Abstract
AbstractCare strategies for older dependants are determined by not only individuals or network characteristics, but also contextual factors. The objective of this study is to determine whether urban contexts (neighbourhoods) are linked to the use of family care (informal), public services or private care at home (formal). We applied logistic regression analysis to data from the Survey of People in a Situation of Dependence 2018. The sample was composed of 530 older people (55 years old and over) living in two types of socio-economic groups of neighbourhoods in Barcelona, Spain. The type of neighbourhood is relevant in explaining the home care that older dependants receive. In neighbourhoods with a high socio-economic level, dependants are more likely to use private services and less likely to use informal care services and public services, even after controlling for household income, degree of dependency, sex, age and the number of people in the household. Understanding the factors that determine the use of public care services, private care services or family care-giving is important due to the increment in the number of older people in the population. Our results suggest that differences in urban socio-economic contexts determine some inequalities in the use of services even after controlling for socio-economic individual differences. The characteristics of neighbourhoods should be considered to adjust care policies for older dependants.
Highlights
The needs of older dependants vary according to the degree and type of dependency, which may result in highly disparate care-giving decisions
To carry out this research, we used the database of the 2018 Survey of People in a Situation of Dependency in Barcelona. This is a survey of people with dependency who use the municipal Home Care Service (Servei d’Atenció Domiciliària-SAD) or people who receive cash benefits rather than the service
75 and over, were more likely to opt for the municipal care services and paid care ( p < 0.01) as strategies
Summary
The needs of older dependants vary according to the degree and type of dependency, which may result in highly disparate care-giving decisions. We define older dependants as older people who need assistance or care. According to the Council of Europe (1996: 1), ‘dependence’ is defined as a ‘state in which persons, by reason of lack or loss of physical, psychological or intellectual autonomy, require significant assistance or help in carrying out their usual day-to-day activities’. Disability is an inseparable attribute of dependency, there may exist different degrees of disability without dependency (Querejeta, 2004)
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