Doblhammer / Scholz Ageing, Care Need and Quality of Life

The Perspective of Care Givers and People in Need of Care
1. Auflage 2010
ISBN: 978-3-531-92335-2
Verlag: VS Verlag für Sozialwissenschaften
Format: PDF
Kopierschutz: 1 - PDF Watermark

E-Book, Englisch, 243 Seiten, eBook

Reihe: Demografischer Wandel - Hintergründe und Herausforderungen

Steadily increasing life expectancy is one of the great achievements of industrialised societies over the last century. Life expectancy has not only been growing among the young and those reaching retirement age, but also, especially in recent decades, among people ages 80 and above. These improvements in life expectancy have led to the emergence of the so-called third age, when people retire, but are still you- ful, healthy and able to participate in society. Nevertheless, closer to the end of life, a fourth age of decrepitude and dependence on others has to be anticipated. - spite the postponement of functional limitations and severe disabilities into higher ages, the debate continues over whether the additional years gained are healthy years, or years with severe care need, particularly among the oldest old, the fastest growing segment of the population. Future improvements in life expectancy and the health status of the elderly will determine the need for care in the future. While different assumptions about these trends based on expert opinion or the extrapolation of past experiences can be made, there will always be a degree of uncertainty about future trends. A third - portant factor driving the extent of future care need is, however, already determined by the history of the past century and is embedded in the age structures of our populations.

Prof. Dr. Gabriele Doblhammer is Professor for Empirical Social Science and Demography at the University of Rostock and Director of the Rostock Center for the Study of Demographic Change.
Dr. Rembrandt Scholz is Research Scientist at the Max Planck Institute for Demographic Research, Rostock.

Zielgruppe

Professional/practitioner

Autoren/Hrsg.

