Carers Research Articles

Relationship Between Primary Caregiving Type and a Peaceful End-Of-Life Experience Among Older Adults in China

ABSTRACT Few studies have compared pain management provided by informal and formal caregivers of older adults in China at the end of life. This study aims to address this gap by investigating the association between formal and informal care and painfulness at the end of life among older adults in China. Specifically, the study focuses on the influence of various types of informal care. Data were obtained from the Chinese Longitudinal Healthy Longevity Survey (CLHLS) conducted from 2002 to 2018, which is the largest nationally representative study of older adults in China, with a sample size of 21,849 deceased participants. Results from multiple logistic regressions suggest that informal care is associated with a more painful end-of-life experience compared to formal care, with care provided by adult children being a more favorable option within informal care. These findings underscore the urgent need to prioritize education on death and dying, improve the formal care system, and enhance professionalism within informal care.

Academic Performance, Health and Support Needs: Comparing Foster Care Alumni and Peers in Higher Education in Norway

The completion rates of higher education are low among young adults with a history of foster care. Understanding how students from foster care alumni fare is imperative for facilitating attainment and preventing drop-out. The aim of this study was to compare students from foster care alumni and the general student population by examining (1) sociodemographic characteristics, academic functioning and need for special assistance; (2) contextual factors important for student life; and (3) mental and somatic health, loneliness, life satisfaction and use of cannabis and alcohol. Data comprised self-reports from the Norwegian national survey Students’ Health and Well-being Study 2022. Reports from foster care alumni students (n = 508) were compared to those of the general student sample (n = 59,036). Compared to the general sample, twice as many foster care alumni students reported receiving or needing special assistance in their studies. Moreover, they reported substantially higher economic burden than their student peers, by higher frequency of work income, more financial worries, and less parental financial support. Foster care alumni students also reported a higher load of informal care responsibilities, poorer mental and somatic health, more loneliness and lower life satisfaction. Foster care alumni students fare comparably well in terms of grades and study progression despite the reported economic burden and impaired health and well-being. As these are factors shown to impact study completion, policies need to be put in place to ensure that care-experienced students receive adequate support through their young adulthood and specifically in higher education.

The role of objects in negotiations in convoys of care: Addressing fundamental concerns of informal caregivers

Due to an increased policy focus on informal care in many Western countries, professionals and informal caregivers increasingly grow more interdependent. Increased involvement of informal caregivers in professional care has consequences for the work of professionals, the care that is received by care recipients, and the role of informal caregivers. Care needs to be negotiated between them within the dynamic networks of care recipients and caregivers (i.e., “care convoys”). Scant attention has been given to objects as part of these convoys and negotiations. Therefore, in this paper, we answer the question: How do objects become part of and what is their role in the negotiations between healthcare professionals and informal caregivers? We use interview data from 48 participants (care recipients, professionals, informal caregivers, and persons in managerial positions). In the results, we discuss how objects, in terms of their affordances and the values they embody, become important in the relationship between professionals and informal caregivers and how they become part of negotiations on quality of care. We find that seemingly mundane objects become topics of conversation to address more fundamental concerns in how healthcare is organized for and provided to individual care recipients. Our study helps to open the care convoys model to objects as important actors and further understand the politics within care convoys.

Changes in care provision to older parents during COVID-19 and the well-being of adult children: The moderating roles of the child-parent relationship and pandemic-related measures

Objective: The study addresses the associations between changes in care provision to older parents since the pandemic and worsened depression and anxiety in adult children. It also explores whether pandemic-related control measures and child-parent relationships moderated these associations. Background: Changes in informal care during the pandemic, such as increased or decreased caregiving frequency, may have affected caregivers’ psychological well-being. Limited research exists on how stressors and resources shape the well-being of adult children caregivers. Method: Data from 740 respondents in the first SHARE Corona Survey (SCS) who provided care for their parents during the pandemic were analyzed. Changes in depression and anxiety were assessed using data from SCS and pre-pandemic Wave. Logistic regression analyses were conducted, with added interactions between the moderators - pandemic measures and child-parent relationship characteristics - and changes in care frequency. Results: Increased caregiving frequency during the pandemic was associated with worsened depression. Stricter pandemic measures intensified this effect but also reduced the likelihood of anxiety for those who provided care less often. A higher quality of relationship with the mother in childhood was marginally associated with lower depression among those increasing caregiving but worsened depression for those decreasing it. Conclusion: To address post-pandemic caregiving challenges, efforts should focus on reducing caregiver stress and considering the enduring influence of early child-parent relationships.

