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Home care and quality of life among community-dwelling dependent older adults in Israel: a multiple mediator model

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Abstract

Purpose

To examine the association between home care provision (combined paid formal home care and non-paid family-only home care) versus non-paid family-only home care with quality of life (QoL) of older adults, as well as the mediating effects of loneliness, social isolation and satisfaction with family relationships and support.

Methods

A convenience sample of 360 Israeli dependent adults aged 65 + responded to questionnaires. Using bootstrapping, we tested the strength and significance of the conditional indirect effects of the four simultaneous mediators.

Results

Using combined home care provision (paid formal home care and non-paid family-only home care) versus non-paid family-only home care for older adults was associated with lower QoL of care-recipients (B = − 4.57, t = − 2.24, p = 0.001, 95% CI − 8.58, − 0.56; R2 = 0.37), and was fully and strongly mediated by feelings of loneliness (B = − 1.92, p = 0.001, 95% CI − 3.66, − 0.79), social isolation (B = − 0.54, p = 0.001, 95% CI − 1.47, − 0.07) and satisfaction with family support (B = − 1.09, p = 0.001, 95% CI − 2.57, − 0.16). However, the indirect effect through satisfaction with family relationships was not significant. The highest proportion of the indirect effect size was (B = 0.42, 95% CI 0.13, 1.97) for loneliness, followed by satisfaction with family support (B = 0.23, 95% CI 0.01, 1.07), and social isolation (B = 0.11, 95% CI 0.01, 0.66), respectively.

Conclusions

Using combined formal home care might reduce the QoL of care-recipients by increasing their feelings of loneliness, social isolation and reduced perceived family support. Practitioners should encourage family members to continue with family regular support and contact alongside the use of formal home care in order to maintain satisfaction and QoL of older relatives.

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Acknowledgements

We acknowledge the Israel National Institute for Health Services and Health Policy for its assistance in support of this research.

Funding

The current study funded by the “The Israel National Institute for Health Policy and Services Research” Study number 2018/263.

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Authors and Affiliations

  1. Zefat Academic College, 11 Jerusalem St, P.O.B 169, 13206, Zefat, Israel

    Rabia Khalaila

  2. Shamir Research Institute, Haifa University and Tel-Hai College, 1290000, Kazrin, Israel

    Adi Vitman-Schorr

  3. University of California San Francisco, Global Brain Health Institute, San francisco, CA, USA

    Rabia Khalaila

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  1. Rabia Khalaila
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Contributions

All authors contributed to the study conception, design, Material preparation, data collection and the first Draft. Analysis was performed by RK. All authors commented on previous versions of the manuscript. All authors read and approved the final manuscript.

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Correspondence to Rabia Khalaila.

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This study was performed in line with the principles of the Declaration of Helsinki. Approval was granted by the Ethics Committee of College (IRB application number: 2019–03).

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Khalaila, R., Vitman-Schorr, A. Home care and quality of life among community-dwelling dependent older adults in Israel: a multiple mediator model. Qual Life Res 33, 507–517 (2024). https://doi.org/10.1007/s11136-023-03541-8

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