Doblhammer, Gabriele

Scholz, Rembrandt

Inhaltsverzeichnis

1;Contents;6
2;Preface;8
3;Part I: Projections of Care Need and Care Resources;13
3.1;People in Need of Long-term Care: The Present and the Future;14
3.1.1;1. Introduction;14
3.1.2;2. In Retrospect: The Development of the Number of People in Need of Long-term Care from 1999 to 2005;14
3.1.2.1;2.1 Persons in Need of Long-term Care by Type of Care;14
3.1.2.2;2.2 Explanations of Terms Relating to Long-term Care Statistics;16
3.1.2.3;2.3 The Development of Persons in Need of Care by Care Level;16
3.1.2.4;2.4 Past Developments of the Number of Persons in Care at Länder-level;17
3.1.3;3. Age-specific Rates of Long-term Care in December 2005;18
3.1.4;4. Development of the Numbers of People in Need of Care in Germany up to 2030 and in the Länder up to 2020 Status-quo Scenario;20
3.1.4.1;4.1 Projection for Germany;20
3.1.4.1.1;Excursus: Declining Long-term Care Rates from 1999 to 2005?;21
3.1.4.2;4.2 Projections for the Länder;23
3.1.5;5. Persons in Need of Care in Germany in 2020 and 2030 Scenario of “Declining Care Rates”;23
3.1.6;6. References to other Projections;25
3.1.7;References;27
3.2;Care Need Projections for Germany until 2050;29
3.2.1;1. Introduction;29
3.2.2;2. Deterministic Projection;30
3.2.2.1;2.1 Methodology and Assumptions;30
3.2.2.2;2.2 Results;32
3.2.3;3. Sensitivity Analysis;35
3.2.4;4. Conclusion;39
3.2.5;References;40
3.3;Care Need Projections by Marital Status and Childlessness for Germany 2000-2030 based on the FELICIE Project;42
3.3.1;1. Introduction;42
3.3.2;2. Gender Proportions;43
3.3.3;3. Family Status among German Elderly and Future Developments;45
3.3.4;4. Childlessness in Germany in the Female Birth Cohorts 1900 to 1968;49
3.3.5;5. The Prevalence of Care Need and the FELICIE Care Need Projections;50
3.3.6;6. Summary and Discussion;56
3.3.7;Literature;58
3.4;Projection of Care Need and Family Resources in Germany;61
3.4.1;1. Introduction;61
3.4.2;2. Population Development and the Need for Care;63
3.4.2.1;2.1 Population Projection by the DIW Assumptions;63
3.4.2.2;2.2 Decline in Population, but Marked Increase in the Share of the Elderly until 2050;63
3.4.3;2.3 Sharp Increase in the Number of People in Need of Care;65
3.4.4;3. Changes in Care Giving Potential;66
3.4.4.1;3.1 Impact of Changing Living Arrangements of the Elderly;67
3.4.4.2;3.2 The Influence of Female Labour Force Participation;68
3.4.4.3;3.3 Estimation of Care Giving Potential by 2050;70
3.4.4.4;3.4 Ratio of People in Need of Care to Potential Care Givers;72
3.4.5;4. Influence of Changing Health Status;75
3.4.6;5. Conclusion;78
3.4.7;Appendix;79
3.4.8;References;81
3.5;Cohort Trends in Disability and Future Care Need in Germany;82
3.5.1;1. Introduction;82
3.5.2;2. Data and Methods;82
3.5.3;3. Results;84
3.5.4;5. Discussion;90
3.5.5;References;92
3.6;Projections of the Number of People with Dementia in Germany 2002 Through 2047;94
3.6.1;1. Introduction;94
3.6.2;2. Dementia in Germany Today;96
3.6.2.1;2.1 Prevalence of Dementia;96
3.6.2.2;2.2 Projections of Numbers of People with Dementia in Germany;97
3.6.3;3. Data and Projection Method;99
3.6.4;4. Results;100
3.6.4.1;4.1 Projection of the Number of People with Dementia;100
3.6.4.2;4.2 Dementia-Free Life Expectancy at Ages 80-84 in Germany in 2002;104
3.6.4.3;4.3 Dementia-Free Life Expectancy at Ages 80-84 in Germany in 2047;104
3.6.5;5. Discussion;105
3.6.6;References;108
4;Part II: Health Factors and Care Determinants;112
4.1;The Effect of Sex, Obesity and Smoking on Health Transitions: A Statistical Meta-analysis;113
4.1.1;1. Introduction;113
4.1.2;2. Methods;114
4.1.2.1;2.1 Study Selection;114
4.1.2.2;2.2 Measures of Outcome;115
4.1.2.3;2.3 Measures of Risk Factors;116
4.1.2.4;2.4 Statistical Analysis;116
4.1.3;3. Results;117
4.1.3.1;3.1 Search Results;117
4.1.3.2;3.2 Sex;118
4.1.3.3;3.3 Obesity;118
4.1.3.4;3.4 Smoking;124
4.1.3.5;3.5 Effect of Study Characteristics;127
4.1.4;4. Discussion;127
4.1.4.1;4.1 Summary of Main Findings;127
4.1.4.2;4.2 Strengths and Limitations of this Study;128
4.1.4.3;4.3 Implications for Future Research;129
4.1.5;5. Acknowledgements;130
4.1.6;Appendix;131
4.1.6.1;Meta-regression Results;131
4.1.7;References;137
4.2;Demand for Long-term Residential Care and Acute Health Care by Older People in the Context of the Ageing Population of Finland;142
4.2.1;1. Introduction;142
4.2.2;2. Drivers of Demand for Acute Hospital and Long-term Care;144
4.2.2.1;2.1. Proximity to Death;144
4.2.2.2;2.2 Other Drivers of Health and Social Care Costs;148
4.2.3;3. The Policy Background;150
4.2.4;4. Aims of the Finnish Case Study Analyses;151
4.2.4.1;4.1 Data for Use of Long-term Care (LTC) before Death in Finland.;152
4.2.4.2;4.2 Results;153
4.2.5;5. Conclusions;158
4.2.6;Acknowledgements;158
4.2.7;References;159
4.3;Old Age, the Need of Long-term Care and Healthy Life Expectancy;162
4.3.1;1. Introduction;162
4.3.2;2. Theoretical Background;163
4.3.3;3. Long-term Care Statistics in Germany;164
4.3.3.1;3.1 Long-term Care Statistics in German Law;164
4.3.3.2;3.2 Data and Method;165
4.3.4;4. Descriptive Results;166
4.3.4.1;4.1 Analysis of the Prevalence of Care Need for Women and Men;166
4.3.4.2;4.2 Analysis of Healthy Life Expectancy;169
4.3.5;5. Conclusions;172
4.3.6;References;174
4.4;Trends in Individual Trajectories of Health Limitations: A Study based on the German Socio-Economic Panel for the Periods 1984 t;176
4.4.1;1. Introduction;176
4.4.2;2. Data;179
4.4.3;3. Method;180
4.4.4;4.Results;181
4.4.5;5. Discussion;193
4.4.6;References;197
5;Part III: Care Givers;201
5.1;Perceived Care Giver Burden of Spouses and Children in Flanders: Who’s Feeling more Burdened and Why?;202
5.1.1;1. Introduction;202
5.1.2;2. Theory;203
5.1.3;3. Methods;206
5.1.3.1;Data;206
5.1.3.2;Measures;206
5.1.4;4. Results;208
5.1.4.1;Bivariate Analyses;208
5.1.4.2;Multivariate Analysis;210
5.1.5;5. Discussion and Conclusion;212
5.1.6;Literature;217
5.2;Voluntary Care Giving in the Life Course of Women in Eastern and Western Germany;220
5.2.1;Introduction;220
5.2.2;1. Social Security Arrangements for Voluntary Home Care in Germany;221
5.2.2.1;1.1 Benefits from the Compulsory Long-term Care Insurance for Voluntary Home Care;222
5.2.2.2;1.2 Care Giving in the Personal Pension Record;225
5.2.3;2. Data from the German Pension Fund;228
5.2.3.1;2.1 Longitudinal Data from the German Pension Fund;228
5.2.3.2;2.2 Information on Care Giving in the Pension Records;230
5.2.4;3 Empirical Results;231
5.2.4.1;3.1 Socio-demographic Profile of the Care Givers;231
5.2.4.2;3.2 Length of Care Giving Episodes in the Life Course;232
5.2.4.3;3.3 Positioning of Care Giving Episodes in the Life Course;233
5.2.5;4. Summary;236
5.2.6;References;238
6;The Authors;239