Demographic ageing: an opportunity to rethink economy, society and regions

Abstract Ageing is often depicted negatively, but we challenge passive views, suggesting that an “active ageing” agenda requires rethinking economy, urban form and societal responses. We present demographic trends in ageing, migration and urbanization across global regions. Building from psychological theories of ageing regarding disengagement and continuity, we argue for an adjustment response at the societal level to address needed structural changes in economy, social policy and regional planning. These adjustments should prioritize well-being and purpose over economic growth; social policy that links household, informal and formal care and new approaches to urban and regional planning that remake cities for all ages. Ageing requires new paradigms. These societal adjustments will permit new approaches that could build a more inclusive world.

A novel explainable machine learning-based healthy ageing scale

BackgroundAgeing is one of the most important challenges in our society. Evaluating how one is ageing is important in many aspects, from giving personalized recommendations to providing insight for long-term care eligibility. Machine learning can be utilized for that purpose, however, user reservations towards “black-box” predictions call for increased transparency and explainability of results. This study aimed to explore the potential of developing a machine learning-based healthy ageing scale that provides explainable results that could be trusted and understood by informal carers.MethodsIn this study, we used data from 696 older adults collected via personal field interviews as part of independent research. Explanatory factor analysis was used to find candidate healthy ageing aspects. For visualization of key aspects, a web annotation application was developed. Key aspects were selected by gerontologists who later used web annotation applications to evaluate healthy ageing for each older adult on a Likert scale. Logistic Regression, Decision Tree Classifier, Random Forest, KNN, SVM and XGBoost were used for multi-classification machine learning. AUC OvO, AUC OvR, F1, Precision and Recall were used for evaluation. Finally, SHAP was applied to best model predictions to make them explainable.ResultsThe experimental results show that human annotations of healthy ageing could be modelled using machine learning where among several algorithms XGBoost showed superior performance. The use of XGBoost resulted in 0.92 macro-averaged AuC OvO and 0.76 macro-averaged F1. SHAP was applied to generate local explanations for predictions and shows how each feature is influencing the prediction.ConclusionThe resulting explainable predictions make a step toward practical scale implementation into decision support systems. The development of such a decision support system that would incorporate an explainable model could reduce user reluctance towards the utilization of AI in healthcare and provide explainable and trusted insights to informal carers or healthcare providers as a basis to shape tangible actions for improving ageing. Furthermore, the cooperation with gerontology specialists throughout the process also indicates expert knowledge as integrated into the model.

BE-SAFE: Intervention to reduce benzodiazepine and sedative hypnotics in elderly with sleep problems

Abstract Introduction Benzodiazepine and sedative hypnotics (BSH) may have significant adverse effects and associated costs, especially in older adults: increased risk of falls, fractures, hospitalisations, impaired functioning, delirium, cognitive impairment and mortality. Addressing BSH overuse is therefore an urgent priority to improve patient safety in Europe. Objectives To present the 5-year research project BE-SAFE, funded by the European Commission (HORIZON Europe) and by the Swiss State Secretariat for Education, Research, and Innovation. BE-SAFE aims to improve patient safety by addressing knowledge and practice gaps related to the reduction of BSH used by older adults for sleep problems. Methods BE-SAFE involves seven inter-related work packages and six European countries (Belgium, Greece, Norway, Poland, Spain and Switzerland) as well as experts from Canada; it proposes an interdisciplinary and inter-sectorial approach with experts in guidelines, implementation, dissemination, case studies, geriatrics and sleep. BE-SAFE will develop an intervention comprising trustworthy clinical guidelines, implementation recommendations and patient-centred material. This intervention will be tested in a cluster randomized controlled trial; 470 patients (65 years old and above) and 62 prescribing physicians in hospital and outpatient settings. Results BE-SAFE is expected to result in reduction of BSH use. Its toolkit, encompassing setting-specific implementation recommendations, will enable healthcare professionals (HCPs) to identify, evaluate and prevent risks of BSH use. The BE-SAFE approach could also be expanded to cover reduction of use of other medications. Conclusions Through BE-SAFE, patient safety is expected to improve; BE-SAFE project will reach a wide-ranging audience, including general population, informal carers, older adults, HCPs, healthcare system leaders and decision makers. Authors acknowledge the significant input of J. Grimshaw and W. Levinson, Canada. Key messages • Deprescription of benzodiazepine and sedative hypnotics, especially in older adults, is a priority due to their side effects, particularly in this age group. • The European project BE-SAFE aspires to create easy-to-use guidelines to this aim, improving thus patient safety and healthcare.

