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Institutionalisation and subjective wellbeing for old-age individuals: is life really miserable in care homes?

Published online by Cambridge University Press:  14 October 2011

PETRI BÖCKERMAN*
Affiliation:
Labour Institute for Economic Research, Helsinki, Finland.
EDVARD JOHANSSON
Affiliation:
Åland University of Applied Sciences, Åland, Finland.
SAMULI I. SAARNI
Affiliation:
National Institute for Health and Welfare, Department of Mental Health and Substance Abuse Services and Helsinki University Central Hospital and Department of Psychiatry, University of Helsinki, Helsinki, Finland.
*
Address for correspondence: Petri Böckerman, Labour Institute for Economic Research, Pitkänsillanranta 3A, FI-00530 Helsinki, Finland. E-mail: [email protected]

Abstract

In this paper we examine whether there are systematic differences in the quality of life, depending on whether an individual is institutionalised or not, holding health status and income level constant. In doing this we use a nationally representative data set, the Health 2000 in Finland. When controlling for health and functional status, demographics and income level, we find that individuals who are living in old-age homes actually report significantly higher levels of subjective wellbeing than those who are living at home. We argue that this finding emerges from queuing for care homes. This implies that there are individuals living at home who are so frail that they should really be living in an old-age institution, but because of the queues for that particular mode of living, they are living at home with a decreased quality of life as a consequence.

