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Formal and Informal Long-Term Care in the Community: Interlocking or Incoherent Systems?

Published online by Cambridge University Press:  19 January 2018

TANIA BURCHARDT ,
EMILY JONES  and
POLINA OBOLENSKAYA
TANIA BURCHARDT
Affiliation:
London School of Economics – Centre for Analysis of Social Exclusion, Houghton Street, London WC2A 2AE, United Kingdom email: [email protected]
EMILY JONES
Affiliation:
email: [email protected]
POLINA OBOLENSKAYA
Affiliation:
London School of Economics – Centre for Analysis of Social Exclusion, Houghton Street, London WC2A 2AE, United Kingdom email: [email protected]
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Abstract

Help with activities of daily living for people in the community is provided through formal services (public and private) and informal (often unpaid) care. This paper investigates how these systems interlock and who is at risk of unmet need. It begins by mapping differences between OECD countries in the balance between formal and informal care, before giving a detailed breakdown for the UK. New analysis of UK Family Resources Survey data for 2012/13 and 2013/14 suggests high levels of unmet need. We investigate who receives formal and informal care, and who receives neither, among the working-age and older populations. We find that while informal care fills some gaps left by the lack of availability of formal services (and vice versa), not all older or working-age disabled people are protected in these ways. Adults living alone and those with high but not the highest levels of difficulty are most likely to have unmet need. Means-tested public entitlements ameliorate but do not remove the increased risk among people in low-income households. The paper concludes that public policy needs to integrate its support for formal and informal modes of care, with particular attention to those groups most at risk of unmet need.

Type
Article
Information
Journal of Social Policy , Volume 47 , Issue 3 , July 2018 , pp. 479 - 503
Copyright
Copyright © Cambridge University Press 2018 