What characterizes the eldercare debut? A registry-based study of pre-entry health care use

Abstract Introduction Timely identification of needs due to functional loss in old age is important. Policy guidelines requires local collaborative care action. Eldercare debut circumstances are poorly investigated from a collaborative perspective. This study explored the socio-demographic characteristics, functional status and patterns of health care use leading up to the first application for eldercare, and how older people’s intensity of primary care use was associated with their intensity of granted eldercare at debut. Methods Data on socio-demographics, functional status, and informal care in people ≥65 years (July ‘21 to June ‘22; n = 3,649) were combined with data on inpatient and outpatient care six months preceding debut in Stockholm, Sweden. Descriptive and regression statistics were used. Results Every second person debuted following a hospital stay and one in four had extensive functional limitations. The majority made one or two visits in primary care, but 13% had a high intensity of use and 20% made no visits at all. More than half received informal care weekly or daily. Non-use and high use of primary care were both significantly associated with increased probability of receiving high intensity of eldercare. Conclusions and implications The intensity of primary care use can provide an indication of people’s intensity of eldercare at debut, which is important for resource allocation. Deeper collaboration between eldercare and primary care actors can facilitate early identification of people in need of support, thereby alleviating individual suffering, enabling secondary and tertiary prevention, and optimizing the management of welfare resources. Key messages • The intensity of primary care use can provide an indication of people’s intensity of eldercare at debut. • Deeper collaboration between eldercare and primary care actors can facilitate early identification of older people with social support needs.

Family function, psychological distress and burden in informal caregivers of people with dementia

Abstract Background Dementia presents a public health priority due to its high global prevalence, mortality, economic cost, and caregiver burden (CB). Dementia care can be stressful and may negatively influence the health of informal caregivers. This cross-sectional study aimed to identify psychological and social factors associated with subjective CB in informal home care providers of people with dementia (PwD), controlling for sociodemographic, clinical, and care-related variables. Methods We included 115 informal caregivers of PwD from community settings (mean age: 54.0±12.4 years; 81.7% women). Participants fulfilled the Zarit Burden Interview (ZBI-12), the Patient Health Questionnaire (PHQ-9), the Generalized Anxiety Disorder Scale (GAD-7), the Family APGAR, and the short IQCODE used to assess dementia severity. Multiple linear analyses were used to analyse the data. Results The mean caregiving duration was 4.8±4.8 years, and 55.7% of informal caregivers extend care for >40 hours/week. We found that a total of 52.5 % of informal caregivers experienced a high CB (ZBI-12 cut-off score: 17). Univariate analyses showed an association between depression (β = 0.36; p < 0.001), anxiety (β = 0.52; p < 0.001), family dysfunction (β = 0.36; p < 0.001), and CB. Regression analyses showed that CB was the most strongly associated with anxiety (β = 0.51; p < 0.001). This association weakened (0.47; p < 0.01) when family function was added to the final model (β=-0.22; p < 0.05). The final model explained 23.5% of the variance in CB. No associations between the caregiver's age, sex, caregiving duration, the extent of care per day, use of community care, dementia severity, and depression were identified. Conclusions Long-term care for people living with dementia can be very demanding. Thus, the implementation of tailored interventions to enhance family function and diminish psychological distress can mitigate level of caregiver burden. [Grant support: APVV-22-0587]. Key messages • Dementia caregiving is a global public health priority. • The caregiver’s burden and distress can be alleviated by the interventions focusing on family dysfunction.

