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Is use of formal community services by older women related to changes in their informal care arrangements?

Published online by Cambridge University Press:  28 September 2012

SAMANTHA J. MCKENZIE*
Affiliation:
School of Population Health, The University of Queensland, Herston, Queensland, Australia.
JAYNE C. LUCKE
Affiliation:
UQ Centre for Clinical Research, The University of Queensland, Herston, Queensland, Australia.
RICHARD L. HOCKEY
Affiliation:
School of Population Health, The University of Queensland, Herston, Queensland, Australia.
ANNETTE J. DOBSON
Affiliation:
School of Population Health, The University of Queensland, Herston, Queensland, Australia.
LEIGH R. TOOTH
Affiliation:
School of Population Health, The University of Queensland, Herston, Queensland, Australia.
*
Address for correspondence: Samantha J. McKenzie, School of Population Health, The University of Queensland, Herston Road, Herston, Queensland, 4006, Australia. E-mail: s.mckenzie5@uq.edu.au

Abstract

This paper examines how the relationships between the factors (predisposing, enabling and illness) of the 1973 Andersen framework and service use are influenced by changes in the caring role in older women of the 1921–26 cohort of the Australian Longitudinal Study on Women's Health. Outcome variables were the use of three formal community support services: (a) nursing or community health services, (b) home-making services and (c) home maintenance services. Predictor variables were survey wave and the following carer characteristics: level of education, country of birth, age, area of residence, ability to manage on income, need for care, sleep difficulty and changes in caring role. Carer changes were a significant predictor of formal service use. Their inclusion did not attenuate the relationship between the Andersen framework factors and service use, but instead provided a more complete representation of carers' situations. Women were more likely to have used support services if they had changed into or out of co-resident caring or continued to provide co-resident care for a frail, ill or disabled person, needed care themselves, and reported sleep difficulties compared with women who did not provide care. These findings are important because they indicate that support services are particularly relevant to women who are changing their caring role and who are themselves in need of care.

