Advertisement

European Journal of Ageing

, Volume 6, Issue 2, pp 137–145 | Cite as

Moving in and out of public old age care among the very old in Sweden

  • Daniel Hallberg
  • Mårten Lagergren
Original Investigation

Abstract

In this paper, we present empirical results for the very old (75+) concerning transitions between independent living in ordinary home without public support, independent living in ordinary home or special accommodations with home help and home health care, and living in around the clock care. We investigate the role of age and gender, dependency in activities of daily living (ADL) and the informal support from a partner. We also study mortality conditional on the above-mentioned variables and on the mode of old age care. The results show that the propensity to move to a more intensive mode of care is less for males, higher with more limitations in personal ADL and increasing with age. There is also a stabilizing effect of the availability of informal care support, as measured by marriage or cohabitation, as it makes it less likely to move from the current care mode. In the case of mortality, the observed relations pointed in the expected directions—mortality increasing with increasing PADL-limitations and age and being higher for men than for women. The age relation, however, does not hold in the same way in around the clock care. The estimated relationships are used as input in a micro-simulation model intended for analysis of the effect of population aging on the needs and resource requirements for old age care in Sweden.

Keywords

Old age care Transfers Mortality 

Notes

Acknowledgments

We are grateful for comments and suggestions from Björn Lindgren, Anders Klevmarken, Lennart Flood, Kristian Bolin, Urban Fransson, Matias Eklöf, and two anonomous referees. Financial support from the Swedish council for working life and social research (FAS) is gratefully acknowledged.

