Informal care relationships and residential aged care recommendations: evidence from administrative data

Jeromey B Temple,Marijan Jukic,Briony Dow

doi:10.1186/s12877-017-0656-4

Jeromey B Temple, Marijan Jukic + Show 1 more

Open Access

https://doi.org/10.1186/s12877-017-0656-4

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Journal: BMC Geriatrics	Publication Date: Dec 1, 2017
Citations: 11	License type: open-access

Affiliation: Melbourne Health, University of Melbourne

Abstract

BackgroundThe Australian government recognises the importance of informal care to enable ageing in place. Yet, few multivariable studies have examined aspects of informal care that alter the probability of entry to residential care in Australia. Existing Australian and international studies show differing effects of informal care on entry to residential care.MethodsWe utilise unique administrative data on aged care assessments collected from 2010 to 2013, consisting of 280,000 persons aged 65 and over. Logistic regression models were fitted to measure the propensity to be recommended care in a residential care setting, disaggregated by characteristics of informal care provision.ResultsProviding some explanation for the divergent findings in the literature, we show that close familial carer relationships (partner or child) and coresidence are associated with recommendations to live in the community. Weaker non-coresidential friend or neighbour carer relationships are associated with recommendations to live in residential care for women, as are non-coresidential other relatives (not a child, partner or in-law) for both males and females. Non-coresident carers who are in-laws (for females) or parents have no impact on assessor recommendations. Despite these significant differences, health conditions and assistance needs play a strong role in assessor recommendations about entry to residential care.ConclusionCo-resident care clearly plays an important protective role in residential care admission. Government policy should consider the need for differential supports for co-resident carers as part of future aged care reform.

Highlights

The Australian government recognises the importance of informal care to enable ageing in place
Providing part of the explanation for these divergent findings in the literature, we use a detailed measure to show that some carer relationships and residence are associated with recommendations to live in the community, some to live in residential care, and some care types have no association with Aged Care Assessment Teams (ACAT) assessor recommendation at all
With future releases of the Aged Care Assessment Program (ACAP) administration data, a priority is to examine whether assessors recommendations have changed. Noting these limitations and extensions, results from this study are important as they provide some evidence as to why some studies show informal care to be positively associated with entry to residential care, others negatively and some studies showing no effect at all

Summary

Introduction

The Australian government recognises the importance of informal care to enable ageing in place. Since the early 1980’s, the Australian Government’s aged care policy has consistently sought to assist older people to remain in their own homes (private dwellings) in preference to residential care. This is consistent with the preferences of older people [1]. The government has long recognised the importance of informal carers in supporting older people at home, with family caregivers being considered a client of the home and community care service since its inception in 1986 and their needs assessed . The objective of the ACAP program is to assess care needs and assist frail clients to access appropriate care. As part of the initial assessment and needs identification, the ACAP toolkit for assessors provides a set of appropriately validated tools that are nationally consistent

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