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PubMed2006

[Tendency of development and perspectives of domestic care. Core results of the potential and limits of independent living (MuG III) study].

The study "Potential and Limits of Independent Living in Private Households" (MuG III) provides a comprehensive picture concerning the life situation of persons in need of help and care within private households. Domestic care in Germany is still provided by the family. Professional services within the framework of the Long Term Care Insurance add to domestic care, with the central objective to support the private willingness to home care. Viewed in line with the trend, domestic care arrangements - also against the background of the effects of demographic change - prove themselves as stable and adaptable. Meanwhile more men are integrated into care giving, and the number of neighbours and friends filling in as main caregivers has increased, too. However, the still considerable burden is noticeable. The limits of domestic care become evident any time when there are not enough caregivers available, as well as in cases of people suffering from dementia who are in need of extensive care.

Aged↗
PubMed2006

[Invested time in private care: estimated by people in need of help and care and their private caregivers].

The amount of time that ought to be invested for private care is regulated by the German Care Assurance (SGB XI). Whether this reflects the actual amount of help given to the people cornered is not certain. In our qualitative study, which was part of the project "Potentials and Limits of Independent Living in Private Households in Germany" [1] funded by the Federal Ministry for Family Affairs, Senior Citizens, Women and Youth, we had the chance to document the amount of time people themselves think they spend or vice versa receive for help and care with a timetable. Even if the amount of time alone does not yet lead to a conclusion about the quality of the given effort, it is one indicator for an adequate care that allows living at home as long as possible.

Activities of Daily Living↗
PubMed2006

[The effects of need and chances for care time spent in home care arrangements].

Within the concomitant research on the implementation of individual care budgets in Germany, the results of verbal interviews involving 329 persons in need of care were analysed with respect to the relation between the actual time expenditure for care measures and its dependency on the level of care required (according to the statutorily regulated levels of long-term care in Germany) on the one hand as well as determining factors of the environment (social networks, milieus) on the other hand. The results of the survey showed that with a high level of care required, the social environment as a chance factor becomes particularly influential. Under disadvantageous environmental circumstances, the difference in time spent on care measures for varying levels of care required was rather low. Disadvantageous environmental circumstances were not compensated by professional services or support provided by other sectors.

Activities of Daily Living↗
PubMed1982

Assistance to the elderly as a common task of the family and social service organizations.

This paper reviews research findings from a December 1979 Austrian 'microcensus' comprising approximately 14,000 interviews of the population aged 60 and older. In comparison with earlier investigations, a fairly stable household structure can be observed. Half of the elderly live together with a spouse. Women are in a disadvantaged position, in view of the household composition; more than two-fifths live alone. Only one out of nine men lives alone. More than two-fifths of all aged Austrians with children live with them in the same house. Sixty percent of all of the elderly with children are visited at least once a week. There is a marked desire to receive more visits from children if elderly are visited by them less than once a week. Only a minority of the elderly are involved in 'help relations' with kin or non-kin. Elderly people report roughly the same amount of help received by and given to children. On the other hand, young or middle-aged members of the household report much more help given to than received by the elderly. Elderly receive far less financial support than they give to children. Nursing expectations are directed mainly towards the spouse. The unmarried express about the same nursing expectations in short-term emergencies as the married, if their children are living nearby. In the case of long-term care only the married with a child living in the same house express rather optimistic nursing expectations, whereas e.g. four-fifths of all childless unmarried women aged 75 and over cannot nominate anyone as care-giver. Even if there is additional help from formal organizations, almost half of all members of households giving aid to an old person express feelings of burden. The paper concludes that help by social service organizations is necessary because neither activities by the elderly themselves nor family assistance can compensate unfulfilled needs completely. Yet, social policy planning is in need of more knowledge about 'interaction effects' between family and social service organizations in order to carry out coordination and cooperation tasks efficiently.

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PubMed1988

Housing for people with AIDS.

