Abstract
ABSTRACTUnderstanding the nature and extent of unmet need for social care among older people is a critical policy priority in the United Kingdom and beyond, as national governments juggle the provision of adequate social care for a growing older population with competing funding priorities. Several factors can heighten the experience of unmet need among older people, for instance their family environment, and their health and socio-economic status. This paper contributes empirical evidence on the patterns of unmet need for social care among older people in England today, focusing on the individual characteristics associated with experiencing unmet need in relation to mobility tasks, activities of daily living (ADLs) and instrumental activities of daily living (IADLs). The results show that about 55 per cent of older individuals with an ADL difficulty had unmet need, compared to 24 per cent of those with an IADL difficulty and 80 per cent of those with a mobility difficulty. Characteristics reflecting greater vulnerability were more strongly associated with the risk of experiencing unmet need for ADLs, and such vulnerability was greater for particular ADLs (e.g. bathing), and for a higher number of ADLs. The findings reaffirm the complexity of conceptualising and empirically investigating unmet need in later life, and add to our understanding of the challenges of providing adequate and appropriate social care to older people.
Highlights
The existence of unmet need for social care among older people is a critical policy question in the British context, against the background of changing family structures which may affect the future supply of informalDownloaded from https://www.cambridge.org/core
Research in Australia identifies unmet need among older patients as a critical component of addressing the tension ‘between fulfilling client and carer wishes and the provider’s duty of care in meeting the client’s health and social needs’ (Harrison et al : ), while in the United States of America (USA), a better understanding of unmet need is seen as facilitating greater use of evidence-based care for older people with particular needs, such as dementia (Johnston et al )
The extent of unmet need among older people for activity of daily living (ADL), instrumental activity of daily living (IADL) or mobility tasks
Summary
The existence of unmet need for social care among older people is a critical policy question in the British context, against the background of changing family structures which may affect the future supply of informal. This paper builds on existing efforts to understand conceptually and examine empirically patterns of unmet need amongst older people, in order to provide an up-to-date analysis of its extent and the characteristics associated with it. The following section engages with conceptual arguments on the definition of need and unmet need, drawing on global scholarship and highlighting the complexity of unmet need as a concept. This is followed by a critical review of empirical evidence in this area, synthesising studies using a range of approaches to define unmet need among older adults. The final section pulls together the key findings and contextualises them in existing knowledge, pointing to policy implications arising from this work, a number of limitations in the paper and avenues for future research
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