References

  1. Aguero-Torres H, von Strauss E, Viitanen M, Winblad B, Fratiglioni L (2001) Institutionalization in the elderly: the role of chronic disease and dementia. Cross-sectional and longitudinal data from a population-based study. J Clin Epidemiol 54:795–801CrossRefGoogle Scholar
  2. Birch S (2002) Health human resources planning for the new millennium: inputs in the production of health, illness and recovery in populations. Can J Nurs Res 33:109–114Google Scholar
  3. Börsch-Supan A, Brugiavini A, Jürges H, Mackenbach J, Siegrist J, and Weber G (eds) (2005) Health, ageing and retirement in Europe—first results from the survey of health, ageing and retirement in Europe. MEA, Mannheim. http://www.share-project.org
  4. Brown LJ, Potter JF, Foster BG (1990) Caregiver burden should be evaluated during geriatric assessment. J Am Geriatr Soc 38:455–460Google Scholar
  5. Fratiglioni L, Grut M, Forsell Y, Viitanen M, Grafström M, Holmen K, Ericsson K, Bäckman L, Ahlbom A, Winblad B (1991) Prevalence of Alzheimer’s disease and other dementias in an elderly urban population. Neurology 41:1886–1892Google Scholar
  6. Fratiglioni L, Viitanen M, Bäckman L, Sandman P-O, Winblad B (1992) Occurrence of dementia in advanced age: the study design of the Kungsholmen project. Neuroepidemiology 11(Suppl 1):29–36CrossRefGoogle Scholar
  7. Geerlings SW, Pot AM, Twisk JWR, Deeg DJH (2005) Predicting transitions in the use of informal and professional care by older adults. Ageing Soc 25:111–130CrossRefGoogle Scholar
  8. Kelman HR, Thomas C (1990) Transitions between community and nursing home residence in an urban elderly population. J Community Health 15:105–122CrossRefGoogle Scholar
  9. Klevmarken A, Lindgren B (eds) (2008) Simulating an ageing population—a microsimulation approach applied to Sweden. Emerald Group Publishing Ltd, BingleyGoogle Scholar
  10. Lagergren M, Fratiglioni L, Hallberg IR et al (2004) A longitudinal study integrating population, care and social services data. The Swedish National study on Aging and Care. Aging Clin Exp Res 16:158–168Google Scholar
  11. Larsson K, Thorslund M (2002) Does gender matter? Differences in patterns of informal support and formal services in a Swedish urban elderly population. Res Aging 24:308–326CrossRefGoogle Scholar
  12. Larsson K, Thorslund T, Forsell Y (2004) Dementia and depressive symptoms as predictors of home help utilization among the oldest old: a population based study in an urban area of Sweden. J Aging Health 16:641–648CrossRefGoogle Scholar
  13. Larsson K, Thorslund T, Kårehult I (2006) Are public care and services for older people targeted according to need? Applying the behavioural model on longitudinal data of a Swedish urban population. Eur J Aging 3:22–33CrossRefGoogle Scholar
  14. Livingston G, Manela M, Katona C (1997) Cost of community care for older people. Br J Psychiatry 171:56–59CrossRefGoogle Scholar
  15. McFadden D (1973) Conditional logit analysis of qualitative choice behavior. In: Zarembka P (ed) Frontiers in econometrics. Academic Press, New YorkGoogle Scholar
  16. Meinow B, Kåreholt I, Lagergren M (2005) According to need? Predicting the amount of municipal home help allocated to elderly recipients in an urban area in Sweden. Health Soc Care Community 13:366–377CrossRefGoogle Scholar
  17. Mustard C, Finlayson M, Derksen S, Berthelot JM (1999) What determines the need for nursing home admission in a universally insured population? J Health Serv Res 4:197–203Google Scholar
  18. Palme J, Bergmark A, Bäckman O, Estrada F, Fritzell J, Lundberg O, Sjöberg O, Sommestad L, Szebehely M (2003) A welfare balance sheet for the 1990s. Final report of the Swedish Welfare Commission. Scand J Public Health Suppl 60:7–143Google Scholar
  19. Pearlman DN, Crown WH (1992) Alternative sources of social support and their impacts on institutional risk. Gerontologist 32:527–535Google Scholar
  20. Sakari-Rantala R, Heikkinen E, Ruoppila I (1995) Difficulties in mobility among elderly people and their association with socio-economic factors, dwelling environment and use of service. Aging Clin Exp Res 7:433–440Google Scholar
  21. Stoddart H, Whitley E, Harvey I, Sharp D (2002) What determines the use of home care services by elderly people. Health Soc Care Community 10:348–360CrossRefGoogle Scholar
  22. Stoller EP, Cutler SJ (1993) Predictors of use of paid help among older people living in the community. Gerontologist 33:31–40Google Scholar
  23. Szebehely M (1998) Changing divisions of carework: caring for children and frail elderly people in Sweden. In: Lewis J (ed) Gender, social care and welfare state restructuring in Europe. Ashgate, Aldershot, pp 257–283Google Scholar
  24. Tennstedt SL, Sullivan LM, McKinley JB, D’Agostino RB (1990) How important is functional status as a predictor of service use by older people? J Aging Health 2:439–441CrossRefGoogle Scholar
  25. Thorslund M (2003) Äldre som flyttar till service och vård. Uppföljning av situationen i Sundsvall 2002 (Elderly people moving to service and care facilities. A follow-up study from Sundsvall 2002). National Board of Health and Welfare, StockholmGoogle Scholar
  26. Thorslund M, Bergmark Å (2002) A guest editiorial—solidarity and welfare transition. Int J Soc Welfare 9:224–227CrossRefGoogle Scholar
  27. Thorslund M, Lundberg O (1994) Health and inequalities among the oldest old. J Aging Health 6:51–69CrossRefGoogle Scholar
  28. Thorslund M, Norström T, Wernberg K (1991) The utilization of home help in Sweden: a multivariate analysis. Gerontologist 31:116–119Google Scholar
  29. Willcocks D, Peace S, Kellaher L (1987) Private lives in public places. Tavistok, LondonGoogle Scholar

Copyright information

© Springer-Verlag 2009

Authors and Affiliations

  1. 1.Institute for Futures StudiesStockholmSweden
  2. 2.Stockholm Gerontology Research CenterStockholmSweden

Personalised recommendations