Type
Articles
Copyright
Copyright © Cambridge University Press 2011

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References

Aromaa, A. and Koskinen, S. (eds) 2004. Health and Functional Capacity in Finland. Baseline Results of the Health 2000 Health Examination Survey. National Public Health Institute, Helsinki.Google Scholar
Brown, S. H. M. and Abdelhafiz, A. H. 2011. Institutionalization of older people: prediction and prevention. Ageing Health, 7, 2, 187203.CrossRefGoogle Scholar
Böckerman, P., Johansson, E. and Saarni, S. I. 2011. Do established health-related quality-of-life measures adequately capture the impact of chronic conditions on subjective well-being? Health Policy, 100, 1, 91–5.CrossRefGoogle ScholarPubMed
Donnenwerth, G. V. and Petersen, L. R. 1992. Institutionalization and well-being among the elderly. Sociological Inquiry, 62, 4, 437–49.CrossRefGoogle Scholar
Ferrer-i-Carbonell, A. and van Praag, B. M. S. 2002. The subjective costs of health losses due to chronic diseases. An alternative model for monetary appraisal. Health Economics, 11, 8, 709–22.CrossRefGoogle ScholarPubMed
Gaugler, J. E., Duval, S., Anderson, K. A. and Kane, R. L. 2007. Predicting nursing home admission in the U.S: a meta-analysis. BMC Geriatrics, 7, 13.CrossRefGoogle ScholarPubMed
Greene, W. H. 2003. Econometric Analysis. Fifth edition, Prentice Hall, Upper Saddle River, New Jersey.Google Scholar
Häkkinen, U. and Lehto, J. 2005. Reform, change and continuity in Finnish health care. Journal of Health Politics, Policy & Law, 30, 1/2, 7996.CrossRefGoogle ScholarPubMed
Hawthorne, G., Richardson, J. and Day, N. A. 2001. A comparison of the assessment of quality of life (AQoL) with four other generic utility instruments. Annals of Medicine, 33, 5, 358–70.CrossRefGoogle ScholarPubMed
Heistaro, S. (ed.) 2008. Methodology Report. Health 2000 Survey. National Public Health Institute, Helsinki.Google Scholar
Luppa, M., Luck, T., Weyerer, S., Konig, H., Brahler, E. and Riedel-Heller, S. G. 2010. Prediction of institutionalization in the elderly. A systematic review. Age and Ageing, 39, 1, 31–8.CrossRefGoogle ScholarPubMed
Martikainen, P., Moustgaard, H., Murphy, M., Einiö, E., Koskinen, S., Martelin, T. and Noro, A. 2009. Gender, living arrangements, and social circumstances as determinants of entry into and exit from long-term institutional care at older ages: a 6-year follow-up study of older Finns. The Gerontologist, 49, 1, 3445.CrossRefGoogle Scholar
Ministry of Social Affairs and Health 2008. National Framework for High-quality Services for Older People 2008. Ministry of Social Affairs and Health, Helsinki.Google Scholar
Nihtilä, E. and Martikainen, P. 2007. Household income and other socio-economic determinants of long-term institutional care among older adults in Finland. Population Studies: A Journal of Demography, 61, 3, 299314.CrossRefGoogle ScholarPubMed
Nihtilä, E. and Martikainen, P. 2008 a. Institutionalization of older adults after the death of a spouse. American Journal of Public Health, 98, 7, 1228–34.CrossRefGoogle ScholarPubMed
Nihtilä, E. and Martikainen, P. 2008 b. Why older people living with a spouse are less likely to be institutionalized: the role of socioeconomic factors and health characteristics. Scandinavian Journal of Public Health, 36, 1, 3543.CrossRefGoogle ScholarPubMed
Nihtilä, E. K., Martikainen, P. T., Koskinen, S. V., Reunanen, A. R., Noro, A. M. and Häkkinen, U. T. 2008. Chronic conditions and the risk of long-term institutionalization among older people. European Journal of Public Health, 18, 1, 7784.CrossRefGoogle ScholarPubMed
Nuotio, M., Tammela, T. L. J., Luukkaala, T. and Jylhä, M. 2003. Predictors of institutionalization in an older population during a 13-year period: the effect of urge incontinence. Journals of Gerontology: Biological Sciences and Medical Sciences, 58A, 8, 756–62.Google Scholar
Organisation for Economic Co-operation and Development 1982. The OECD List of Social Indicators. Organisation for Economic Co-operation and Development, Paris.Google Scholar
Oswald, A. 1997. Happiness and economic performance. Economic Journal, 107, 1815–31.CrossRefGoogle Scholar
Oswald, A. 2010. Emotional prosperity and the Stiglitz commission. British Journal of Industrial Relations, 48, 4, 651–69.CrossRefGoogle Scholar
Pinquart, M. and Sörensen, S. 2000. Influences of socioeconomic status, social network, and competence on subjective well-being in later life: a meta-analysis. Psychology and Aging, 15, 2, 187224.CrossRefGoogle ScholarPubMed
Powdthavee, N. and van den Berg, B. 2011. Putting different price tags on the same health condition: re-evaluating the well-being valuation approach. Discussion Paper No. 5493, IZA, Bonn.CrossRefGoogle Scholar
Saarni, S. I., Härkänen, T., Sintonen, H., Suvisaari, J., Koskinen, S., Aromaa, A. and Lönnqvist, J. 2006. The impact of 29 chronic conditions on health-related quality of life: a general population survey in Finland using 15D and EQ-5D. Quality of Life Research, 15, 8, 1403–14.CrossRefGoogle ScholarPubMed
Saarni, S. I., Suvisaari, J., Sintonen, H., Koskinen, S., Härkänen, T. and Lönnqvist, J. 2007. The health-related quality-of-life impact of chronic conditions varied with age in general population. Journal of Clinical Epidemiology, 60, 12, 1288–97.CrossRefGoogle ScholarPubMed
Sintonen, H. 1994. The 15D measure of health-related quality of life: reliability, validity and sensitivity of its health state descriptive system. Working Paper 41, Centre for Health Program Evaluation, Monash University, Melbourne.Google Scholar
Sintonen, H. 1995. The 15D measure of health-related quality of life. II. Feasibility, reliability and validity of its valuation system. Working Paper 42, Centre for Health Program Evaluation, Monash University, Melbourne.Google Scholar
Sintonen, H. 2001. The 15D instrument of health-related quality of life: properties and applications. Annals of Medicine, 33, 5, 328–36.CrossRefGoogle ScholarPubMed
Stakes 2006. Hoivan ja hoidon taloudellinen kestävyys. Arvioita sosiaali- ja terveyspalveluiden kustannusten kehityksestä. Stakes, Helsinki.Google Scholar
Stakes 2008. Statistical Yearbook on Social Welfare and Health Care 2008. Stakes, Helsinki.Google Scholar
Stavem, K., Bjornaes, H. and Lossius, M. I. 2001. Properties of the 15D and EQ-5D utility measures in a community sample of people with epilepsy. Epilepsy Research, 44, 2/3, 179–89.CrossRefGoogle Scholar
Stiglitz, J., Sen, A. and Fitoussi, J. P. 2009. Report by the Commission on the Measurement of Economic Performance and Social Progress. Available online at www.stiglitz-sen-fitoussi.fr [Accessed 19 April 2010].Google Scholar
Webb, E., Blane, D., McMunn, A. and Netuveli, G. 2011. Proximal predictors of change in quality of life at older ages. Journal of Epidemology and Community Health, 65, 6, 542–7.CrossRefGoogle ScholarPubMed
Wittchen, H. U., Lachner, G., Wunderlich, U. and Pfister, H. 1998. Test–retest reliability of the computerized DSM-IV version of the Munich-Composite International Diagnostic Interview (M-CIDI). Social Psychiatry and Psychiatric Epidemiology, 33, 11, 568–78.CrossRefGoogle ScholarPubMed
World Health Organization 1946. Preamble to the Constitution of the World Health Organization as adopted by the International Health Conference, New York, 19–22 June; signed on 22 July by the representatives of 61 States. Official Records of the World Health Organization, No. 2.Google Scholar