Abstract
ABSTRACTOBJECTIVE To estimate the proportion of unmet need for personal assistance for basic and instrumental activities of daily life and to evaluate socioeconomic inequalities related to the unmet need among community-dwelling Brazilian older adults.METHODS This was a cross-sectional study with data from the last National Health Survey in Brazil. Unmet need was considered as the presence of at least one unmet need for basic or instrumental activities of daily life among individuals reporting the need for assistance. Logistic regression models were used to assess the correlates and probabilities of unmet need.RESULTS The proportion of unmet need was 18% and 7.1% for basic and instrumental activities of daily life, respectively. Unmet need was significantly related to living arrangements and socioeconomic status. Individuals in the first quintile of wealth status had about 50% higher probability of having an unmet need. A family member was the most prevalent type of caregiver.CONCLUSIONS Long-term care policy is needed to reduce the proportion of unmet need, especially among socioeconomically disadvantaged groups. Future studies should address the availability, training, and remuneration of caregivers, as those are an indispensable labor force in an aging society.
Highlights
The increase in life expectancy has raised the number of older individuals living in the community with disabilities and with a higher risk of dependence, who need frequent human help or care beyond the kind habitually required by a healthy adult[1]
Unmet need was significantly related to living arrangements and socioeconomic status
Regarding instrumental activities of daily life (IADL), no need was reported by 11.6%, while 82.2% and 6.3% reported meet and unmet need, respectively
Summary
The increase in life expectancy has raised the number of older individuals living in the community with disabilities and with a higher risk of dependence, who need frequent human help or care beyond the kind habitually required by a healthy adult[1]. The aging population is increasing the attention to the challenges and demands for longterm care[2], especially in low- and middle-income countries, where most older individuals will live[2]. Unmet need for basic activities of daily life (BADL) was found to range from 14% in the United States[8], to 61% in China[4]. Regarding instrumental activities of daily life (IADL) unmet need ranged from 18% in the United States[5], to 40%, among women in Montreal[9]. Understanding the correlates of unmet care is essential for planning long-term policy[12,13], and for avoiding poor health outcomes
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