| 1. |
- Augustsson, Erika, et al.
(författare)
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Can Sex Differences in Old Age Disabilities be Attributed to Socioeconomic Conditions? Evidence from a Mapping Review of the Literature
- 2023
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Ingår i: Journal of Population Ageing. - : Springer Science and Business Media LLC. - 1874-7884 .- 1874-7876. ; 16:3, s. 761-780
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Tidskriftsartikel (refereegranskat)abstract
- Old age disabilities are more common among women than men, and adverse socioeconomic conditions are associated with a higher prevalence of disabilities among older adults. The goal of this study was to complete a mapping review of the available evidence assessing the extent to which the observed sex differences in older adults´ disabilities can be attributed to sex differences in socioeconomic status. We searched three databases for articles published between 2009 and 2019, and after screening and looking at eligibility criteria, 6 articles were included in the review. For those studies that did not directly analyse the contribution of socioeconomic conditions, we used the´difference method´ to estimate the proportion of the sex gap in disabilities among older adults that could be attributed to socioeconomic conditions. Our review demonstrated that women generally have a higher prevalence of disabilities than men. In several studies, these differences could be partly attributed to sex differences in the distribution of socioeconomic conditions. We also find great elasticity in the magnitude of both the sex gap in disabilities and in the proportion that could be attributed to differences in socioeconomic conditions.
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| 2. |
- Buttigieg, Sandra C., et al.
(författare)
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Researching Ageism in Health-Care and Long Term Care
- 2018
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Ingår i: Contemporary Perspectives on Ageism. - Cham : Springer. - 9783319738192 - 9783319738208 ; , s. 493-515
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Bokkapitel (refereegranskat)abstract
- The literature across different fields defines ageism ambiguously and widely covers a span of intolerant knowledge, values, attitudes and behaviors towards older adults or more generally toward people of a certain age. In this chapter we provide an overview of how ageism is defined, measured, and assessed in health care and long-term care. In so doing, we aim to bridge the gap between the concept and measurement of ageism in these two contexts and to provide some general insights into the approaches, which researchers can apply to assess ageism in these settings. In this chapter, we therefore aim to answer the following questions namely (i) Why is it important to know how ageism in healthcare and long-term care has been empirically studied? (ii) What evidence for the existence of ageism among key stakeholders (e.g. health care professionals and long-term care workers, family members and older adults) is reported in empirical research covering these two contexts? and (iii) Which are the conceptual and methodological approaches used to measure and assess ageism involving these key stakeholders in the two contexts?
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| 3. |
- Chen, Yaohua Sophie, et al.
(författare)
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COVID-19-related loneliness and social isolation in caregivers of people with brain health challenges : The CLIC-Caregiver Global Survey
- 2021
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Ingår i: Alzheimer's & dementia : the journal of the Alzheimer's Association. - : Wiley. - 1552-5279. ; 17
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: Prior to COVID-19, >90% of caregivers of people with brain health challenges (dementia, mental ill health, intellectual disability) experienced high levels of distress, burden, loneliness and social isolation. The COVID-19 pandemic has significantly increased these impacts, particularly since these caregivers are often older and physically vulnerable themselves. The aim of this cross-sectional study is to explore coping and caregiver burden, loneliness and social isolation in caregivers of people with brain health challenges during the COVID-19 pandemic. METHOD: CLIC-Caregiver was a cross-sectional, online, and global survey (June 2nd - November 15th , 2020) using self-administered questionnaires directed at informal caregivers of people with long-term brain health challenges. The study was embedded within a larger survey of loneliness and social isolation for general public ('Comparing Loneliness and Isolation in COVID-19' (CLIC)), including validated loneliness and isolation tools. Translated into ten different languages such as Arabic, French, Romanian, etc, the survey was disseminated over 100 countries. Respondents were included in the CLIC-caregiver sub-study if they answered yes to the question 'Do you provide care and support to a family member or friend with a long-term or life-limiting health problem or disability (including mental health)'. The CLIC project received the initial global ethical approval from Ulster University. The data were fully anonymized. RESULT: From the CLIC main study, 5243 (25%) identified themselves as caregivers. This proportion varied in different countries, from 12 % in Romania to 65% in France. 2323 (44%) had care recipients with dementia, 1761 with physical conditions (disability or long-term illness), 832 with enduring mental health problems, and 404 with intellectual disability. Measures of caregiver burden, loneliness and social isolation will be compared across geographic regions, sociodemographic factors, and risk factors for poor outcomes sought. Findings will be distributed to relevant stakeholders in the form of a project report, with region and country-specific outcomes. This will support recommendations and actions supporting caregivers of people with brain health challenges. CONCLUSION: This represents the largest, most widespread survey on the impact of the COVID-19 pandemic on caregivers of people with long-term conditions to date. It will be an important resource for support agencies and to inform policy.
