Abstract

BackgroundLong-term care is one of the most pressing health policy issues in Germany. It is expected that the need for long-term care will increase markedly in the next decades due to demographic shifts. The purpose of this study was to investigate the factors associated with preferences for long-term care settings in old age individuals in Germany.MethodsBased on expert interviews and a systematic review, a questionnaire was developed to quantify long-term care preferences. Data were drawn from a population-based survey of the German population aged 65 and over in 2015 (n = 1006).ResultsIn multiple logistic regressions, preferences for home care were positively associated with providing care for family/friends [OR: 1.6 (1.0–2.5)], lower self-rated health [OR: 1.3 (1.0–1.6)], and no current need of care [OR: 5.5 (1.2–25.7)]. Preferences for care in relatives’ homes were positively associated with being male [OR: 2.0 (1.4–2.7)], living with partner or spouse [OR: 1.8 (1.3–2.4)], having children [OR: 1.6 (1.0–2.5)], private health insurance [OR: 1.6 (1.1–2.3)], providing care for family/friends [OR: 1.5 (1.1–2.0)], and higher self-rated health [OR: 1.2 (1.0–1.4)]. Preferences for care in assisted living were positively associated with need of care [OR: 1.9 (1.0–3.5)] and higher education [for example, University, OR: 3.5 (1.9–6.5)]. Preferences for care in nursing home/old age home were positively associated with being born in Germany [OR: 1.8 (1.0–3.1)] and lower self-rated health [OR: 1.2 (1.0–1.4)]. Preferences for care in a foreign country were positively associated with lower age [OR: 1.1 (1.0–1.2)] and being born abroad [OR: 5.5 (2.7–11.2)].ConclusionsNumerous variables used are sporadically significant, underlining the complex nature of long-term care preferences. A better understanding of factors associated with preferences for care settings might contribute to improving long-term care health services.

Highlights

  • Long-term care is one of the most pressing health policy issues in Germany

  • Preferences for care in assisted living were positively associated with need of care [Odds ratio (OR): 1.9 (1.0–3.5)] and higher education [for example, University, OR: 3.5 (1.9–6.5)]

  • Preferences for care in nursing home/old age home were positively associated with being born in Germany [OR: 1.8 (1.0–3.1)] and lower self-rated health [OR: 1.2 (1.0–1.4)]

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Summary

Introduction

It is expected that the need for long-term care will increase markedly in the decades due to demographic shifts. The purpose of this study was to investigate the factors associated with preferences for long-term care settings in old age individuals in Germany. It is projected that the number and proportion of individuals in old age will increase considerably in the future decades [1]. Because old age is associated with the need for long-term care, it is projected that the number of individuals in need for long-term care will increase substantially [2]. If long-term care is needed, home care is often provided informally by relatives or friends which matches the preferences expressed by care-recipients [3]. Preferences shift toward inpatient care when the need for care grows [4,5,6,7]

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