of control over care, while publicly paid formal care use decreases feeling in control of care (Galvin, 2004;Rogero-García and Rosenberg, 2011;Potter, 2017), suggesting that paying for care overcomes issues of feeling dependent on caregivers and offers potentially more control over the service provided than being the passive receiver of care from a state-funded provider. The general hypothesis reads: H4: Differences in depressive symptoms among the four network types are, in part, due to differences in feeling in control of care.…”

Why do spouses provide personal care? A study among care‐receiving Dutch community‐dwelling older adults

“…First, health problems may make it necessary for many older adults to rely on others for care (Miller et al, 2009;Potter, 2019).…”