Skip to main content
Top
Published in: BMC Geriatrics 1/2017

Open Access 01-12-2017 | Research Article

Informal care relationships and residential aged care recommendations: evidence from administrative data

Published in: BMC Geriatrics | Issue 1/2017

Login to get access

Abstract

Background

The Australian government recognises the importance of informal care to enable ageing in place. Yet, few multivariable studies have examined aspects of informal care that alter the probability of entry to residential care in Australia. Existing Australian and international studies show differing effects of informal care on entry to residential care.

Methods

We utilise unique administrative data on aged care assessments collected from 2010 to 2013, consisting of 280,000 persons aged 65 and over. Logistic regression models were fitted to measure the propensity to be recommended care in a residential care setting, disaggregated by characteristics of informal care provision.

Results

Providing some explanation for the divergent findings in the literature, we show that close familial carer relationships (partner or child) and coresidence are associated with recommendations to live in the community. Weaker non-coresidential friend or neighbour carer relationships are associated with recommendations to live in residential care for women, as are non-coresidential other relatives (not a child, partner or in-law) for both males and females. Non-coresident carers who are in-laws (for females) or parents have no impact on assessor recommendations. Despite these significant differences, health conditions and assistance needs play a strong role in assessor recommendations about entry to residential care.

Conclusion

Co-resident care clearly plays an important protective role in residential care admission. Government policy should consider the need for differential supports for co-resident carers as part of future aged care reform.
Literature
1.
go back to reference Dow B, Sparrow P, Moore K, Gaffy E, Yates I. What do older Australians want? Australasian Journal on Ageing. 2013;32:236–40.CrossRefPubMed Dow B, Sparrow P, Moore K, Gaffy E, Yates I. What do older Australians want? Australasian Journal on Ageing. 2013;32:236–40.CrossRefPubMed
2.
go back to reference ABS. Disability, ageing and Carers, Australia: summary of findings. Catalogue number 4430.0. Canberra: Australian Bureau of Statistics; 2016. ABS. Disability, ageing and Carers, Australia: summary of findings. Catalogue number 4430.0. Canberra: Australian Bureau of Statistics; 2016.
3.
go back to reference ABS. (2015). Australian Demographic Statistics. Catalogue number 3101 0. Canberra: Australian Bureau of Statistics; 2015. ABS. (2015). Australian Demographic Statistics. Catalogue number 3101 0. Canberra: Australian Bureau of Statistics; 2015.
4.
go back to reference Deloitte Access Economics. The economic value of informal care in 2015. Canberra: Report for Carers Australia, Access Economics; 2010. Deloitte Access Economics. The economic value of informal care in 2015. Canberra: Report for Carers Australia, Access Economics; 2010.
5.
go back to reference Productivity Commission 2011, Caring for Older Australians, Report No. 53, Final Inquiry Report, Canberra. Productivity Commission 2011, Caring for Older Australians, Report No. 53, Final Inquiry Report, Canberra.
6.
go back to reference Kendig H, Browning C, Pedlow R, Wells Y, Thomas S. Health, social and lifestyle factors in entry to residential aged care: an Australian longitudinal analysis. Age Ageing. 2010;39:342–9.CrossRefPubMed Kendig H, Browning C, Pedlow R, Wells Y, Thomas S. Health, social and lifestyle factors in entry to residential aged care: an Australian longitudinal analysis. Age Ageing. 2010;39:342–9.CrossRefPubMed
7.
go back to reference McCallum J, Simons L, Simons J, Friedlander Y. Patterns and predictors of nursing home placement over 14 years: Dubbo study of elderly Australians. Australasian Journal on Ageing. 2005;24(3):169–73.CrossRef McCallum J, Simons L, Simons J, Friedlander Y. Patterns and predictors of nursing home placement over 14 years: Dubbo study of elderly Australians. Australasian Journal on Ageing. 2005;24(3):169–73.CrossRef
8.
go back to reference Bharucha AJ, Pandav R, Shen C, Dodge HH, Ganguli M. Predictors of nursing home admission: a 12-year epidemiological study in the US. Journal of American Geriatric Society. 2004;52:434–9.CrossRef Bharucha AJ, Pandav R, Shen C, Dodge HH, Ganguli M. Predictors of nursing home admission: a 12-year epidemiological study in the US. Journal of American Geriatric Society. 2004;52:434–9.CrossRef