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| 4. |
- Chen, Yaohua Sophie, et al.
(författare)
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COVID-19-related loneliness, social isolation and burden in informal caregivers worldwide
- 2022
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Ingår i: Alzheimer's and Dementia. - : Wiley. - 1552-5260 .- 1552-5279. ; 18:S8
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Tidskriftsartikel (refereegranskat)abstract
- Background: Informal caregivers may experience high levels burden. Prior to COVID-19, loneliness and social isolation, and especially the discordance between them, were recognized for rapid aging-related cognitive decline. The COVID-19 has significantly increased social isolation and loneliness in caregivers. Thus, we aimed to explore the variables that were associated with higher care burden among all caregivers and only among caregivers for people living with dementia, and whether the increased burden could be associated with a discrepancy between loneliness and social isolation. Method: ‘Comparing Loneliness and Isolation in COVID-19’ was an online global survey of over 20,000 respondents, including 5243 caregivers across 50 countries with enduring brain or/and physical health conditions. We first used a multilevel modelling to identify risk factors associated with higher burden. Then, we defined profiles of discrepancy between loneliness and social isolation, based on the differences between standardized score on a scale of loneliness and of social connectedness and estimated the association between the discrepancy and higher burden. Result: In our sample, 74% of caregivers were female, 44% were caring for people with dementia, and 22% for people with multiple conditions, including dementia. The most prevalent age group was 60-69 years old. Factors significantly associated with higher care burden were being female, having poorer financial situation, worse mental health during the pandemic, caring for people with dementia or intellectual disabilities, caring in the same home, being diagnosed with COVID, and changes of care abilities. 40% of caregivers consistently reported high level of loneliness and social isolation, 38% reported consistent lower levels of both, and two groups reported discordance (low levels of loneliness and high social isolation in 13%; high levels of loneliness and mild social isolation in 12%). The latter group was at the highest risk of self-reported increased and intense care burden. Conclusion: This represents the largest, most widespread survey on the impact of the COVID-19 pandemic on caregivers of people with long-term conditions to date and reflects the importance of capturing the nuances in the relationship between loneliness and social isolation in caregivers. It will be an important resource for support agencies and to inform policy.
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| 5. |
- Ilinca, Stefania, et al.
(författare)
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Gender differences in access to community-based care : a longitudinal analysis of widowhood and living arrangements
- 2022
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Ingår i: European Journal of Ageing. - : Springer Science and Business Media LLC. - 1613-9372 .- 1613-9380. ; 19:4, s. 1339-1350
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Tidskriftsartikel (refereegranskat)abstract
- Persistent inequalities in access to community-based support limit opportunities for independent living for older people with care needs in Europe. Our study focuses on investigating how gender, widowhood and living arrangement associate with the probability of receiving home and community-based care, while accounting for the shorter-term associations of transitions into widowhood (bereavement) and living alone, as well as the longer-term associations of being widowed and living alone. We use comparative, longitudinal data from the Survey of Health, Ageing and Retirement in Europe (collected between 2004 and 2015 in 15 countries) specifying sex-disaggregated random-effects within-between models, which allow us to examine both cross-sectional and longitudinal associations among widowhood, living arrangements and community-based care use. We find widowhood and living alone are independently associated with care use for both older women and men, while bereavement is associated with higher probability of care use only for women. Socio-economic status was associated with care use for older women, but not for men in our sample. The gender-specific associations we identify have important implications for fairness in European long-term care systems. They can inform improved care targeting towards individuals with limited informal care resources (e.g. bereaved older men) and lower socio-economic status, who are particularly vulnerable to experiencing unmet care needs. Gender differences are attenuated in countries that support formal care provision, suggesting gender equity can be promoted by decoupling access to care from household and family circumstances.
