Effects of own and spousal disability on loneliness among older adults

Objectives: This study examines the effects of own and spousal disability on social and emotional loneliness among married adults aged 65 and older. Method: Data from 710 men and 379 women of a Dutch community sample were analyzed with linear regression analyses. Results: For men, only their wives' disability was related to higher levels of social loneliness, whereas for women mainly their own disability was related to higher levels of social loneliness. Own disability and spousal disability were related to higher levels of emotional loneliness among both men and women. Effects of disability remained unaffected after controlling for characteristics of the social network and the marital relationship. Discussion: Findings underscore the importance of considering effects of both spouses' health on measures of individual well-being. Also, the traditional division of social roles makes older married men relatively vulnerable to social loneliness when their wives suffer from disability. © 2008 Sage Publications

Social network type and informal care use in later life:A comparison of three Dutch birth cohorts aged 75-84

Recent societal changes have increased the salience of non-kin relationships. It can be questioned whether networks types that are more strongly non-kin based give more informal care nowadays. We study how informal care use differs according to network type for three birth cohorts. Data from the Longitudinal Aging Study Amsterdam (LASA) on older adults aged 75-84 years, interviewed in 1992, 2002 and 2012 respectively (total sample size N=2151, analytical sample having functional limitations N=926). We found four network types: restricted, family-focused with partner, family-focused without partner and wider community-focused diverse networks. Wider-community focused diverse networks are more common in the late birth cohort, whereas restricted networks and family-focused networks without partner are less common. Logistic regression analyses reveal that those in a family-focused network with a partner use informal care more often than those in the other three network types, and insignificant interaction terms show that this does not differ by birth cohort. Irrespective of their network type, those in the late birth cohort use informal care less often. However, after controlling for need, predisposing and context factors, this cohort-difference is no longer significant. We conclude that despite large-scale societal changes, wider-community-focused diverse networks do not provide more informal care than before and that among the functionally impaired, the odds of receiving informal care does not decline across birth cohorts

Explanations of socioeconomic differences in changes in physical function in older adults: results from the Longitudinal Aging Study Amsterdam

BACKGROUND: This study examines the association between socioeconomic status and changes in physical function in younger- (aged 55–70 years) and older-old (aged 70–85 years) adults and seeks to determine the relative contribution of diseases, behavioral, and psychosocial factors in explaining this association. METHODS: Data were from 2,366 men and women, aged 55–85 years, participating in the Longitudinal Aging Study Amsterdam (LASA). Two indicators of socioeconomic status were used: education and income. Physical function was measured by self-reported physical ability over nine years of follow-up. RESULTS: In older adults, low socioeconomic status was related to a poorer level of physical function during nine years of follow-up. In subjects who were between 55 and 70 years old, there was an additional significant socioeconomic-differential decline in physical function, while socioeconomic differentials did not further widen in subjects 70 years and older. Behavioral factors, mainly BMI and physical activity, largely explained the socioeconomic differences in physical function in the youngest age group, while psychosocial factors reduced socioeconomic status differences most in the oldest age group. CONCLUSION: The findings indicate age-specificity of both the pattern of socioeconomic status differences in function in older persons and the mechanisms underlying these associations

Positive and negative evaluation of caregiving among three different types of informal care relationships

Based on the caregiver stress model, we examined how care demands, caregiver motivation, coping style and external support are associated with positive evaluation and caregiver burden among spousal, adult child and other types of care relations. Data from a sample of Dutch informal caregivers of 1,685 older persons (55 and older) were analyzed employing multivariate linear regression analyses for each of the care relationship types. Spouses (N = 206) report high positive evaluation and high burden, adult children (N = 1,093) report low positive evaluation, and other caregivers (N = 386) report high positive evaluation and a low burden. Multivariate linear regression analyses showed that motives and external support were important for positive evaluation but the impact varied among types of caregivers, whereas care demands and not asking for help were associated with burden for all types. Only among 'other' caregiver relationships, positive evaluation was negatively associated with burden. It is concluded that results confirm the dual nature of caregiving among spouses and children. The care context and motivation of the different types of caregivers explain their differences in care evaluation. Various interventions for types of caregivers are discussed. © 2013 Springer-Verlag Berlin Heidelberg

Utilization of acute and long-term care in the last year of life: comparison with survivors in a population-based study

Background. It is well-known that the use of care services is most intensive in the last phase of life. However, so far only a few determinants of end-of-life care utilization are known. The aims of this study were to describe the utilization of acute and long-term care among older adults in their last year of life as compared to those not in their last year of life, and to examine which of a broad range of determinants can account for observed differences in care utilization. Methods. Data were used from the Longitudinal Aging Study Amsterdam (LASA). In a random, age and sex stratified population-based cohort of 3107 persons aged 55 ? 85 years at baseline and representative of the Netherlands, follow-up cycles took place at 3, 6 and 9 years. Those who died within one year directly after a cycle were defined as the "end-of-life group" (n = 262), and those who survived at least three years after a cycle were defined as the "survivors". Utilization of acute and long-term care services, including professional and informal care, were recorded at each cycle, as well as a broad range of health-related and psychosocial variables. Results. The end-of-life group used more care than the survivors. In the younger-old this difference was most pronounced for acute care, and in the older-old, for long-term care. Use of both acute and long-term home care in the last year of life was fully accounted for by health problems. Use of institutional care at the end of life was partly accounted for by health problems, but was not fully explained by the determinants included. Conclusion. This study shows that severity of health problems are decisive in the explanation of the increase in use of care services towards the end-of-life. This information is essential for an appropriate allocation of professional health care to the benefit of older persons themselves and their informal caregivers. © 2009 Pot et al; licensee BioMed Central Ltd

Heeft de COVID-19 pandemie de zorgsituatie van ouderen veranderd?