9.
go back to reference Miller EA, Weissert WG. Predicting elderly people's risk for nursing home placement, hospitalization, functional impairment and mortality: a synthesis. Med Care Res Rev. 2000;57(3):259–97.CrossRefPubMed Miller EA, Weissert WG. Predicting elderly people's risk for nursing home placement, hospitalization, functional impairment and mortality: a synthesis. Med Care Res Rev. 2000;57(3):259–97.CrossRefPubMed
10.
go back to reference Lo Sasso AT, Johnson RW. Does informal care from adult children reduce nursing home admissions for the elderly? Inquiry. 2002;39:279–97.PubMed Lo Sasso AT, Johnson RW. Does informal care from adult children reduce nursing home admissions for the elderly? Inquiry. 2002;39:279–97.PubMed
11.
go back to reference Grundy E, Jitlal M. Socio-demographic variations in moves to institutional care 1991-2001. A record linkage study from England and Wales. Age Ageing. 2007;36:424–30.CrossRefPubMed Grundy E, Jitlal M. Socio-demographic variations in moves to institutional care 1991-2001. A record linkage study from England and Wales. Age Ageing. 2007;36:424–30.CrossRefPubMed
12.
go back to reference Gaugler JE, Edwards AB, Femia EE, et al. Predictors of institutionalization of cognitively impaired elders: family help and the timing of placement. J Gerontol Psychol Sci. 2000;55B(4):247–55.CrossRef Gaugler JE, Edwards AB, Femia EE, et al. Predictors of institutionalization of cognitively impaired elders: family help and the timing of placement. J Gerontol Psychol Sci. 2000;55B(4):247–55.CrossRef
13.
go back to reference Miller EA, Booth M, Mor V. Assessing experts’ views of the future of long-term care. Research on Ageing. 2008;30(4):450–73.CrossRef Miller EA, Booth M, Mor V. Assessing experts’ views of the future of long-term care. Research on Ageing. 2008;30(4):450–73.CrossRef
14.
go back to reference AIHW. ACAP de-identified data, National Aged Care Data Clearing House. Canberra: Australian Institute of Health and Welfare; 2015. AIHW. ACAP de-identified data, National Aged Care Data Clearing House. Canberra: Australian Institute of Health and Welfare; 2015.
15.
go back to reference Martikainen P, Moustgaard H, Murphy M, Einiö E, Koskinen S, Martelin T, Noro A. Gender, living arrangements, and social circumstances as determinants of entry into and exit from long-term institutional care at older ages: a 6-year follow-up study of older Finns. The Gerontologist. 2009;49(1):34–45.CrossRefPubMed Martikainen P, Moustgaard H, Murphy M, Einiö E, Koskinen S, Martelin T, Noro A. Gender, living arrangements, and social circumstances as determinants of entry into and exit from long-term institutional care at older ages: a 6-year follow-up study of older Finns. The Gerontologist. 2009;49(1):34–45.CrossRefPubMed
16.
go back to reference Wang J, Mitchell P, Smith W, Cumming R, Leeder S. Incidence of nursing home placement in a defined community. Med J Aust. 2001;174:271–5.PubMed Wang J, Mitchell P, Smith W, Cumming R, Leeder S. Incidence of nursing home placement in a defined community. Med J Aust. 2001;174:271–5.PubMed
17.
go back to reference Tomiak M, Berthelot JM, Guimond E, Mustard CA. Factors associated with nursing home entry for elders in Manitoba, Canada. Journal of gerontology a biological sciences and medical. Sciences. 2000;55(5):279–87. Tomiak M, Berthelot JM, Guimond E, Mustard CA. Factors associated with nursing home entry for elders in Manitoba, Canada. Journal of gerontology a biological sciences and medical. Sciences. 2000;55(5):279–87.
18.
go back to reference Gaugler JE, Kane RL, Kane RA, Clay T, Newcomer R. Predicting institutionalization of cognitively impaired older people: utilizing dynamic of predictors of change. Gerontologist. 2003;43:219–29.CrossRefPubMed Gaugler JE, Kane RL, Kane RA, Clay T, Newcomer R. Predicting institutionalization of cognitively impaired older people: utilizing dynamic of predictors of change. Gerontologist. 2003;43:219–29.CrossRefPubMed
19.
go back to reference Kendig H, Browning C, Thomas S, Wells Y. Health, lifestyle, and gender influences on ageing well: an Australian longitudinal analysis to guide health promotion.Front. Public Health. 2014;2:70. Kendig H, Browning C, Thomas S, Wells Y. Health, lifestyle, and gender influences on ageing well: an Australian longitudinal analysis to guide health promotion.Front. Public Health. 2014;2:70.
20.
go back to reference Raftery A. Bayesian model selection in social research. Sociol Methodol. 1995;25:111–63.CrossRef Raftery A. Bayesian model selection in social research. Sociol Methodol. 1995;25:111–63.CrossRef