Public Health Challenges for 2050 in the Netherlands

Abstract Every 4 years, the National Institute for Public Health and the Environment (RIVM) carries out the Dutch Public Health Foresight Study, commissioned by the Ministry of Health. The ninth edition (PHFS-2024) compiles an outlook on future public health and the health care system in the Netherlands. It combines a business-as-usual Trend Scenario with literature study and a range of qualitative and mixed-methods approaches. The Trend Scenario comprises projections up to 2050 for a broad range of epidemiological indicators. Such as (healthy) life expectancy, disease burden, life style factors. The qualitative and mixed methods approaches supported an incremental intersubjective process. Methods were a focus groups study, stakeholder sessions and workshops. An important innovation in this study was the Citizen Council and Panel. The outcomes show that demographic development, in particular growth of the group people at high age with multimorbidity, will lead to high pressure on the formal and informal health care system but also on e.g. mental health. A life course approach applied shows that decreasing mental health of youth will have long term consequences. Also, overweight will deeply impact older people’s health in the future. Lastly, climate change in combination with e.g. energy transition will deeply affect our society and living environment. Next to these challenges, there will also be opportunities to improve health. Building a climate-proof living environment that also stimulates healthy life styles and social interaction is one of them. However, improving health has linkages with policy areas outside the traditional public health domain as well and requires, firstly, a Health in/for All Policies approach. Secondly a whole-of-society approach in which companies and civil organizations take action is needed. All these efforts can only be effective if people and communities are put at the core of all health policies.

How to improve informal caregiver’s quality of life and health literacy? – a NGT approach

Abstract Background Previous studies revealed that informal caregivers have a large number of unmet needs, reinforcing the necessity of national policies that ensure an adequate sustainability of the provision of informal care and takes into account the needs of caregiving dyads in the planning process. This study aimed to identify and consensualize initiatives and action strategies to improve the Portuguese Informal Caregiver’s reality and health literacy levels. Methods A Nominal Group Technique (NGT) was conducted with 10 experts. The NGT panel was asked about feasible action strategies to improve informal caregiver’s reality, consensualized and voted them according to perceived relevance in a semantic differential (1 pts to nothing relevant and 6 pts to very relevant), allowing a score calculation. Results Thirty-two initiatives emerged from the NGT. The five most relevant initiatives were identified based on an average score namely: 1) Pressure political decision-makers on the need for an effective implementation of the Informal Caregiver status, which is not being done (score=56); 2) Creation of a specific emergency social line for informal caregivers, as a measure of greater equity (score=52); 3) Raise employers awareness about caregiving demands (score=52); 4) Creation of a proximity social manager, linked to primary care services, that facilitates caregiver connection to health and social care services (score=51); 5) Decentralization of respite care services support, with multidisciplinary teams (score=49). Conclusions The informal caregiver’s role needs to be recognised and understood by healthcare and social care providers. (Re)design political, economic and social policies that address both caregiver and care recipients’ needs is critical to enable the continuity of informal care provision. Key messages • Informal caregivers play a fundamental social role but still have many needs to be addressed, particularly at the level of the official definition of their role. • (Re)design political, economic and social policies targeted to informal carers is imperative to enable the continuity of informal care provision.

