Abstract
Aging is pushing states to rethink long-term care policies in several dimensions. This study aims to characterize the reality of dependent older people regarding their demographic and health characteristics, to describe their informal carers and understand the availability of informal care. A cross-sectional study was developed in Portugal in 2013. Descriptive statistical analyses and binary logistic analysis were conducted. Results show that the informal long-term care sector is primarily aimed at older people with severe limitations in their activities of daily living and at the chronically ill, particularly older women. Additionally, 39.5% of dependent older persons do not have informal care and only receive informal aid in cases of extreme need. Results show a critical situation for both social groups (older persons and caregivers) and the prospect of an alarming situation in the near future (aging and reduced availability of informal caregivers) unless a new approach for long-term care is developed.
Highlights
Improvements in living conditions and the quality of health services have led to a significant increase in the proportion of older people in the population, a trend that is expected to continue over the decades
A significant proportion of long-term care is provided in this way in Spain and in France, according to Costa-Font and Courbage [11]
The absence of some relevant variables referred to in the literature constitutes a limitation of this study. It appears that the informal long-term care sector in Portugal is primarily aimed at older people with severe limitations in their activities of daily living (ADL) and at the chronically ill, older women
Summary
Improvements in living conditions and the quality of health services have led to a significant increase in the proportion of older people in the population, a trend that is expected to continue over the decades. Public health authorities face the challenge of promoting the reform of health policies that are aimed at older people, due to the progressive loss of functionality and the consequent increase in dependence for their activities of daily living (ADL), leading the older person to an increased need for long-term care. These personal care components are often provided in combination with basic medical services (medication, health monitoring, prevention, rehabilitation, or palliative care services) and, sometimes, with lower level help, namely those related with Instrumental Activities of Daily Living (IADL), such as meals, shopping, and housework [1]. Portugal shares the main characteristics of other Southern European countries, i.e., the family (in particular women) is the main provider of care, but differs in one key aspect: it has a high female participation rate in the labor market [9, 10, 12,13,14]
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