People with AIDS are homeless for a variety of reasons, including financial devastation, rejection based on fear of contagion or fear of the dying process, and homelessness prior to a diagnosis of AIDS. The author developed and directed the Shanti AIDS Residence Program in San Francisco, the first program to provide housing for people with AIDS. This model is appropriate for single, independent people able to live cooperatively with others. It provides shared living situations for three to six people per apartment, and office staff physically maintain the houses and assure that the needs for community-based home care and other services are met. Other models are proposed for people who are physically or cognitively dependent (and require physical care or supervision in addition to housing), who are socially unable to live cooperatively with others in an unstructured living environment (e.g., active substance users or the emotionally disturbed), or who have families (e.g., mothers with dependent children or gay men who live with their lovers).

Acquired Immunodeficiency Syndrome↗
PubMed1990

The impact of community care on provision of informal care to homebound elderly persons.

This study examined the impact of community care on informal care provided by family and friends to homebound elderly persons. Secondary analyses were conducted on data collected from clients at baseline, 9 months (N = 225), and 48 months (N = 76) after acceptance to community care and home-delivered meals programs. Analyses revealed a significant increase in the amount of formal services provided to both groups of clients at 9 months and to community care clients at 48 months. The increase was attributed to the large proportion of "new" or "supplementary" services provided by agencies. No significant decrease in the amount of service provided by informal caregivers was found. In addition, regression analyses demonstrated only a weak impact of formal service on informal care. Analysis of patterns of service provision for each client demonstrated that formal care supplemented rather than substituted for informal care significantly more often in both the 9- and 48-month samples. We conclude that formal care in general supplemented the efforts of informal caregivers, and that informal caregiving remained stable over time.

Activities of Daily Living↗
PubMed1994

Gender differences in spousal caregiving and unmet need for care.

This study investigated gender differences in spousal caregiving in a sample of 353 currently married people with cancer who were undergoing outpatient treatment. Results indicate that husbands were less likely than wives to help their sick spouses with household tasks, and husbands who helped were more likely to have other helpers, whereas wives tended to be sole caregivers. Wives provided approximately twice the hours of care that husbands provided. Women undergoing treatment who experienced high levels of morbidity received more hours of help with household tasks from nonspousal sources than men with comparable levels of morbidity, thus compensating for the deficit in hours of care provided by their husbands. At lower levels of morbidity, however, compensatory help to women was not sufficient to fill the gap in care. Women were more likely than men to report unmet need for assistance with household tasks, although not with personal care.

Activities of Daily Living↗
PubMed2003

Community care for people with disability: blurring boundaries between formal and informal caregivers.

Health care for individuals with disability is increasingly shifting from institutional settings to the "community," with assistance by those in the formal sector. In this article, the authors examine 5 case studies illustrating interactions and relationships between people with disability and their caregivers, using qualitative data collected as part of a community study of disability conducted in a medium-sized city in the northeastern United States. Employing the task specificity framework, they explore the implications of using either formal care providers to fill needs that are more typically met by family and friends or family caregivers to provide care that is best provided by the formal sector. Although our narratives illustrate the negative implications of mismatched care substitution, we conclude that the framework is less applicable to emerging systems of community care.

Adult↗
PubMed1988

The role of home care service in family care of developmentally disabled children: an exploratory study.

Recent concern about the needs of developmentally disabled children living at home has led to increased attention to family support programs. Home care service is one family support option which should be viewed as a basic fundamental support strategy. An exploratory study of a small number of families caring for developmentally disabled children in New York City indicates that publicly-funded home care produces a great number of benefits for this special population.

Adolescent↗
PubMed1993

Impact of employment-based health insurance on home attendants.

This study examines 253 newly hired home attendants to measure the degree to which employment-based health insurance can affect health status and utilization of health care services among a working poor population that has little experience with health insurance and may face other significant barriers to care. Physician contacts increased after benefits were received; attendants who had no coverage during the prior year experienced the greatest average increase. More attendants also reported using emergency rooms. Neither hospitalizations nor health status were affected. These findings indicate that insurance benefits may substantially improve access to care for many working poor persons, regardless of other barriers they may face.

Female↗
PubMed1992

The reform and redirection of long-term care in Ontario.

In Ontario, the current fragmented health services system cannot respond to projected demands. Several government reports recommend a shift of focus from institutionalization to community-based services--one-stop shopping--to integrate services.

Aged↗