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References

Allen, S., Piette, E. and Mor, V. (2014), ‘The Adverse Consequences of Unmet Need Among Older Persons Living in the Community: Dual-Eligible Versus Medicare-Only Beneficiaries’, Journals of Gerontology B: Psychological Sciences and Social Sciences, 69 (Suppl 1): S51–S58CrossRefGoogle ScholarPubMed
Bien, B., McKee, K., Dohner, H., Triantafillou, J., Lamura, G., Doroszkiewicz, H., Krevers, B. and Kofahl, C. (2013), ‘Disabled older people's use of health and social care services and their unmet care needs in six European countries’, European Journal of Public Health, 23 (6): 1032–1038Google Scholar
Bolin, K., Lindgren, B. and Lundborg, P. (2008), ‘Informal and formal care among single-living elderly in Europe’, Health Economics, 17 (3): 393–409CrossRefGoogle ScholarPubMed
Bonsang, E. (2009), ‘Does informal care from children to their elderly parents substitute for informal care in Europe?’ Journal of Health Economics, 28: 143–154Google Scholar
Brawn, E., Bush, M., Hawkings, C. and Trotter, R. (2013), The other care crisis: Making social care funding work for disabled adults in England. Published by Scope, Mencap, National Autistic Society, Sense, and Leonard Cheshire Disability.Google Scholar
Brimblecombe, N., Pickard, L., King, D. and Knapp, M. (2017), ‘Perceptions of unmet needs for community social care services in England. A comparison of working carers and the people they care for’, Health and Social Care in the Community, 25 (2): 435–446CrossRefGoogle Scholar
Burchardt, T., Obolenskaya, P. and Vizard, P. (2016), ‘Social Care’, in Lupton, R., Burchardt, T., Hills, J., Stewart, K. and Vizard, P. (eds) Social Policy in a Cold Climate: Policies and Their Consequences Since the Crisis. Policy PressGoogle Scholar
DWP [Department for Work and Pensions] (2013), Family Resources Survey 2011–12, https://www.gov.uk/government/uploads/system/uploads/attachment_data/file/206887/frs_2011_12_report.pdf (accessed 19/04/2017)Google Scholar
DWP [Department for Work and Pensions], National Centre for Social Research, Office for National Statistics. Social and Vital Statistics Division. (2014). Family Resources Survey, 2012–2013. [data collection]. UK Data Service. SN: 7556Google Scholar
DWP [Department for Work and Pensions] (2015a), Households Below Average Income: an analysis of the income distribution 1994/95 to 2013/14. https://www.gov.uk/government/statistics/households-below-average-income-19941995-to-20132014 (accessed 18/11/2016)Google Scholar
DWP [Department for Work and Pensions], National Centre for Social Research, Office for National Statistics. Social and Vital Statistics Division. (2015b), Family Resources Survey, 2013–2014. [data collection]. UK Data Service. SN: 7753-2Google Scholar
Eurostat (2015), Disability statistics - barriers to social integration, Table 3 http://ec.europa.eu/eurostat/statistics-explained/images/1/17/Number_of_disabled_persons_aged_15_and_over_and_distribution_by_number_of_life_areas_reported%2C_by_age%2C_2012_DIS2015.png (accessed 26/07/2017)Google Scholar
Fine, M. (2007), ‘The social division of care’, Australian Journal of Social Issues, 42 (2): 137–149Google Scholar
Geerts, J. and Van den Bosch, K. (2012), ‘Transitions in formal and informal care utilisations amongst older Europeans: the impact of national contexts’, European Journal of Ageing, 9: 27–37CrossRefGoogle ScholarPubMed
Greenwood, N., Habibi, R., Smith, R. and Manhtorpe, J. (2014), ‘Barriers to access and minority ethnic carers’ satisfaction with social care services in the community: a systematic review of qualitative and quantitative literature’, Health and Social Care in the Community, 1: 64–78Google Scholar
Gurnon, E. (2017), ‘The Staggering Prices Of Long-Term Care 2017’, Next Avenue, September 26 https://www.forbes.com/sites/nextavenue/2017/09/26/the-staggering-prices-of-long-term-care-2017/#5f6d24ef2ee2 (accessed 07/112017)Google Scholar
Hoeymans, N., Feskens, E., Kromhout, D. and Van Den Bos, G. (1997), ‘Ageing and the relationship between functional status and self-rated health in elderly men’, Social Science & Medicine, 54 (10): 1527–1536Google Scholar
Komisar, H., Feder, J. and Kasper, J. (2005), ‘Unmet Long-Term Care Needs: An Analysis of Medicare-Medicaid Dual Eligibles’, Inquiry 42: 171–182Google Scholar
Lewis, J. and West, A. (2014), ‘Re-shaping social care services for older people’, Journal of Social Policy, 43 (1): 1–18Google Scholar
Lloyd, J. and Ross, A. (2014), The bigger picture. Understanding disability and care in England's older population. http://strategicsociety.org.uk/bigger-picture-understanding-disability-care-englands-older-population/#.VQw3QuGVhHQ (accessed 01/03/2015).Google Scholar
Mitra, M., Bogen, K., Long-Bellil, L.M. and Heaphy, D. (2011), ‘Unmet needs for home and community-based services among persons with disabilities in Massachusetts’, Disability and Health Journal, 4: 219–228Google Scholar
Newcomer, R., Kang, T., LaPlante, M. and Kaye, S. (2005), ‘Living Quarters and Unmet Need for Personal Care Assistance Among Adults With Disabilities’ The Journals of Gerontology: Series B, 60: 205–213CrossRefGoogle ScholarPubMed
OECD (2011), Help Wanted? Providing and Paying for Long-Term Care. OECD Publishing, Paris.Google Scholar
OECD (2015), Health at a Glance 2015. OECD Indicators, OECD Publishing, Paris.Google Scholar
OECD (2016), Health expenditure and financing: Health expenditure indicators, in OECD Health Statistics (database). https://doi.org/10.1787/data-00349-en (accessed 05/10/2016)CrossRefGoogle Scholar
Pickard, L. (2012), ‘Substitution between formal and informal care: a ‘natural experiment’ in social policy in Britain between 1985 and 2000’, Ageing and Society, 32 (7): 1147–1175CrossRefGoogle Scholar
Pickard, L. (2015), ‘A growing care gap? The supply of unpaid care for older people by their adults children in England to 2032?’, Ageing and Society, 35 (1). pp. 96–123Google Scholar
Robertson, R., Gregory, S. and Jabba, J. (2014), The social care and health systems of nine countries. The King's Fund.Google Scholar
Sienkiewicz, D. (2010), Access to Health Services in Europe, European Social Watch Report, pp17-20 http://www.socialwatch.eu/wcm/access_to_health_services.html (accessed 26/07/2017)Google Scholar
Verbakel, E., Tamlagsrønning, S., Winstone, L., Fjær, E. and Eikemo, T. (2017), ‘Informal care in Europe: findings from the European Social Survey (2014) special module on the social determinants of health’, European Journal of Public Health, 27 (Supplement 1): 90–95CrossRefGoogle ScholarPubMed
Vlachantoni, A., Shaw, R., Willis, R., Evandrou, M., Falkingham, J. and Luff, R. (2011), ‘Measuring unmet need for social care amongst older people’, Population Trends, 145: 56–72Google Scholar
Vlachantoni, A., Shaw, R. J., Evandrou, M. and Fankingham, J. (2015), ‘The determinants of receiving social care in later life in England’, Ageing and Society, 35 (2): 321–345Google Scholar
Whalley, R. (2012), ‘Social care: need for and receipt of help’, Chapter 8 in HSCIC (ed) Health Survey for England 2012, Volume 1. Health and Social Care Information Centre.Google Scholar
Zhu, H. (2015) ‘Unmet needs in long-term care and their associated factors among the oldest old in China’, BMC Geriatrics, 15: 46.Google Scholar
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