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| 6. |
- Rodrigues, Ricardo, et al.
(författare)
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Cohort Trajectories by Age and Gender for Informal Caregiving in Europe Adjusted for Sociodemographic Changes, 2004 and 2015
- 2023
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Ingår i: The journals of gerontology. Series B, Psychological sciences and social sciences. - : Oxford University Press (OUP). - 1079-5014 .- 1758-5368. ; 78:8, s. 1412-1422
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Tidskriftsartikel (refereegranskat)abstract
- Objectives We present a dynamic view of gender patterns in informal caregiving across Europe in a context of sociodemographic transformations. We aim to answer the following research questions: (a) has the gender gap in informal caregiving changed; (b) if so, is this due to changes among women and/or men; and (c) has the gender care gap changed differently across care regimes? Methods Multilevel growth curve models are applied to gendered trajectories of informal caregiving of a panel sample of 50+ Europeans, grouped into 5-year cohorts and followed across 5 waves of the Survey of Health, Ageing and Retirement in Europe survey, stratified by sex and adjusted for several covariates. Results For men in cohorts born more recently, there is a decrease in the prevalence of informal care outside the household, whereas cohort trajectories for women are mostly stable. Prevalence of care inside the household has increased for later-born cohorts for all without discernible changes to the gender care gap. Gender care gaps overall widened among later-born cohorts in the Continental cluster, whereas they remained constant in Southern Europe, and narrowed in the Nordic cluster. Discussion We discuss the cohort effects found in the context of gender differences in employment and care around retirement age, as well as possible demographic explanations for these. The shift from care outside to inside the household, where it mostly consists of spousal care, may require different policies to support carers, whose age profile and possible care burden seem to be increasing.
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| 7. |
- São José, José Manuel Sousa, et al.
(författare)
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Ageism in Health Care : A Systematic Review of OperationalDefinitions and Inductive Conceptualizations
- 2019
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Ingår i: The Gerontologist. - : Oxford University Press. - 0016-9013 .- 1758-5341. ; 59:2, s. E98-E108
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Forskningsöversikt (refereegranskat)abstract
- Purpose:International and national bodies have identified tackling ageism in health care as an urgent goal. However, health professionals, researchers, and policy makers recognize that it is not easy to identity and fight ageism in practice, as the identification of multiple manifestations of ageism is dependent on the way it is defined and operationalized. This article reports on a systematic review of the operational definitions and inductive conceptualizations of ageism in the context of health care.Design and Methods:We reviewed scientific articles published from January 1995 to June 2015 and indexed in the electronic databases Web of Science, PubMed, and Cochrane. Electronic searches were complemented with visual scanning of reference lists and hand searching of leading journals in the field of ageing and social gerontology.Results:The review reveals that the predominant forms of operationalization and inductive conceptualization of ageism in the context of health care have neglected some components of ageism, namely the self-directed and implicit components. Furthermore, the instruments used to measure ageism in health care have as targets older people in general, not older patients in particular.Implications:The results have important implications for the advancement of research on this topic, as well as for the development of interventions to fight ageism in practice. There is a need to take into account underexplored forms of operationalization and inductive conceptualizations of ageism, such as self-directed ageism and implicit ageism. In addition, ageism in health care should be measured by using context-specific instruments.
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| 8. |
- Schmidt, Andrea, et al.