The study examined changes in giving and receiving care by community-dwelling older adults during the COVID-19 pandemic in 2020 compared to a period about two years before. Using data collected in two waves by the Longitudinal Aging Study Amsterdam (N = 1013), we study how many and which older adults report a change in care use and provision and how these changes impact on psychological well-being. The results show that only for a small part of the sample changes occurred. The large majority provides no care (73%) or uses no care (62%) in both waves. 7% stayed a care provider during the pandemic, where 15% quitted care provision and 5% started care provision. 17% remained a care user, where 15% did not receive care anymore and 6% started to use care. The informal carers mainly consisted of women and younger elderly in good health and the care recipients were mainly women and older elderly in poorer health. Using care had a negative impact on psychological well-being, but providing care was not related to wellbeing during the pandemic. The results imply that the pandemic and the measures taken affected the care situation of only a small part of the older adults. Dit onderzoek vergelijkt het geven en het ontvangen van zorg aan huis door ouderen ten tijde van de COVID-19 pandemie in 2020 met een periode ongeveer twee jaar daarvoor. Middels data verzameld op twee waarnemingen van de Longitudinal Aging Study Amsterdam (N = 1013) wordt onderzocht hoeveel en welke ouderen een verandering rapporteren, en wat de invloed van deze veranderingen is op het psychisch welbevinden. De resultaten tonen dat er weinig is veranderd in de zorgsituatie van ouderen. De overgrote meerderheid geeft op beide metingen geen zorg (73%) of krijgt geen zorg (62%). 7% is zorg aan anderen blijven geven, terwijl 15% daarmee is gestopt en 5% met zorgverlening is gestart. 17% bleef zorg ontvangen, terwijl 15% geen zorg meer kreeg, en 6% voor het eerst zorg ontving. De mantelzorgers bestaan voornamelijk uit vrouwen en jongere ouderen met een goede gezondheid en de zorgontvangers zijn voornamelijk vrouwen en oudere ouderen met een slechtere gezondheid. Het krijgen van zorg heeft een significant negatieve invloed op het psychisch welbevinden, maar het geven van zorg heeft geen effect op welbevinden. De resultaten impliceren dat de pandemie en de maatregelen maar bij een kleine groep invloed hadden op de zorgverlening van en door ouderen

Living arrangements among older people: an overview of trends in Europe and the USA.

This article compares the trends in living arrangements of older people in several European countries and in the United States. Trends and cross-country variability in several factors that could account for these cross-national differences, including marital status, fertility, labour force participation and attitudes, are also examined. In most countries the proportion of older people living alone increased substantially between 1970 and 1990. However the increase in living alone stabilised or even declined between 1990 and 2000 in most of the countries analysed indicating a possible reversal in the trend. Increases in proportions of older women who are married and reductions in the proportions childless may partially explain this. Considerable variability in both trends and levels of older people's living arrangements was seen especially between north-western and southern European countries. These variations mirrored contrasts in attitudes towards residential care and parent-child coresidence between the countries

Male and Female Partner-Caregivers' Burden:Does It Get Worse Over Time?

Background and Objectives: The general view is that partner-caregiver burden increases over time but findings are incon-sistent. Moreover, the pathways underlying caregiver burden may differ between men and women. This study examines to what degree and why partner-caregiver burden changes over time. It adopts Pearlin’s Caregiver Stress Process Model, as it is expected that higher primary and secondary stressors will increase burden and larger amounts of resources will lower burden. Yet, the impact of stressors and resources may change over time. The wear-and-tear model predicts an increase of burden due to a stronger impact of stressors and lower impact of resources over time. Alternatively, the adaptation model predicts a decrease of burden due to a lower impact of stressors and higher impact of resources over time.Research Design and Methods: We used 2 observations with a 1-year interval of 279 male and 443 female partner-caregiv-ers, derived from the Netherlands Older Persons and Informal Caregivers Survey Minimum Data Set. We applied multilevel regression analysis, stratified by gender. Results: Adjusted for all predictors, caregiver burden increased over time for both men and women. For female caregiv-ers, the impact of poor spousal health on burden increased and the impact of fulfillment decreased over time. Among male caregivers, the impact of predictors did not change over time. Discussion and Implications: The increase of burden over time supports the wear-and-tear model, in particular for women. This study highlights the need for gender-specific interventions that are focused on enabling older partners to be better prepared for long-term partner-care