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Patterns of care and support in old age
Jönköping University, School of Health Science, HHJ. Ageing - living conditions and health.
2013 (English)Doctoral thesis, comprehensive summary (Other academic)
Abstract [en]

This study describes the situation for community living older people, 65 years of age and older in Iceland, analyzing their needs for care and services and how these needs are met. The study analyzes the relationship between the main providers of help and care, the formal caregivers and the informal carers. The study further depicts what kinds of care and support older informal caregivers provide and receive themselves and analyze what factors are related to providing care alone or in combination with other caregivers, informal and formal. The study also analyzes the relationship and mutual support between grandparents and grandchildren and whether there are gender differences in intergenerational relations and support. As little research has been conducted on informal care in Iceland, it is important to show the importance of the informal carers in the care paradigm. Two Icelandic studies were used for the descriptions and analysis. The main data source is the ICEOLD survey (Icelandic older people), based on a random representative national sample of 700 non-institutionalized persons in ages 65 – 79 years and 700 persons aged 80+. The final sample consists of 1,189 older persons to which an introduction letter was sent. They were contacted by phone a few days later and 782 persons, 341 men and 441 women, agreed to participate, giving a response rate of 66%. A study carried out among college students in Iceland, The Grammar School study, was also used to retrieve information on intergenerational relations between grandparents and grandchildren.

The study indicates that older people in Iceland are receiving help and care from both informal and formal carers but informal help provided by family members seems to play a major role in supporting older people in their home. The great majority of the respondents with Instrumental Activities of Daily Living (IADL) limitations and Personal Activities of Daily Living (PADL) limitations received either informal or formal help but not both. The care and help provided is more often help with domestic tasks than with personal care. However, when the need increases the formal system steps in. It is not clear whether the informal care is a substitute for the formal one. As the formal help provided is rather sparse, it is suggested that when the need for personal care increases, the older person moves into a nursing home instead of increasing the formal care in the home. Women more often than men are the sole carers, and daughters are more important carers for older people than sons are.

Older informal caregivers were alone in their caregiving in almost half of the cases and women more often than men. One third provided help with several tasks, such as help with errands and surveillance or keeping company in addition to ADL help. Older caregivers provide care even when they need help themselves.

The results indicate that grandparents and grandchildren exchange more emotional than practical support. The emotional support provided and received by the generations is of great value. Gender influences the contact frequency between the generations, as women more often cultivate ties between grandparents and grandchildren.

Place, publisher, year, edition, pages
Jönköping: School of Health Sciences , 2013. , 86 p.
Series
Hälsohögskolans avhandlingsserie, ISSN 1654-3602 ; 40
National Category
Gerontology, specializing in Medical and Health Sciences
Identifiers
URN: urn:nbn:se:hj:diva-20524ISBN: 978-91-85835-39-3 (print)OAI: oai:DiVA.org:hj-20524DiVA: diva2:605385
Public defence
2013-03-08, Forum Humanum, HHJ (School of Health Sciences), Jönköping, 13:00
Opponent
Supervisors
Available from: 2013-02-14 Created: 2013-02-14 Last updated: 2014-05-20Bibliographically approved
List of papers
1. Needs and care of older people living at home in Iceland
Open this publication in new window or tab >>Needs and care of older people living at home in Iceland
2012 (English)In: Scandinavian Journal of Public Health, ISSN 1403-4948, E-ISSN 1651-1905, Vol. 40, no 1, 1-9 p.Article in journal (Refereed) Published
Abstract [en]

Background:The Icelandic old-age care system is universal and the official goal is to support older people live independently for as long as possible. The aim of this study is to analyse living conditions and use of formal and informal care of older people in Iceland.

Methods:The results are based on the new study ICEOLD, a telephone survey which included questions on social network, health, activities of daily living, and received support from the community and/or from relatives, neighbours, and friends.

