Do community-dwelling Dutch older adults receive the care that they need?

Abstract

Background Aged care homes have been substituted by homecare to reduce the increasing Dutch healthcare costs. Ageing in place has led to a growing demand on formal and informal caregivers. The aim of this study was to examine: 1) the trends in formal and informal care, 2) whether care needs of community-living older adults are met, and 3) the association between care needs and quality of life (QoL). Methods Baseline data were used from 'The Older Persons and Informal Caregivers Survey - Minimum DataSet', which combines 54 studies conducted in 2008-2014. 12,735 participants met the inclusion criteria (age ≥65 years, living independently, needing assistance with washing, dressing, medication or household chores). Proportions of participants receiving formal or informal care were reported and associations with QoL were examined using ordinal (self-rated QoL) and linear (EQ-5D) regression. Results Formal care decreased from 75% to 63% and informal care increased from 16% to 28% between 2009 and 2013 (P < .001). Approximately one in four participants received no formal or informal care. Receiving no formal care was associated with a better QoL (self-rated QoL OR=1.39, CI=[1.251-1.544]; EQ-5D regression coefficient=0.038 CI=[0.023-0.053]). Conclusion The shift from formal to informal care together with the unmet care needs of community-living older adults in the Netherlands underlines the need for more support and a higher demand on informal caregivers.