Telemonitoring activities of daily living in home healthcare services to support aging in place

Abstract Context Assessing older adults’ abilities to carry out their activities of daily living (ADLs) is a key determinant in the provision of homecare services for aging in place. Amidst a growing aging population and lack of human resources, continuous remote monitoring technology appears promising to support health and social care professionals (HSCPs) in identifying service needs. However, implementation studies conducted in real-life settings are lacking. This study is part of an on-going action design research project aimed at developing an ambient telemonitoring system monitoring ADLs to support clinical decision making. It focused on the initial step of implementation and aimed to understand 1) which HSCPs would want to use the system, 2) for which care recipient they requested it, and 3) for which reasons. Methods A multiple embedded case study utilizing mixed methods was conducted across 3 healthcare establishments in Quebec, Canada. Descriptive statistics from surveys and medical records was conducted to describe the profile of HSCPs and their care recipients. An inductive qualitative analysis was carried out through interviews with 23 HSCPs, in charge of 31 care recipients, to deepen our understanding of the reasons why they requested the system. Results HSCPs were primarily women (89%) occupational therapists (43%). Home care recipients were also primarily women (74%), with documented refusal of homecare services (65%), diagnosed with cognitive decline (94%), and living in a single-family home or apartment (68%). Overall, interviews revealed HSCPs challenges in getting the necessary information to assess their care recipients needs, despite the presence of in-home services and other strategies in place (e.g. informal carer support). Moreover, the telemonitoring system was perceived as promising for risk management. Conclusions There is an interest for the use of ADL telemonitoring technology in the delivery of home healthcare services for aging in place. Key messages • To facilitate its integration in practice, we explored the need for, and value of, ADLs telemonitoring technology by health and social care professionals (HSCPs) in real-life contexts. • By studying the integration of innovative technologies in home healthcare practices, such as ADLs telemonitoring, we aim to support HSCPs practice in fulfilling older adults desire to age in place.

The health of older caregivers in Spain: a matter of age or a matter of care?

Abstract Introduction Informal care is crucial in Spain’s care system, with a rising number of caregivers aged 75 or older, yet studies on its health effects are lacking. This study aims to determine the differential impact of age and care-related variables on the health of older caregivers. Materials and methods This is a cross-sectional, national study with a sample of 3,870 informal caregivers from the Spanish 2020 Disability, Personal Autonomy and Dependency Survey. We performed a logistic regression where self-reported deterioration in caregiver health due to caregiving was the dependent variable and age (<75 vs. ≥ 75) was the independent variable. Caregivers’ sex, educational level (primary and lower or secondary and higher), income (<1,150 euros per month vs. ≥ 1,150), severe functional limitation of caregivers and care-receptors (yes or no), duration of care (< 8 years vs. ≥ 8 years), and daily hours of care were used as covariates. Results One in 6 caregivers was 75 or older (16,1%). Caregivers’ mean age was 58.4, and care-receptors’ 66.6 years. Women represented 63.0% of caregivers, and 42.8% of care-receptors. Up to 4.6% of caregivers had a severe limitation, and 43.7% of caregivers reported deterioration of their health due to caregiving. A greater perception of deterioration in caregiver health due to caregiving was associated with being 75 years or older (β = 0.34, p = 0.009). Covariates associated with caregivers’ health deterioration were being a woman (β = 0.77, p < 0.001), presence of severe limitation of care receptors (β = 0.58, p < 0.001), and increased daily hours of care (β = 0.01, p = 0.013). Caregivers’ severe limitation, level of education, income and years of care did not show a significant association with perception of health deterioration. Discussion Caregivers older than 75 years in Spain experience a key deterioration in their health associated with caregiving. This vulnerable population must be prioritized in health and social policies. Key messages • One out of 6 caregivers in Spain is aged 75 years or older. Caregiving impacts greatly in their health status. • Older caregivers is a vulnerable population that must be a priority for health and social services.

Risk Profiles of Avoidable and Unavoidable Hospitalizations: a Swedish population-based study

