Transitions to informal care in Great Britain during the 1990s

Abstract

Objectives: To estimate annual changes and trends in the population of informal carers and to investigate transitions to caregiving by age, gender, locus of care, and level of involvement. Design: Longitudinal analysis of data from the British household panel survey, 1991 to 1998, an annual prospective survey of a nationally representative sample of more than 5000 private households in England, Scotland, and Wales. Subjects: Over 9000 adults over 16 years interviewed personally in successive waves of the survey, including around 1300 informal carers each year. Results: One third of co-resident carers and 40% of extra-resident carers start caregiving each year and similar proportions cease to provide care. Five year period rates are at least 75% higher than the one year prevalence estimates. Almost everyone is involved in caregiving at one time or another and over half are likely to provide 20 hours or more care per week at some point in their lives. Recent trends indicate that more adults are becoming heavily involved in providing longer episodes of care. Although the onset of caregiving peaks in late middle and early older age, above average incidences span three decades or more of adult life. Age variations in the start of caring relationships are driven by the changing demands for care within and between generations over the life course. There is no firm evidence that carers increase their involvement in caring activities over the first three years of a caring episode.Conclusions: The population of carers is constantly changing as some people stop providing care and others take on a caring role or vary their level of involvement. Policy measures responsive to the diversity of caring roles, and geared around key transitions, are likely to be most effective in supporting carers through changing circumstances. Recognition and support for carers who are heavily involved in caring activities from the outset should be a priority.T he market value, or replacement cost, of unpaid care provided by family members and friends to ill and disabled adults in the United States was estimated to be $196 billion in 1997. 1 The economic value of informal caregiving in Britain is reported to be around £34 billion per year, although the methodologies used to produce such estimates are contested. 1a 2 However, few would argue that state provision of care could ever replace the carers' role or that, without their contribution, community health and social care services could cope with the additional demands on their resources. On the contrary, supporting informal carers in their caring role is high on the public policy agendas of many developed countries.With mounting concern about funding the long term care needs of older people, a determined shift from institutional arrangements to community and home based provision, and uncertainty about the impact of demographic and social change on the demand for and supply of family care, government policies towards carers and the people they care for are evolving rapidly. 3 Central to policy ...

Final Transitions: Family Caregiving at the End of Life

“…31 An important concept within the caregiving career model involves the transitions that occur from one stage of caregiving to another and the transitional events that may occur within each stage. 31 Research on the experiences of family members caring for an older adult with cognitive or physical impairments has produced the most empirical data about these transitional events: (1) onset of the illness, precipitating the start of care in the role-acquisition stage; [32][33][34][35] (2) nursing home admission, precipitating institutional care in the role-enactment phase [35][36][37][38][39][40] ; and (3) the patient's death, precipitating bereavement in the role disengagement stage. 37,39,[41][42][43] Because these transitional events occurring between and within stages represent periods of rapid change, they are particularly challenging and important to under-stand.…”

The experience of partners of young stroke survivors

“…Care is usually provided by family members, most often the partner/spouse [3] and these caregivers are a vital resource in the move towards more home-based care [4,5]. The emotional and practical support provided enhances the functional, psychological and psychosocial outcomes for the survivor [6][7][8].…”

Associations between Birth Health, Maternal Employment, and Child Care Arrangement among a Community Sample of Mothers with Young Children

“…The considerable influence of employment status on child care arrangement regardless of child's birth health illustrates the importance of child care in balancing childrearing responsibilities with work-related obligations as suggested by the work-family conflict model (Bianchi & Milkie, 2010;Goode, 1960;Kelly & Voydanoff, 1985;Warren & Johnson, 1995). While decisions to work and use child care influence and interact with each other in complex ways (Han, 2004;Hirst, 2002), results of the present study indicate that maternal employment largely explains the association between perceived child's birth health and subsequent child care arrangement decisions. In addition, the results also support the construct of a mother's "perceived susceptibility to illness" for her child, as found in the Health Belief Model.…”