Type
Articles
Copyright
Copyright © Cambridge University Press 2012 

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References

Access Economics 2010. The Economic Value of Informal Care in 2010. Report for Carers Australia, Access Economics, Canberra, 1–68.Google Scholar
Andersen, R. M. and Newman, J. F. 1973. Societal and individual determinants of medical care utilization in the United States. Milbank Memorial Fund Quarterly, 51, 1, 95124.Google Scholar
Australian Bureau of Statistics 2001. Outcomes of ABS Views on Remoteness Consultation, Information Paper. ABS Catalogue No. 1244.0.00.001, Australian Bureau of Statistics, Canberra, 128.Google Scholar
Bass, D. M., Looman, W. J. and Ehrlich, P. 1992. Predicting the volume of health and social services: integrating cognitive impairment into the modified Andersen framework. Gerontologist, 32, 1, 3343.CrossRefGoogle ScholarPubMed
Beeber, A. S., Thorpe, J. M. and Clipp, E. C. 2008. Community-based service use by elders with dementia and their caregivers – a latent class analysis. Nursing Research, 57, 5, 312–21.Google Scholar
Berecki-Gisolf, J., Lucke, J., Hockey, R. and Dobson, A. 2008. Transitions into informal caregiving and out of paid employment of women in their 50s. Social Science and Medicine, 67, 1, 122–7.Google Scholar
Bookwala, J., Zdaniuk, B., Burton, L., Lind, B., Jackson, S. and Schulz, R. 2004. Concurrent and long-term predictors of older adults' use of community-based long-term care services: the Caregiver Health Effects Study. Journal of Aging & Health, 16, 1, 88115.Google Scholar
Bond, M. J., Clark, M. S. and Davies, S. 2003. The quality of life of spouse dementia caregivers: changes associated with yielding to formal care and widowhood. Social Science and Medicine, 57, 12, 2385–95.Google Scholar
Brilleman, S., Pachana, N. and Dobson, A. 2010. The impact of attrition on the representativeness of cohort studies of older people. BMC Medical Research Methodology, 10, 1, 71.Google Scholar
Brodaty, H., Thomson, C., Thompson, C. and Fine, M. 2005. Why caregivers of people with dementia and memory loss don't use services. International Journal of Geriatric Psychiatry, 20, 6, 537–46.Google Scholar
Byles, J. E. and Carroll, M. 2008. Mars and Venus: does gender matter in ageing? Medical Journal of Australia, 188, 5, 271–3.Google Scholar
Castora-Binkley, M., Noelker, L. S., Ejaz, F. K. and Rose, M. 2010. Inclusion of caregiver supports and services in home- and community-based service programs: recent reports from state units on aging. Journal of Aging & Social Policy, 23, 1, 1933.Google Scholar
Diggle, P., Heagerty, P., Liang, K.-Y. and Zeger, S. L. 2002. Analysis of Longitudinal Data. Second edition, Oxford University Press, Oxford.Google Scholar
Gaugler, J. E., Hanna, N., Linder, J., Given, C. W., Tolbert, V., Kataria, R. and Regine, W. F. 2005. Cancer caregiving and subjective stress: a multi-site, multi-dimensional analysis. Psycho-Oncology, 14, 9, 771–85.Google Scholar
Haywood, K. L., Garratt, A. M. and Fitzpatrick, R. 2005. Quality of life in older people: a structured review of generic self-assessed health instruments. Quality of Life Research, 14, 7, 1651–68.Google Scholar
Hirst, M. 2002. Transitions to informal care in Great Britain during the 1990s. Journal of Epidemiology and Community Health, 56, 8, 579–87.Google Scholar
Hirst, M. 2005. Carer distress: a prospective, population-based study. Social Science and Medicine, 61, 3, 697708.CrossRefGoogle ScholarPubMed
Hong, S.-I. 2010. Understanding patterns of service utilization among informal caregivers of community older adults. The Gerontologist, 50, 1, 8799.Google Scholar
Hunt, S. M., McKenna, S. P., McEwen, J., Williams, J. and Papp, E. 1981. The Nottingham Health Profile: subjective health status and medical consultations. Social Science and Medicine. Part A, Medical Sociology, 15, 3, 221–9.Google Scholar
Keene, J. and Prokos, A. 2008. Widowhood and the end of spousal care-giving: relief or wear and tear? Ageing & Society, 28, 4, 551.Google Scholar
Kratiuk, S., Young, J., Rawson, G. and Williams, S. 1992. Double Jeopardy: A Report on Dementia Clients of Non-English Speaking Backgrounds. South Western Area Health Services, Sydney.Google Scholar
Kumamoto, K., Arai, Y. and Zarit, S. H. 2006. Use of home care services effectively reduces feelings of burden among family caregivers of disabled elderly in Japan: preliminary results. International Journal of Geriatric Psychiatry, 21, 2, 163–70.Google Scholar
Laidlaw, K. and Pachana, N. 2009. Demographics in older adults. Professional Psychology, Research and Practice, 40, 601–8.Google Scholar
Larson, S. L. and Fleishman, J. A. 2003. Rural–urban differences in usual source of care and ambulatory service use: analyses of national data using urban influence codes. Medical Care, 41, 7, III-6574.Google Scholar