21.
go back to reference Belsley D, Kuh E, Welsch R. Regression diagnostics: identifying influential data and sources of collinearity. New York: John Wiley & Sons, Inc; 1980.CrossRef Belsley D, Kuh E, Welsch R. Regression diagnostics: identifying influential data and sources of collinearity. New York: John Wiley & Sons, Inc; 1980.CrossRef
22.
go back to reference Hosmer D, Hosmer T, Le Cessie S, Lemeshow S. A comparison of goodness-of-fit tests for the logistic regression model. Stat Med. 1997;16(9):965–80.CrossRefPubMed Hosmer D, Hosmer T, Le Cessie S, Lemeshow S. A comparison of goodness-of-fit tests for the logistic regression model. Stat Med. 1997;16(9):965–80.CrossRefPubMed
23.
go back to reference Wessie J. Seemingly unrelated estimation and the cluster adjusted sandwich estimator. Stata Tech Bull. 2000;52:231–48. Wessie J. Seemingly unrelated estimation and the cluster adjusted sandwich estimator. Stata Tech Bull. 2000;52:231–48.
24.
go back to reference Chow G. Tests of equality between sets of coefficients in two linear regressions. Econometrica. 1960;28(3):591–605.CrossRef Chow G. Tests of equality between sets of coefficients in two linear regressions. Econometrica. 1960;28(3):591–605.CrossRef
25.
go back to reference ABS. Population projections, Australia. Catalogue number 3222.0. Canberra: Australian Bureau of Statistics; 2013. ABS. Population projections, Australia. Catalogue number 3222.0. Canberra: Australian Bureau of Statistics; 2013.
26.
go back to reference Temple J. National and subnational projections of elderly living arrangements: an application of the net transition probability macrosimulation model. J Popul Res. 2007;24(2):227–51.CrossRef Temple J. National and subnational projections of elderly living arrangements: an application of the net transition probability macrosimulation model. J Popul Res. 2007;24(2):227–51.CrossRef
27.
go back to reference McDonald P. Gender equity, social institutions and the future of fertility. J Popul Res. 2000;17(1):1–16.CrossRef McDonald P. Gender equity, social institutions and the future of fertility. J Popul Res. 2000;17(1):1–16.CrossRef
28.
go back to reference McDonald P. Low fertility in Australia: evidence, causes and policy responses. People and Place. 2000;8(2):6–21. McDonald P. Low fertility in Australia: evidence, causes and policy responses. People and Place. 2000;8(2):6–21.
29.
go back to reference Joseph A, Hallman B. Over the hill and far away: distance as a barrier to the provision of assistance to elderly relatives. Soc Sci Med. 1998;46(6):631–9.CrossRefPubMed Joseph A, Hallman B. Over the hill and far away: distance as a barrier to the provision of assistance to elderly relatives. Soc Sci Med. 1998;46(6):631–9.CrossRefPubMed
30.
go back to reference AIHW. (2004). Carers in Australia: assisting frail older people and people with a disability. Catalogue Number. AGE 41. Australian Institue of Health and Welfare: Canberra. AIHW. (2004). Carers in Australia: assisting frail older people and people with a disability. Catalogue Number. AGE 41. Australian Institue of Health and Welfare: Canberra.
31.
go back to reference Temple J, McDonald P. Is demography Destiny? The role of structural and demographic factors in Australia’s past and future labour supply. J Popul Res. 2008;25(1):29–49.CrossRef Temple J, McDonald P. Is demography Destiny? The role of structural and demographic factors in Australia’s past and future labour supply. J Popul Res. 2008;25(1):29–49.CrossRef
32.
go back to reference Spillman B, Long S. Does high caregiver stress predict nursing home entry. Inquiry. 2009;46:140–61.PubMed Spillman B, Long S. Does high caregiver stress predict nursing home entry. Inquiry. 2009;46:140–61.PubMed
33.
go back to reference Hill, T Thomson, C and Cass, B. (2011). The costs of caring and the living standards of carers. Social Policy research paper No. 43, Department of Family, Housing, Community Services and Indigenous Affairs, Australian Government: Canberra. Hill, T Thomson, C and Cass, B. (2011). The costs of caring and the living standards of carers. Social Policy research paper No. 43, Department of Family, Housing, Community Services and Indigenous Affairs, Australian Government: Canberra.
Metadata
Title
Informal care relationships and residential aged care recommendations: evidence from administrative data
Publication date
01-12-2017
Published in
BMC Geriatrics / Issue 1/2017
Electronic ISSN: 1471-2318
DOI
https://doi.org/10.1186/s12877-017-0656-4

Other articles of this Issue 1/2017

BMC Geriatrics 1/2017 Go to the issue