(författare)
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Comparing caregiving patterns of older people in poor and good health in Europe
- 2015
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Ingår i: Irish Ageing Studies Review. - 1649-9972. ; 6:1, s. 50-50
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Tidskriftsartikel (refereegranskat)abstract
- Background: The question of how health selects into caregiving activities of older people has been largely neglected in previous studies. This aspect is, however, important from an ‘active ageing’ perspective in that social participation can have positive effects on health, thus possibly contributing to primary, secondary and tertiary disease prevention strategies in old-age. This paper aims to address this gap in the literature by analysing participation in two different types of informal caregiving: care to older adults (inside and outside the household) and grandparenting.Methods: Using longitudinal data from the Survey on Health, Ageing and Retirement in Europe (waves 1, 2 and 4) on people aged 65 years and older from 10 European countries, we analyse differences in factors that determine informal care provision by older people in good health compared to that provided by older people in poor health. We apply logistic regression methods and account for potential individual heterogeneity.Results: We find that participation in care is significantly correlated with individual characteristics of carers, differing by health status and type of care, while only small differences are found between health groups.Conclusions: Even though the determinants of informal care giving are not very different between the two considered groups, policies to promote social engagement should take into account older people‘s health, as those with chronic conditions have less capacity to provide care. Further, co-residential carers have been identified as a vulnerable group, due to their lower socio-economic status and risk of social exclusion.
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| 9. |
- Schmidt, Andrea E., et al.
(författare)
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Fit for caring : factors associated with informal care provision by older caregivers with and without multimorbidity
- 2016
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Ingår i: European Journal of Ageing. - : Springer. - 1613-9372 .- 1613-9380. ; 13:2, s. 103-113
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Tidskriftsartikel (refereegranskat)abstract
- Due to an increased prevalence of chronic diseases, older individuals may experience a deterioration of their health condition in older ages, limiting their capacity for social engagement and in turn their well-being in later life. Focusing on care provision to grandchildren and (older) relatives (‘informal care’) as forms of engagement, this paper aims to identify which individual characteristics may compensate for health deficits and enable individuals with multimorbidity to provide informal care. We use data from the SHARE survey (2004–2012) for individuals aged 60 years and above in 10 European countries. Logistic regression estimates for the impact of different sets of characteristics on the decision to provide care are presented separately for people with and without multimorbidity. Adapting Arber and Ginn’s resource theory, we expected that older caregivers’ resources (e.g., income or having a spouse) would facilitate informal care provision to a greater extent for people with multimorbidity compared to those without multimorbidity, but this result was not confirmed. While care provision rates are lower among individuals suffering from chronic conditions, the factors associated with caregiving for the most part do not differ significantly between the two groups. Results, however, hint at reciprocal intergenerational support patterns within families, as the very old with multimorbidity are more likely to provide care than those without multimorbidity. Also, traditional gender roles for women are likely to be weakened in the presence of health problems, as highlighted by a lack of gender differences in care provision among people with multimorbidity.
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| 10. |
- Vafaei, Afshin, et al.
(författare)
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Inequities in home care use among older Canadian adults : Are they corrected by public funding?
- 2023
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Ingår i: PLOS ONE. - : Public Library of Science (PLoS). - 1932-6203. ; 18:2
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Tidskriftsartikel (refereegranskat)abstract
- BackgroundAlthough care use should parallel needs, enabling and predisposing circumstances including the socio-demographic inequities of socioeconomic status (SES), gender, or isolation often intervene to diminish care. We examine whether availability of state-funded medical and support services at home can rebalance these individual and social inequities, and do this by identifying if and how intersecting social identities predict homecare use among older Canadian adults.MethodsUsing the Canadian Longitudinal Study on Aging (CLSA) of 30,097 community-dwelling adults aged 45 to 85, we performed recursive partitioning regression tree analysis using Chi-Squared automatic interaction detection (CHAID). Combinations of individual and social characteristics including sociodemographic, family-related, physical and psychological measures and contextual indicators of material and social deprivation were explored as possible predictors of formal and informal care use.ResultsDiminished function i.e. increased need, indicated by Activities of Daily Living, was most strongly aligned with formal care use while age, living arrangement, having no partner, depression, self-rated health and chronic medical conditions playing a lesser role in the pathway to use. Notably, sex/gender, were not determinants. Characteristics aligned with informal care were first—need, then country of birth and years since immigration. Both ‘trees’ showed high validity with low risk of misclassification (4.6% and 10.8% for formal and informal care, respectively).ConclusionsAlthough often considered marginalised, women, immigrants, or those of lower SES utilised formal care equitably. Formal care was also differentially available to those without the financial or human resources to receive informal care. Need, primarily medical but also arising from living arrangement, rather than SES or gender predicted formal care, indicating that universal government-funded services may rebalance social and individual inequities in formal care use.
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