Health: support provided and received in advanced old age: A five-year follow-up

Abstract : While research focuses mainly on support provided to the elderly, this paper deals with the very old as a support provider to his family as much as a care recipient from both his family and a formal network. We hypothesize that elders with declining health will try to maintain the provision of services, even when they require and receive help. A total of 340 octogenarians from the Swiss Interdisciplinary Longitudinal Study on the Oldest Old (SWILSOO) were interviewed up to five times over five years (N=1225 interviews). A multilevel model was applied to assess the effects of health, controlled for socio-demographic and family network variables, on the frequency of services that the old persons provided to their family and received from their family and formal networks. Health is operationalized in three statuses: ADL-dependent, ADL-independent frail, and robust. While the recourse to the informal network increased progressively with the process of frailty, the recourse to the formal network drastically increased for ADL-dependent individuals. Being ADL-dependent seriously altered the capacity to provide services, but ADL-independent frail persons were providers with the same frequency as the robust oldest old, showing their ability to preserve a principle of reciprocity in their exchanges with their family network. This continuity of roles may help frail persons to maintain their self-esteem and well-bein

Le grand âge: un domaine de recherche récent

Les auteurs présentent un survolde la recherche pluridisciplinaire sur la grande vieillesse, avec ses tâtonnements, ses élaborations théoriques et ses principaux acquis. Ce domaine de recherche s'est constituté très récemment, dans la seconde moitié des années 1980, avec la prise de conscience de certaines implicaitons de la longévité croissante, en particulier de la forte poussée démographique de la population très âgée. L'"agenda" initial de la recherche focalisait essentiellement les pathologies du grand âge et leurs implications en termes de politique de la vieillesse et de coûts de la santé. Au fil des années, la perspective s'est élargieet enrichie, l'intérêt se tournant également vers le vieillard "robuste", l'interrogation portant sur les différentes formes et trajectoires de vieillissement. Après un quart de siècle, la "géographie" de la grande vieillesse comme l'étude de l'organisation de son déroulement sont assez bien blisés; la description est solide, mais l'explicaiton demeure balbutiante. Une psite d'avenir pourrait résider dans un examen des trajectoires de vie des vieillards basé sur l'analyse combinée de données génétiques et d'informations biographiques

The Elderly and their Families, 1979-94: Changing Networks and Relationships

This article analyses the changes occurring in the structure of the family network of older people and their family interactions over a 15-year period. Data are from two Swiss cross-sectional surveys carried out on a random sample of people aged 65-94 years, in 1979 (N = 1519) and 1994 (N = 1447). Both were conducted in two specific regions, namely, the Alpine canton of Valais, steeped in a rural tradition, and the city-canton of Geneva. Our results show a widening of the family circle due to increased life expectancy and a sharp drop in the number of childless families in the urban region because of the baby boom; at the same time, family ties multiplied, contrary to the widely held view that family relationships are weakening. Furthermore, while in 1979 each region had its own specific family culture, an alignment of family structures and relationships in the two regions took place over the 15-year period. Finally, an analysis of the instrumental support relationships based on the 1994 survey reveals the strong involvement of the elderly in their families

Impact des relations sociales sur le maintien de l'indépendance durant la grande vieillesse : résultats d'une étude longitudinale suisse.

Cette étude examine, pour une population très âgée, l'action de la vie relationnelle sur le maintien de l'indépendance à 12 ou 18 mois, en différenciant réseau familial et réseau amical. Elle se fonde sur les cinq premières vagues d'entretiens (1994-1999) de SWILSO-O (Swiss Interdisciplinary Longitudinal Study on the Oldest-Old). 306 personnes, âgées de 80 à 84 ans au départ, ont été retenues pour les analyses. L'indépendance est définie comme la capacité à accomplir, sans aide, huit activités de la vie quotidienne. Pour la vie relationnelle, on dispose d'une série de variables sur la composition des réseaux, ainsi que sur la fréquence des contacts. Des modèles de régression logistique ont été effectués, où l'indépendance à une vague donnée est expliquée par les facteurs sociaux mesurés à la vague précédente, sous contrôle de variables sociodémographiques et de santé. La présence d'un ami intime est significativement associée au maintien de l'indépendance (OR = 1.58, p < 0.05), ce qui n'est pas le cas des autres variables concernant la composition des réseaux. On constate également une influence positive des contacts familiaux sur la santé fonctionnelle (OR = 1.09, p < 0.05)

The impact of social relationships on the maintenance of independence in advanced old age: findings of a Swiss Longitudinal Study .

The impact of social relationships on the maintenance of independence over periods of 12-18 months in a group of 306 octogenarians is assessed in this study. The study is based on the results of the Swilsoo (Swiss Interdisciplinary Longitudinal Study on the Oldest Old). Participants (80-84 years old at baseline) were interviewed five times between 1994 and 1999. Independence was defined as the capacity to perform without assistance eight activities of daily living. We distinguished in our analyses kinship and friendship networks and evaluated social relationships with the help of a series of variables serving as indicators of network composition and contact frequency. Logistic regression models were used to identify the short-term effects of social relationships on independence, after controlling for sociodemographic and health-related variables; independence at a given wave of interviews was interpreted in the light of social factors measured at the previous wave. Our analyses indicate that the existence of a close friend has a significant impact on the maintenance of independence (OR=1.58, p&lt;0.05), which is not the case with the other variables concerning network composition. Kinship contacts were also observed to have a positive impact on independence (OR=1.12, p&lt;0.01)