Results: Almost half of the sample (47%) receives some kind of care, with 27% of them receiving only informal care, which is understood to mean that informal care is of great importance and families are the main providers of help. For hypothetical future long-term care, older people wish to be cared for in their homes, but those already in need of assistance prefer to be cared for in institutions.

Discussion:Caring relatives are the main providers of support to older people in their homes and it is important to provide them with suitable formal support when the care responsibility increases.

Conclusions:As the care system in Iceland is now under reconstruction, the important contribution of informal carers must be recognised and taken into account when planning the care of older people.

Keyword
Aged, caregivers, care system, Iceland, older people, social support
National Category
Social Work
Identifiers
urn:nbn:se:hj:diva-16998 (URN)10.1177/1403494811421976 (DOI)
Available from: 2012-01-04 Created: 2012-01-04 Last updated: 2017-12-08Bibliographically approved
2. Older caregivers in Iceland: Providing and receiving care
Open this publication in new window or tab >>Older caregivers in Iceland: Providing and receiving care
2013 (English)In: Nordic Social Work Research, ISSN 2156-857X, E-ISSN 2156-8588, Vol. 3, no 1, 4-19 p.Article in journal (Refereed) Published
Abstract [en]

Few studies have looked at care provided by older caregivers. This study analysed the characteristics of older informal caregivers and investigated how those caregivers interacted with other informal caregivers and the formal care system. The ‘Icelandic Older People’ (ICEOLD) survey provided data for 782 participants, of whom 157 were caregivers aged 65 years and older. The analysis demonstrated that older people who live with someone are more often informal caregivers than those who live alone. Emotional support was the most frequent help provided. The older caregiver was often alone in his/her role as a caregiver, but when the care was extensive, the formal care system provided support in addition to the care provided by the older caregiver. Almost half of the older caregivers needed help themselves, mostly with ‘Instrumental Activities of Daily Living’ (IADL). This study provides information about older caregivers and how their care interacts with the formal care system. This group is likely to grow as more people live longer. Thus, the number of older caregivers and the care they provide must be taken into account when making plans to care for older people in the coming years.

Keyword
older caregivers, old age, informal care, formal care, shared care
National Category
Social Sciences Interdisciplinary
Identifiers
urn:nbn:se:hj:diva-20019 (URN)10.1080/2156857X.2013.768180 (DOI)
Available from: 2012-12-03 Created: 2012-11-30 Last updated: 2017-12-07Bibliographically approved
3. Factors associated with informal and formal care of older Icelandic people
Open this publication in new window or tab >>Factors associated with informal and formal care of older Icelandic people
(English)Manuscript (preprint) (Other academic)
National Category
Medical and Health Sciences
Identifiers
urn:nbn:se:hj:diva-20523 (URN)
Available from: 2013-02-14 Created: 2013-02-14 Last updated: 2013-02-14
4. Reciprocity in relationships and support between grandparents and grandchildren: An Icelandic example
Open this publication in new window or tab >>Reciprocity in relationships and support between grandparents and grandchildren: An Icelandic example
2013 (English)In: Journal of Intergenerational Relationships, ISSN 1535-0770, E-ISSN 1535-0932, Vol. 11, no 2, 118-133 p.Article in journal (Refereed) Published
Abstract [en]

This study explores and discusses the relationships between grandchildren and grandparents with an emphasis on the reciprocal, practical, emotional and financial support that is provided between generations. Two independent surveys were conducted in Iceland, one of grandparents aged 65 years and older (n=206), and one of grandchildren among college students (n=648). The questions used were the same. The results indicated that there is certain consistency in the pattern of views of the younger towards the older generation and the other way around.  These findings are discussed in relation to family development and the value of intergenerational relationships and support. 

Keyword
intergenerational relationships, grandparents, grandchildren, gender, family support.
National Category
Social Work
Identifiers
urn:nbn:se:hj:diva-20020 (URN)10.1080/15350770.2013.782743 (DOI)
Available from: 2012-12-03 Created: 2012-11-30 Last updated: 2017-12-07Bibliographically approved

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