Lee, C., Dobson, A. J., Brown, W. J., Bryson, L., Byles, J., Warner-Smith, P. and Young, A. F. 2005. Cohort profile: the Australian Longitudinal Study on Women's Health. International Journal of Epidemiology, 34, 5, 987–91.Google Scholar
Litwin, H. 2004. Social networks, ethnicity and public home-care utilisation. Ageing & Society, 24, 921–39.Google Scholar
Lucke, J., Russell, A., Tooth, L., Lee, C., Watson, M., Byrne, G., Wilson, A. and Dobson, A. 2008. Few urban–rural differences in older carers' access to community services. Australian Health Review, 32, 4, 684–90.Google Scholar
Markowitz, J. S., Gutterman, E. M., Sadik, K. and Papadopoulos, G. 2003. Health-related quality of life for caregivers of patients with Alzheimer disease. Alzheimer Disease and Associated Disorders, 17, 4, 209–14.CrossRefGoogle ScholarPubMed
McAuley, W. J. and Arling, G. 1984. Use of in-home care by very old people. Journal of Health and Social Behavior, 25, 1, 5464.CrossRefGoogle ScholarPubMed
McCallum, J. 1995. The SF-36 in an Australian sample: validating a new, generic health status measure. Australian Journal of Public Health, 19, 2, 160–6.CrossRefGoogle Scholar
McConaghy, R. and Caltabiano, M. L. 2005. Caring for a person with dementia: exploring relationships between perceived burden, depression, coping and well-being. Nursing and Health Sciences, 7, 2, 8191.Google Scholar
McNamara, B. and Rosenwax, L. 2010. Which carers of family members at the end of life need more support from health services and why? Social Science and Medicine, 70, 7, 1035–41.Google Scholar
Molyneaux, V., Butchard, S., Simpson, J. and Murray, C. 2011. Reconsidering the term ‘carer’: a critique of the universal adoption of the term ‘carer’. Ageing & Society, 31, 3, 422–37.Google Scholar
Morgan, D. G., Semchuk, K. M., Stewart, N. J. and D'Arcy, C. 2002. Rural families caring for a relative with dementia: barriers to use of formal services. Social Science and Medicine, 55, 7, 1129–42.Google Scholar
Pan, W. 2001. Akaike's Information Criterion in generalized estimating equations. Biometrics, 57, 1, 120–5.CrossRefGoogle ScholarPubMed
Pickard, L., Wittenberg, R., Comas-Herrera, A., Davies, B. and Darton, R. 2000. Relying on informal care in the new century? Informal care for elderly people in England to 2031. Ageing & Society, 20, 6, 745–72.Google Scholar
Pinquart, M. and Sörensen, S. 2003. Differences between caregivers and noncaregivers in psychological health and physical health: a meta-analysis. Psychology and Aging, 18, 2, 250–67.Google Scholar
Ryan, K. A., Weldon, A., Huby, N. M., Persad, C., Bhaumik, A. K., Heidebrink, J. L., Barbas, N., Staffend, N., Franti, L. and Giordani, B. 2010. Caregiver support service needs for patients with mild cognitive impairment and Alzheimer disease. Alzheimer Disease and Associated Disorders, 24, 2, 171–6.Google Scholar
Scharlach, A. E., Giunta, N., Chow, J. C. C. and Lehning, A. 2008. Racial and ethnic variations in caregiver service use. Journal of Aging and Health, 20, 3, 326–46.CrossRefGoogle ScholarPubMed
Seltzer, M. M. and Li, L. W. 2000. The dynamics of caregiving: transitions during a three-year prospective study. Gerontologist, 40, 2, 165–78.Google Scholar
Smith, M. H. and Longino, C. F. Jr 1994. Demography of caregiving. Educational Gerontology, 20, 7, 633.Google Scholar
Tennstedt, S. L., Chang, B.-H. and Delgado, M. 1998. Patterns of long-term care – a comparison of Puerto Rican, African-American, and non-Latino white elders. Journal of Gerontological Social Work, 30, 1, 179–99.Google Scholar
Tennstedt, S. L., Crawford, S. and McKinlay, J. B. 1993. Determining the pattern of community care – is coresidence more important than caregiver relationship. Journals of Gerontology, 48, 2, S7483.CrossRefGoogle ScholarPubMed
Tooth, L., Hockey, R., Byles, J. and Dobson, A. 2008. Weighted multimorbidity indexes predicted mortality, health service use, and health-related quality of life in older women. Journal of Clinical Epidemiology, 61, 2, 151–9.Google Scholar
von Kanel, R., Dimsdale, J. E., Ancoli-Israel, S., Mills, P. J., Patterson, T. L., McKibbin, C. L., Archuleta, C. and Grant, I. 2006. Poor sleep is associated with higher plasma proinflammatory cytokine interleukin-6 and procoagulant marker fibrin D-dimer in older caregivers of people with Alzheimer's disease. Journal of the American Geriatrics Society, 54, 3, 431–7.CrossRefGoogle ScholarPubMed
Ward, B. M., Anderson, K. S. and Sheldon, M. S. 2005. Patterns of home and community care service delivery to culturally and linguistically diverse residents of rural Victoria. Australian Journal of Rural Health, 13, 6, 348–52.Google Scholar
Wimo, A., Winblad, B. and Jönsson, L. 2007. An estimate of the total worldwide societal costs of dementia in 2005. Alzheimer's & Dementia: The Journal of the Alzheimer's Association, 3, 2, 8191.CrossRefGoogle ScholarPubMed
Wolinsky, F. D. and Johnson, R. J. 1991. The use of health services by older adults. Journal of Gerontology, 46, 6, S345–57.Google Scholar