Abstract Background Older adults frequently experience multiple hospitalizations, owing to their complex health and social needs. This study aims to comprehensively characterize the risk factors associated with avoidable and unavoidable hospitalization among older adults. Specific emphasis is placed on avoidable/unavoidable hospitalization originating from chronic or acute causes. Methods Data on 3,166 individuals aged ≥60 years were obtained from the Swedish National Study on Aging and Care in Kungsholmen (SNAC-K), linked to the Swedish National Patient Register. Multistate models were used to investigate the risk profiles of participants experiencing their first and recurrent hospitalizations over 15 years. The Swedish National Board of Health and Welfare criteria were used to define avoidable/unavoidable hospitalizations. Results Women had a lower hazard of avoidable hospitalizations for chronic conditions as well as unavoidable hospitalizations (HR range 0.46-0.84). However, receiving informal care was associated with 88% increased hazard of avoidable hospitalizations due to chronic causes (95%CI 1.18-2.99), while receiving formal care was associated with 44% increasing hazard of avoidable hospitalization due to acute causes (95%CI1.04-1.98). Factors such as slow walking speed, multimorbidity, and polypharmacy were associated with a high risk of avoidable hospitalizations due to both acute (HR range1.27-3.03) and chronic (HR range1.63-2.54) causes. Conclusions Both clinical and functional factors have emerged as key predictors of avoidable hospitalization, underscoring the importance of comprehensive risk assessment and proactive healthcare management strategies to reduce the burden of hospital utilization in older adults. Key messages • Targeted interventions are essential to improve healthcare outcomes among older adults at risk of avoidable hospitalizations due to chronic and acute conditions. • The study identified predictors such as slow walking speed, multimorbidity, and polypharmacy, underscoring the need for comprehensive risk assessment to prevent avoidable hospitalization.

6.P. Scientific session: Economic evaluation of health impacts for better decision choices

Abstract The strategy of Health in All Policies (HiAP) pursues to analyse the wider determinants of health affected by the decision-making process of traditionally non-health sectors, seeking to enhance population health benefits while avoiding health inequalities. This usually involves the use of health impact assessment (HIA) or health lens analysis to any policy, program, plan or project (PPPP), preferably prior to its implementation. On the other hand, decision-makers from a wide range of public and private sectors also demand a better insight of the meaning of the health impacts quantified under HIA. Assuming the (ubiquitous) situation of limited resources and budgets, decisions need to be based on cost effectiveness criteria and, whenever possible, direct and indirect health costs should be part of the impact assessment. Economic appraisal attempts to define whether a proposal makes a net contribution to social welfare, quantifying and valuing changes to individuals’ utility from the societal perspective, taking into account the impact of health on the individual, their family, employers, healthcare providers and the state. This approach can incorporate different components of the welfare costs of illness, including direct medical and paid care expenses, indirect lost opportunity costs such as productivity and the value of informal care time, as well as a value that monetises the disutility or pain and suffering associated with disease. The range of methods and estimated benefits can make it challenging to identify a best practice approach. The present session aims to address certain methodological aspects related to the economic evaluation of health impacts, which still generate some controversy and debate, with particular emphasis on the following topics: • Approaches for synthesizing evidence on health impact pathways and economic evaluation of health impacts for a better decision choice; • Health metrics: influence on the conclusions of economic analysis within HIA; • Sources of metrics used for economic analysis; • Uncertainties inherent to economic valuation of health outcomes: how to deal with it. Key messages • The economic analysis of health impacts can help prioritizing aspects with the greatest impact on population health, facilitating a more effective use of human and economic resources. • The economic analysis within HIA can improve decision-making but requires careful consideration of health metrics, sourcing of data, and management of uncertainties.

Mental health impacts of spousal caregiving intensity in the US.

In the US, spouses are a major source of informal care for older adults and, therefore, key to the US national strategy to provide long-term care to the growing population of older adults. Understanding the mental health impacts of spousal caregiving is therefore critically important. Existing studies on the topic have often been limited by methodological limitations, and most overlook the role of caregiving intensity. In this study, we assess the impact of providing different intensities of caregiving to a spouse on mental health outcomes using data from the Health and Retirement Study. We address the endogeneity of the decision to provide different caregiving intensities using an augmented inverse probability weighted (AIPW) estimator adapted to handle multivalued treatments. We check the robustness of our estimates to the AIPW's identifying assumptions by re-estimating the model using a dynamic fixed effects estimator. We find strong evidence that becoming a caregiver is associated with worsened mental health outcomes for women, while the evidence for men is weaker. When disaggregating by caregiving intensity, we find that transitions into high-intensity caregiving lead to large increases in depression symptoms and the probability of exhibiting major depression for both men and women. The overall mental health impact of transiting into caregiving is driven almost exclusively by the negative impact of high-intensity caregiving, as transitions into low- and moderate-intensity caregiving are not associated with worsening mental health in most specifications. This study provides timely insights that can inform the targeting of long-term care policies and programs aimed at supporting family caregivers of older adults.