Projections of Care Need and Care Resources.- People in Need of Long-term Care: The Present and the Future.- Care Need Projections for Germany until 2050.- Care Need Projections by Marital Status and Childlessness for Germany 2000-2030 based on the FELICIE Project.- Projection of Care Need and Family Resources in Germany.- Cohort Trends in Disability and Future Care Need in Germany.- Projections of the Number of People with Dementia in Germany 2002 Through 2047.- Health Factors and Care Determinants.- The Effect of Sex, Obesity and Smoking on Health Transitions: A Statistical Meta-analysis.- Demand for Long-term Residential Care and Acute Health Care by Older People in the Context of the Ageing Population of Finland.- Old Age, the Need of Long-term Care and Healthy Life Expectancy.- Trends in Individual Trajectories of Health Limitations: A Study based on the German Socio-Economic Panel for the Periods 1984 to 1987 and 1995 to 1998.- Care Givers.- Perceived Care Giver Burden of Spouses and Children in Flanders: Who’s Feeling more Burdened and Why?.- Voluntary Care Giving in the Life Course of Women in Eastern and Western Germany.

Leseproben

Part III: Care Givers (S. 203-205)

Perceived Care Giver Burden of Spouses and Children in Flanders: Who’s Feeling more Burdened and Why?

Benedicte De Koker

1. Introduction

The ageing of the population, in combination with other societal evolutions such as the increasing labour market participation of women and the shift towards care ‘in the community’, has led to a growing awareness of the care provided by spouses, relatives, neighbours and friends. It is now widely recognised that informal care constitutes the majority of all care given to elderly people, and that preservation of the informal care capacity is of paramount importance. In accordance with this perspective, scientists as well as policy makers have shown an increasing concern about the well-being of informal carers (Döhner/Kofahl 2005, Kröger 2001, Walker et al. 1995).

Since the 1980’s a bulk of studies have been carried out on the outcomes of informal care giving (Walker et al. 1995). From this research it emerged that giving care to a loved person who is ill or disabled may generate a considerable amount of strain and burden (Braithwaite 1992, Walker et al. 1995). Compared to persons not involved in care giving or population norms, informal carers are reporting more depressive symptoms and higher levels of distress and anxiety (Hirst 2003, Marks et al. 2002, Schulz et al. 1995). While results with regard to physical well-being are less univocal (Hirst 2004, Taylor et al. 1995), a number of studies have found that informal carers tend to have a lower immunity, more physical health complaints and even a higher mortality risk (Schulz/Beach 1999, Vitaliano et al. 2003).

Moreover, evidence exists that care giving is associated with other negative outcomes, like a higher risk of social isolation (Fast et al. 1999, George/Gwyther 1986) and a less favourable financial situation (Fast et al. 1999, Heitmueller/Inglis 2007). The concept of “care giver burden” plays an important role in understanding the outcomes of informal care giving. Although various definitions are apparent in the literature (Braithwaite 1992), the concept generally refers to the care givers’ perception of the impact care giving has on their lives (Stuckey et al. 1996). Because it is based on a personal perception, it is sometimes also referred to as perceived care burden or subjective care burden.

Care giver burden has proved useful in order to understand variation within care giving populations and as a predictor of carerelated outcomes such as the (desire for) institutionalisation of the person in need of care (Stuckey et al. 1996, Stull et al. 1994). Moreover, care giver burden has turned out to be a predictor of the general (psychological) well-being of the care giver (Braithwaite 1996, Chappell/Reid 2002, Lawton et al. 1991, Yates et al. 1999).

Über Autor(innen)

Prof. Dr. Gabriele Doblhammer is Professor for Empirical Social Science and Demography at the University of Rostock and Director of the Rostock Center for the Study of Demographic Change. Dr. Rembrandt Scholz is Research Scientist at the Max Planck Institute for Demographic Research, Rostock.