Transformation of informal elder care practices and mobilities during the pandemic

ABSTRACT The COVID-19 pandemic revealed that when formal care services closed down, informal care burden was unequally transferred to women. Women across the world became part of “caregiver pools”. Using textual archive material collected by the Finnish Literature Society, we analyse the transformation of informal elder care practices in Finland. We adopt a care mobility and care process perspective to analyse how informal elder care was transformed due to social distancing measures that restricted ageing individuals and their family members’ local and translocal mobilities. We find that over 70-year-olds had to adapt their daily mobilities according to risk assessment. Caregiving provided by mostly female family members was replaced by digital care at a distance, which reinforced existing inequalities in care. We argue that the pandemic simultaneously brought about both a time–space compression and what we call a time–space expansion that affected the everyday practices and mobilities of care.

‘I am afraid to fly there’: informal care in Polish migrants’ families immobilised by COVID-19

ABSTRACT This paper discusses the COVID-19 pandemic as a new external challenge to transnational family life that can undermine the care arrangements and intentions developed by the families of Polish migrants following the 2004 EU enlargement. The pandemic, associated lockdowns and travel restrictions raise questions about assumed transnationalism, building upon earlier concerns about taking for granted migrants’ cross-national mobility. Based on focus group discussions with Polish grandparents conducted in July 2020 and March 2021, we analyse the pandemic’s impact on intergenerational relations with both geographically close and distant kin. We point to perceptions of risks of COVID-19 associated with ethnicised stereotypes and evolving with time. While the pandemic caused temporary restrictions to mobility, it shows the immobilising side of “unsettling events”], the consequences of which, for privileged EU migrants, will unfold in time as their parents’ age and require personal care.

Successful ability to stay at home - an interview study exploring multiple diagnosed older persons and their relatives’ experiences

BackgroundSociety places increased demands on regions and municipalities to jointly carry out activities for multi-diagnosed older persons with extensive coordination needs. Interprofessional collaboration is reported as an important success factor for the overall health care of this group of patients. This project focuses on older persons with multiple diagnoses and their relatives’ own experiences of what is most important for safety and security in their homes. The aim of the study was: to illuminate the meaning of success for the ability to stay at home as experienced by older persons with multiple diagnoses and their relatives.MethodsThe project had a descriptive explorative design with a phenomenological hermeneutic approach based on analysis of 14 in-depth interviews with older people and their relatives.FindingsOwn resources were identified such as belief in the future, spiritual belief, social network, having loved ones and pets. Technical aids were seen as helpful resources, working as indoor and outdoor security safeguards. These resources included having good telephone contact with social and professional networks as well as other forms of personal equipment such as a personal alarm. The professional network was a resource, acting as support when the patient’s own abilities were not sufficient. Finally, having personnel who had the time and interest to listen was seen as crucial to experience safety.ConclusionsThe main reason for being able to continue homecare was the person’s self-care system, their personal, social, and technical resources. Professional care development should anchor team work to the patient’s own system of self and informal care.

Zwolnienie od pracy z powodu działania siły wyższej i urlop opiekuńczy z perspektywy prawa socjalnego

The subject of this study is to critically discuss the implementation of Directive 2019/1158 on time off from work and carers’ leave from a social law perspective, taking into account the objectives of the Directive and in the context of the EU’s competences regarding social policy. The starting point will be to outline both institutions in the light of the statements in the labour law literature. Next, the instruments in force in Germany for the protection of informal carers during time off or carer’s leave will be presented. Against this background, it will be possible to discuss the existing de lege lata and postulated de lege ferenda regulations of Polish social law, which—as it seems—could and should serve to protect employees using the newly introduced labour law institutions, so as to achieve the goal of ensuring a balance between the professional and private lives of parents and carers.